浙江省非超重成年人血脂异常患病率及影响因素分析

目的 探讨浙江省非超重成年人血脂异常流行特征及影响因素。方法 选择参加2010年浙江省代谢综合征流行病学调查的10 868名年龄≥18周岁非超重/肥胖居民(BMI<24.0 kg/m²)为研究对象,进行问卷调查、体检和血脂检测,采用多因素logistic回归模型分析影响因素。结果 该人群血脂异常患病率为41.38%,男性(43.19%)显著高于女性(39.84%)(χ²=12.53,P<0.001);随年龄增长,男性血脂异常患病率降低(趋势χ²=47.61,P<0.001),女性患病率升高(趋势χ²=3.88,P<0.05),<50岁男性患病率明显高于女性;农村人群患病率(41.49%)略高于城市(41.21%),但差异无统计学意义(χ²=0.08,P=0.774);多因素logistic回归分析显示,性别、慢性病家族史、现在吸烟、现在饮酒、高肉蛋类饮食、烹调使用动物油、体力活动、中心性肥胖和BMI是非超重成年人血脂异常的影响因素。结论 浙江省非超重成年人血脂异常患病率较高,家族史、吸烟、高脂饮食、体力活动不足、中心性肥胖等是主要影响因素。     

中国成年人肉类食物摄入与代谢综合征的相关性研究

目的 分析我国≥18岁成年人肉类食物摄入量与MS患病的关系。方法 2010－2012年中国居民营养与健康状况监测中34 923名≥18岁完成膳食调查并具有完整体检及血糖、血脂检测结果的成年人作为研究对象,根据2013年中华医学会糖尿病分会提出的中国人的MS诊断标准,经复杂抽样加权处理后,计算患病率与成年人肉类摄入量间关系。结果 成年居民人均肉类食物摄入量为94.8 g/d。平均每日摄入量在100～199 g/d的人群MS、腹型肥胖和高血糖的患病率最低。随着摄入量的增加,男性MS患病率显著增加,且摄入量≥300 g/d的人群发生MS的风险显著高于低摄入水平人群,调整后患病率比（PR）为1.46（95% CI：1.14～1.87）,但未在摄入量≥300 g/d的女性人群中观察到相似趋势。结论 中国成年人群摄入适量肉类发生MS的风险较低。     

2013年中国成年人吸烟状况与多种慢性病的关联研究

目的 研究我国成年人吸烟现状及不同吸烟人群与多种慢性病的关联。方法 基于2013年全国慢性病及其危险因素监测,覆盖31个省份的298个监测县（区）,按多阶段分层整群抽样方法抽取全国≥ 18岁居民176 534人。利用询问调查收集对象前12个月的吸烟行为（吸烟状态、现在吸烟者日均吸烟量、现在每日吸烟者吸烟年限等）、慢性病（高血压、糖尿病、高TC血症和高TG血症）相关信息,测量血压,检测血糖和血脂。采用基于复杂抽样设计的权重对指标进行分析。结果 共收集有效样本175 386人。其中男性占42.7%,女性占57.3%。成年人男性吸烟者高血压、高TC血症和高TG血症患病率分别为30.4%、7.2%和18.0%,高于非吸烟者;女性吸烟者高血压、糖尿病、高TC血症和高TG血症患病率分别为35.6%、14.0%、10.3%和15.9%,均高于非吸烟者,差异均有统计学意义（均P<0.05）。多因素分析结果显示,我国成年人男性吸烟者比非吸烟者高血压患病风险有所降低,患高TG血症风险比非吸烟者高19%（OR=1.19,95% CI：1.10~1.30）。其中,现在日均吸烟≥ 20支男性高TG血症患病风险比非吸烟者高41%（OR=1.41,95% CI：1.28~1.55）。我国成年人女性吸烟者比非吸烟者高TG血症患病风险高40%（OR=1.40,95% CI：1.15~1.70）;每日吸烟年限≥ 20年者高TG血症比<20年者高60%（OR=1.60,95% CI：1.31~1.95）。结论 吸烟者比非吸烟者总体慢性病患病率高,且吸烟年限长或现在每日吸烟量大的人群患病风险大幅增加。     

