高血压合并肥胖影响因素分析

目的探讨高血压合并肥胖者的主要影响因素,为高血压合并肥胖的防治提供理论依据。方法以社区医院门诊病人为基础进行病例对照研究,其中以门诊收治的高血压合并肥胖患者372人为病例组,在同一社区人群中选择血压和体重均正常者437人为对照组;对研究对象进行问卷调查和实验室检查。运用单因素与多因素分析方法,探讨高血压合并肥胖者的主要影响因素。结果高血压合并肥胖的发病危险随着年龄的增长而增加,男性高于女性;有家族遗传倾向者发病风险明显增高,父亲肥胖（OR=5.04,95%CI=3.12～8.14）,父亲高血压（OR=2.46,95%CI=1.81～3.35）,母亲肥胖（OR=2.55,95%CI=1.78～3.64）,母亲高血压（OR=2.14,95%CI=1.60～2.86）;膳食口味偏咸（OR=2.45,95%CI=1.82～3.29）与饮酒（OR=1.92,95%CI=1.37～2.68）等行为可以增加发病风险,而坚持骑车或步行上班（OR=0.64,95%CI=0.46～0.89）、饮用牛奶（OR=0.73,95%CI=0.55～0.97）等行为则可降低发病风险。病例组血脂异常率高于对照组（P〈0.01）,提示高血压合并肥胖可增加血脂紊乱的风险。结论将戒烟限酒、减少食盐的摄入量,适量运动、合理膳食作为高血压合并肥胖人群的主要预防措施;家族遗传倾向是高血压与肥胖发病的主要危险因素,应对此类高危人群加强一、二级预防。     

广西成人高血压患病情况及其相关危险因素分析

目的　了解广西壮族自治区高血压患病情况及其相关危险因素,为制定高血压防治措施提供参考。方法　采用多阶段分层整群随机抽样方法,对广西18岁以上常住居民1824人的基本情况,饮食及行为习惯共23种因素进行了调查,就其可能危险因素进行单因素χ2检验和多因素非条件logistic回归分析。结果　人群高血压患病率17.4%。单因素分析表明性别、年龄、BMI、夜宵习惯、肉制品食用频率等18个因素差异均有统计学意义。多因素非条件logistic回归分析结果显示,年龄（OR=2.130）,BMI（OR=2.489）,早餐食物种类过多（OR=2.000）,深色蔬菜摄入量不足（OR=1.590）,吸烟（OR=1.270）等10项为高血压危险因素（P<0.05）。结论　改善不良行为因素如深色蔬菜及水产品摄入量不足,动物性产品摄入过多等不健康饮食,吸烟,缺少运动等以及防止体重过高可以有效预防高血压的发生。     

高血压病高危人群相关危险因素分析

目的调查高血压病高危人群相关危险因素。方法 2012年11月至2013年4月,通过整群抽样的方法,以浦东新区金杨街道某小区的1 348名居民为目标人群,其中高血压病组459名,高血压病高危组393名,正常血压组496名,采用自行设计问卷,收集被调查人群个人基本情况,并测量身高、体重、腰围、血压、血糖、血脂,评估高血压病高危人群的相关危险因素。结果高血压病组、高血压病高危组分别和正常血压组相比,在性别、年龄、腰围、BMI、受教育程度、空腹血糖、甘油三酯、胆固醇、LDL-C、饮酒史差异均具有统计学意义(P0.05);而吸烟史、HDL-C差异均无统计学意义。高血压病组与高血压病高危组相比,性别、LDL-C差异具有统计学意义(P0.05);而年龄、腰围、BMI、受教育程度、空腹血糖、甘油三酯、胆固醇、饮酒史、吸烟史、HDL-C差异均无统计学意义。Logistic回归分析显示患者的性别、年龄、受教育程度与高血压病的发病密切相关(P0.05)。结论女性、年龄是高血压病高危人群的独立危险因素;受教育程度9年是高血压病高危人群的独立保护因素。     

天津市居民不同亚型高血压患病率及其相关危险因素分析

目的 了解天津市居民不同亚型高血压患病率及其相关危险因素.方法 按照2005年<中国高血压防治指南>推荐标准