不同膳食行为因素对成年人血甘油三酯水平影响的横断面研究

目的 分析不同膳食行为因素对成年人血TG水平影响。方法 利用2010年浙江省居民代谢综合征流行病学调查资料,纳入无主要慢性病病史的调查对象13 434人,采用广义线性模型估计相关膳食行为影响因素的作用。结果 样本人群血TG均值为（1.36±1.18） mmol/L,TG测定值升高和边缘值升高的比例分别为10.3%和11.0%,其中男性升高和边缘升高的比例分别为11.9%和11.7%,均高于女性的8.8%和10.3%,差异有统计学意义（χ²=44.135,P<0.001）。样本人群食用油超过推荐量一半以上,而水果、奶制品和坚果摄入量以及体育锻炼则远低于推荐量;男性是否吸烟、是否饮酒以及不同畜禽肉、水果和饮水摄入情况之间,女性不同水产品摄入量和体育锻炼情况之间的差异有统计学意义。在调整其他因素后,年龄、饮酒、主食和水产品摄入量增加血TG水平,摄入奶制品可降低血TG水平;交互作用分析发现男性水果和畜禽肉摄入量以及女性主食摄入量对血TG水平存在交互作用。结论 高甘油三酯血症是浙江省居民一种主要的代谢异常,在社区干预中应将饮酒、主食和肉类（畜禽肉和水产品）摄入量作为优先考虑因素。     

出生体重对成年期慢性病患病风险及血尿酸的影响研究

目的 探索出生体重对成年期罹患高血压、糖尿病等慢性病的患病风险,并研究出生体重与血尿酸的关系。方法 根据中国成年人慢性病与营养监测方案,在天津市河西、南开、红桥、武清、津南、宝坻、蓟州区共计调查1 131名成年人,收集其出生体重、血压等数据,并采集空腹静脉血检测血尿酸、血糖和血脂等。描述调查人群出生体重状况分布,并分析出生体重对其成年期罹患高血压、糖尿病等慢性病风险及与血尿酸的关系。结果 天津市调查人群平均出生体重为3.37 kg,男性高于女性;无论是超重/肥胖、高血压还是糖尿病,正常出生体重者成年期患病率最低,经单因素logistic回归分析,校正年龄、性别、吸烟、饮酒后发现,与正常出生体重者相比,低出生体重与成年期罹患糖尿病（OR=2.91,95%CI：1.46~5.76）、血脂异常（OR=1.79,95%CI：1.01~3.19）关联较强,巨大儿与成年期罹患超重/肥胖关联较强（OR=1.47,95%CI：1.08~2.01）;不同出生体重的血尿酸差异无统计学意义。结论 天津市调查人群低出生体重与其成年期糖尿病、血脂异常患病风险关联较大,巨大儿与其成年期超重/肥胖患病风险关联较大。     

苏州市成年人睡眠时长与慢性阻塞性肺疾病发病风险关联的前瞻性研究

目的 探讨苏州市成年人睡眠时长与慢性阻塞性肺疾病（COPD）发病的前瞻性关联。方法 利用中国慢性病前瞻性研究苏州市吴中区项目点53 269名30~79岁调查对象的基线和随访信息,基线调查开展于2004-2008年,本研究使用的数据随访截至2017年12月31日。剔除基线气流阻塞者、基线调查时自报患有慢性支气管炎/肺气肿/肺心病、数据异常或缺失的研究对象后,最终纳入分析45 336名。利用Cox比例风险回归模型分析睡眠时长与COPD发病风险的关联,并计算发病风险比（HR）值及其95%CI。按照年龄、性别、生活方式等因素进行分层分析,根据吸烟状况和每日睡眠时长交叉分组进行联合分析。结果 研究对象中位随访时间为11.12年,随访期间共诊断COPD 515名。调整潜在混杂因素后,多因素Cox比例风险回归分析显示,每日睡眠时长≥10 h增加COPD发病风险（HR=1.42,95%CI：1.03~1.97）。联合分析结果显示,睡眠时长过长（≥10 h）可显著增加吸烟者COPD发病风险（HR=2.49,95%CI：1.35~4.59,交互作用P<0.001）。结论 每日睡眠时长过长（≥10 h）可以增加苏州市成年人中COPD发病风险,在吸烟者中更加明显。     

武汉市大肠癌危险因素的病例对照研究

目的 探索武汉市大肠癌危险因素。方法 对原发性大肠癌危险因素进行了1：1配比的病例对照研究。病例、对照各82例,用条件logistic回归模型分析各因素与疾病危险性的联系。结果 高频率摄入烟熏、腌制食品、大量吸烟,出生地为平原、大便性质不规律的OR值分别为3.194,1.450,2.575,21.191,9.593;体育锻炼、不食高温和重盐食物OR值分别为0.809,0.634,0.896。结论 高频率摄入烟熏、腌制食品、大量吸烟、出生地为平原、大便性质不规则为大肠癌发病的危险因素,体育锻炼、不良高温和重盐食物为保护因素。     

北京市成年人健康期望寿命影响因素分析

目的 了解北京市成年人健康期望寿命（HALE）主要影响因素。方法 采用沙利文法,利用北京市成年人居民自报健康调查的数据和HOPIT模型计算得到北京市各年龄组的伤残测度和HALE,以伤残测度为因变量利用广义相加模型分析评价北京市成年人HALE的影响因素。结果 影响北京市成年人HALE的主要影响因素有年龄（t=40.351,P<0.001）、性别（t=9.689,P<0.001）、学历（t=5.021,P<0.001）、体育锻炼（t=5.487,P<0.001）和饮酒（t=-2.380,P=0.017）有统计学意义,人均月收入（χ²=3.949,P=0.044）对北京市成年人HALE的影响是非线性的。结论 收入较低和较高都会导致伤残测度的增加,从而降低HALE,提倡健康的生活方式及重点加强女性的健康保健服务应成为今后工作的重点。     

吸烟和糖尿病对脑卒中联合效应的研究

目的 探讨吸烟和糖尿病与脑卒中的关系,分析两者对脑卒中的交互作用。方法 采用病例对照研究方法,通过调查问卷收集脑卒中患者及对照者的研究信息。以2013年徐州市慢性病危险因素调查发现的918例脑卒中患者作为病例组,同期参加慢性病危险因素调查相同例数的健康者作为对照组。采用非条件logistic回归模型分析吸烟和糖尿病与脑卒中的关系,通过Bootstrap法计算相对超额危险度比（RERI）、归因比（AP）和交互作用指数（S）以评价吸烟和糖尿病对脑卒中的相加交互作用。结果 吸烟与脑卒中有关联（OR=1.63,95%CI：1.33~2.00）;糖尿病与脑卒中也有关联（OR=2.75,95%CI：2.03~3.73）;吸烟和糖尿病同时存在时,与脑卒中关联增大（OR=8.94,95%CI：3.77~21.19）。吸烟和糖尿病对脑卒中的相加交互作用：S=3.65（95%CI：1.68~7.94）,RERI=5.77（95%CI：0.49~11.04）,AP=0.65（95%CI：0.42~0.87）。结论 吸烟和糖尿病对脑卒中具有交互作用,两因素同时存在时,对脑卒中的危害大于单因素的作用。     

2007-2015年四次横断面调查中陕西省居民吸烟变化情况分析

目的 分析2007-2015年陕西省成年人烟草流行现状及趋势变化。方法 利用2007、2010、2013和2015年全国慢性病及其危险因素监测数据,计算4次调查的吸烟率、吸烟量、戒烟率及二手烟暴露率,用趋势χ²检验计算其变化趋势,以抽样权重及2010年第六次人口普查数据计算加权率,以敏感性分析加以验证。结果 2007年陕西省成年人吸烟率为38.26%,2013年降至30.95%,但2015年上升到34.11%（趋势性χ²检验：Z=2.46,P=0.014）;2007-2015年,陕西省吸烟者吸烟量从16.90支/d,上升到17.76支/d;成年人戒烟率从11.02%上升到16.95%（趋势性χ²检验：Z=-4.18,P<0.01）;二手烟暴露率从2010年48.10%上升到2015年的63.88%（趋势性χ²检验：Z=-10.60,P<0.01）。敏感性分析趋势不变。结论 2007-2015年,陕西省成年人吸烟率和吸烟量保持在比较高的水平且变化不大,虽然吸烟人群的戒烟率逐渐提高,但非吸烟人群中二手烟暴露率迅速增加。     

2008年成都市成年人慢性非传染性疾病相关危险因素调查

目的了解成都市成年人慢性病及相关危险因素流行特征。方法于2008年采用多阶段随机抽样,对成都市主城区及近郊区县12个社区7 179名18岁以上成年人进行调查。结果 24.49%的调查人群患1种以上慢性病;人群吸烟率、饮酒率分别为18.16%和5.20%;12.06%的人群缺乏体力活动;人群钙质摄入不足率和嗜腌食品率分别为9.90%和1.81%;人群非定时就餐率和不规律早餐率分别为7.29%和8.20%;超重、肥胖的粗率分别为24.15%和5.39%,年龄标化率分别为21.47%和4.69%。19.92%的人群从未测过血压;38.64%的人群从未测过血糖;35.45%的调查人群从未做过健康体检。结论成都市成年居民普遍存在着吸烟、饮酒、不合理膳食、缺乏体力活动、超重等危险因素,且自我保健意识较差,应将慢性病作为一组疾病针对共同的危险因素实施综合干预措施,同时建立和完善人群健康行为危险因素监测系统。     

中国10个地区成年人腌制蔬菜摄入情况的流行病学特征分析

目的 描述中国慢性病前瞻性研究（CKB）队列10个地区不同种类腌制蔬菜摄入的地区、时间和人群分布特征。方法 CKB项目分别在2004-2008年、2008年和2013-2014年开展了基线调查、第一次和第二次重复调查。根据10个地区第二次重复调查对象的咸菜和酸泡菜平均摄入频率,将调查地区分为摄入咸菜为主地区、摄入酸泡菜为主地区和几乎不摄入腌制蔬菜地区。然后分别在前两组地区中运用logistic回归描述腌制蔬菜摄入的时间变化趋势和人群分布特征,并分析其他膳食特征的分布情况。结果 摄入咸菜为主地区包括青岛、哈尔滨、苏州、浙江项目点,而摄入酸泡菜为主地区包括甘肃、四川项目点,两类地区分别纳入204 036和105 573名基线调查对象。摄入咸菜为主地区在基线调查、第一次和第二次重复调查腌制蔬菜的平均摄入频率分别为3.1、3.3、1.8 d/周;摄入酸泡菜为主地区相应的频率为2.8、2.7、1.6 d/周,均呈下降趋势（P<0.001）。基线调查时两类地区的已婚、文化程度较低者腌制蔬菜摄入频率均更高;摄入咸菜为主地区年龄较大者腌制蔬菜摄入频率更高,而摄入酸泡菜为主地区相反（P<0.001）。随着腌制蔬菜摄入频率的增加,两类地区经常摄入辣食、口味偏咸等人群比例也呈增加趋势（P<0.05）。结论 CKB项目人群的腌制蔬菜摄入种类和水平存在明显的地区和人群分布差异,摄入频率呈下降趋势,且与其他膳食特征存在相关。     

The Effects of a Multivitamin/Mineral Supplement on Micronutrient Status,Antioxidant Capacity and Cytokine Production in Healthy Older Adults Consuming a Fortified Diet

Background: Inadequate micronutrient intake among older adults is common despite the increased prevalence of fortified/enriched foods in the American diet. Although many older adults take multivitamin supplements in an effort to compensate, studies examining the benefits of this behavior are absent.

Objective: To determine whether a daily multivitamin/mineral supplement can improve micronutrient status, plasma antioxidant capacity and cytokine production in healthy, free-living older adults already consuming a fortified diet.

Methods: An eight-week double-blind, placebo-controlled clinical trial among 80 adults aged 50 to 87 years (mean=66.5±8.6 years).

Results: Multivitamin treatment significantly increased (p<0.01, compared to placebo) plasma concentrations of vitamins D (77 to 100 nmol/L), E (27 to 32 μmol/L), pyridoxal phosphate (55.1 to 75.2 nmol/L), folate (23 to 33 nmol/L), B12 (286 to 326 pmol/L)), C (55 to 71 μmol/L), and improved the riboflavin activity coefficient (1.23 to 1.15), but not vitamins A and thiamin. The multivitamin reduced the prevalence of suboptimal plasma levels of vitamins E (p=0.003), B12 (p=0.004), and C (p=0.08). Neither glutathione peroxidase activity nor antioxidant capacity (ORAC) were affected. No changes were observed in interleukin?2, ?6 or ?10 and prostaglandin E₂, proxy measures of immune responses.

Conclusions: Supplementation with a multivitamin formulated at about 100% Daily Value can decrease the prevalence of suboptimal vitamin status in older adults and improve their micronutrient status to levels associated with reduced risk for several chronic diseases.     

Nutritional Status and Obesity Prevalence in People with Gender Dysphoria

Gender dysphoria is a condition that involves a failure to adapt and a body dissatisfaction that makes these individuals especially susceptible to eating disorders. The aim of this paper was to ascertain the nutritional status, dietary behaviour and lifestyle and their effect on overweight/obesity prevalence of the people with gender dysphoria.MethodsA longitudinal study on 157 individuals from the Gender Disorder Unit at the Ramón y Cajal Hospital (Madrid) who are undergoing hormonal treatment has been carried out. Usual dietary intake, physical activity habits and socioeconomic parameters were evaluated. The anthropometric parameters determined were weight, height, body-mass index (BMI), waist and hip circumference and body fat content.ResultsThe mean of the population eats a large number of servings of food, which leads to high levels of energy intake: 3,614.32 ± 1,314 kcal/day. These intakes are related to the physical activity performed. The average diet among this population is unbalanced, with a high consumption of fats, especially saturated fats and cholesterol. The breakfast is skipped by 16% of the population. Together with cross-hormone treatment, this dietary habitsand lifestylelead to an increase in body fat, especially in the female to male group whose overweight andobesity prevalence increase (22.72% vs 34.85%).ConclusionThis population suffers a change of their nutritional status due to a variation in their eating behaviour and lifestyle. This increase in the obesity prevalencemake it susceptible to chronic diseases and cardiovascular disorders. It is therefore necessary to include nutrition education courses in the comprehensive treatment programme (anatomical, psychological, etc.) for these individuals.     

北京市2005年成年人慢性病相关生活方式和行为习惯研究

目的 探索北京市成年人中慢性病相关生活方式和行为习惯的分布特征.方法 于2005年9-11月份采用多阶段等比例分层整群抽样的方法调查北京市18岁以上16 658名常住居民,调查内容包括问卷调查、体格测量和实验室检查.结果 北京市成年人有33.2%超重,16.4%肥胖,腹型肥胖率为45.6%.现在吸烟率为26.2%,经常吸烟率为21.4%,男女性现在吸烟率分别为57.7%和4.6%.男性中64.3%每月至少饮一次酒,16.1%几乎每天饮酒,16.5%为过量饮酒,18.5%为单次大量饮酒.北京市成年人46.0%缺乏体育锻炼(每周锻炼时间不超过2 h).膳食中最突出的问题是钠盐和食用油摄入过多、豆奶制品摄入不足、不吃早餐、常吃咸菜腌菜和油炸食品、经常吃零食和蔬菜水果摄入不足等问题.绝大多数慢性病危险因素的流行水平都是郊县高于城区,青壮年高于其他年龄段.结论 北京市成年人中慢性病相关危险因素高度流行,郊县和青壮年是今后干预的重点.     

The prevalence of obesity and lifestyle behaviors of parents of youth with intellectual and developmental disabilities

BackgroundParents of youth with intellectual and developmental disabilities (IDD) may have a higher prevalence of overweight and obesity and poorer weight management behaviors compared to the general population.ObjectiveTo describe the prevalence of overweight/obesity and related socioeconomic and lifestyle factors including diet quality, physical activity, and reported health habits in parents of youth with IDD.MethodsWe assessed: BMI (kg/m²), moderate-to-vigorous physical activity (MVPA), fruit and vegetable intake (FVI), parental diet and physical activity habits, and socioeconomic characteristics. Associations of BMI on MVPA and FVI were assessed with Spearman's correlation; differences in BMI by parental diet and physical activity habits were assessed with Kruskall-Wallis tests; and the relationships of BMI to household income, race, and education were assessed with Kendall Tau-b and Mann Whitney U tests.ResultsData was obtained from 110 parents (97.3% female) who were study partners for their adolescents/young adults with IDD participating in a weight loss clinical trial. Approximately 81% of parents were overweight or obese (25.7% overweight, 55.1% obese), with 46.3% and 20% meeting the recommended U.S. guidelines for MVPA and FVI, respectively. Higher FVI and higher income were significantly associated with lower parent BMI. BMI was significantly lower in parents who reported to be physically active and choose healthy food.ConclusionWe observed a high prevalence of overweight/obesity, low FVI and low levels of MVPA in parents of adolescents with IDD. These observations suggest that interventions designed to address these factors have the potential to improve the health and wellbeing of both parents and adolescents with IDD.Clinical trials numberNCT02561754.     

陕西省成年居民慢性病及其危险因素分析

目的 了解陕西省慢性病及相关危险因素。方法 采用多阶段分层整群随机抽样的方法,调查2015年陕西省10个国家级监测点常住居民的慢性病危险因素相关指标,4项行为危险因素（吸烟、饮酒、饮食、体力活动）和4项身体因素（BMI、血压、血糖、血脂）分别采用面对面访问、体格测量和实验室检测的形式收集相关信息。各项指标计算均考虑权重（设计权重、无应答权重和事后分层权重）。采用二分类logistic回归模型分析8项危险因素两两之间的关联性。结果 共纳入分析6 174人,经加权调整后,陕西省成年居民现在吸烟率为28.19%,有害饮酒率为6.20%,蔬菜水果摄入不足率为55.62%,体力活动不足率为19.56%;超重/肥胖率为46.82%,高血压患病率为31.12%、FPG升高率为4.27%、TC升高率为20.96%。8项行为和身体因素两两间均存在相关性,危险因素男性平均有2.41项,女性平均1.85项,城市居民1.94项,农村居民2.28项。结论 2015年陕西省成年居民行为危险因素和身体因素均高于全国平均水平,且性别及城乡间存在明显差异,不同危险因素间均存在关联,提示针对多种危险因素的公共卫生干预效果可能更好。     

Dietary Quality and Diet-Related Factors Among Female Adults of Reproductive Age With and Without Disabilities Participating in the National Health and Nutrition Examination Surveys, 2013-2018

BackgroundFemale adults of reproductive age (18 to 44 years) with disabilities have higher rates of health-risk behaviors and chronic conditions compared with their counterparts without disabilities; however, there is limited examination of diet.ObjectiveOur aim was to examine associations of self-reported disability status with diet quality and diet-related factors.DesignCross-sectional data were from the National Health and Nutrition Examination Surveys, 2013-2018.Participants/settingFemale adults aged 18 through 44 years were included. Disability was defined as serious difficulty hearing, seeing, concentrating, walking, dressing, and/or running errands due to physical, mental, or emotional conditions.Main outcome measuresThe Healthy Eating Index-2015 assessed diet quality. Diet-related factors included self-rated diet healthfulness, meal characteristics, food security, and food assistance programs.Statistical analysisMultivariable linear regression estimated differences in Healthy Eating Index-2015 scores for a given day and multivariable Poisson regression estimated adjusted prevalence ratios and 95% CI of diet-related factors by disability status.ResultsOf 3,579 female adults, 557 (16%) reported any disabilities, 207 (6%) of whom reported having 2 or more types of disabilities. Differences in mean Healthy Eating Index-2015 scores for a given day were one-third to one-half a point lower for fruits, total protein foods, and seafood and plant proteins among female adults with 2 or more types of disabilities compared with those without disabilities. Female adults with any disabilities were more likely to rate their diet as poor, have low food security, participate in food-assistance programs, and consume frozen foods or pizza, compared with those without disabilities (adjusted prevalence ratio ranged from 1.35 to 1.93); they were less likely to be the main food planner or preparer or shopper for their households.ConclusionsSome indicators of diet quality and diet-related factors differed between female adults with and without disabilities. Additional investigation of dietary intakes and behaviors, as well as access to and availability of healthy foods, among female adults with disabilities is necessary.     

职业人群不健康行为生活方式与高尿酸血症的关系及高血压、血脂异常的效应修饰作用

目的 探索不健康行为生活方式与高尿酸血症的关系,以及高血压、血脂异常的效应修饰作用,为预防高尿酸血症提供理论依据。方法 采用横断面调查研究设计,基于2021年10-12月来自四川省、贵州省28个地级市和重庆市33个区（县）中国铁路成都局集团有限公司的西南职业人群队列基线数据,通过问卷调查、体格测量及实验室生化检测收集研究对象的人口学特征、行为生活方式、慢性非传染性疾病患病情况。不健康行为生活方式得分根据吸烟、饮酒、膳食模式、体力活动和低体重/超重状况进行评分,分值越高不健康行为生活方式越多。采用多因素logistic回归模型分析不健康行为生活方式评分、吸烟状况、饮酒状况等与高尿酸血症的关系,采用分层分析探索高血压等疾病对不健康行为生活方式与高尿酸血症之间关系的修饰效应。结果 共纳入11 748名研究对象,高尿酸血症患病率为34.4%。多因素logistic回归分析显示,现在吸/既往吸烟、现在饮/既往饮酒及BMI异常是高尿酸血症患病的危险因素,不健康行为生活方式对高尿酸血症患病风险呈现累积效应,随着得分的升高,高尿酸血症患病风险升高,OR值由1.64（95%CI：1.34~2.00）上升至2.89（95%CI：2.39~3.50）。分层分析结果显示,在高血压及血脂异常人群中,不健康行为生活方式对高尿酸血症患病风险影响更大。结论 多种不健康行为生活方式的共存会升高高尿酸血症患病风险,这一效应在高血压、血脂异常人群中更明显。及时纠正不健康行为生活方式,并控制高血压和血脂异常,降低患高尿酸血症的风险。     

Associations Between Perceived Stress and Dietary Intake in Adults in Puerto Rico

BackgroundPsychological stress may influence health by negatively affecting dietary intake. However, there are few studies on the connection between stress and dietary intake in Puerto Rico (PR), a population with documented poor diet quality.ObjectiveTo explore the association between perceived stress and intake of macronutrients and diet quality among adults in PR.DesignCross-sectional data came from the Puerto Rico Assessment of Diet, Lifestyle, and Diseases study (2015).ParticipantsThis analysis included data from 238 adults (30-75 years old) in the San Juan metro area.Main outcome measuresDietary intake was measured with a food frequency questionnaire adapted and validated to the PR population. The Alternate Healthy Eating Index (AHEI) score was calculated to measure diet quality.Statistical analysesMultivariate linear models adjusted for sociodemographics, anthropometrics, behavioral factors, and social support were used to determine adjusted mean macronutrient intake and AHEI scores by perceived stress category.ResultsIn models adjusted for sociodemographic characteristics, high perceived stress was significantly associated with higher intake of total energy, added sugars, and saturated fats; lower intake of dietary fiber and vegetable protein; and lower AHEI score compared with low perceived stress (all P < .05). With further adjustment for lifestyle behaviors, central obesity, and social support, high perceived stress remained significantly associated with added sugars, saturated fats, and vegetable protein only.ConclusionsHigher perceived stress was associated with unhealthy dietary intake in adults residing in the San Juan area, PR. Future longitudinal studies with larger sample size are needed to build on these findings and to test the potential mediating and moderating roles of behavioral and social support factors in this population.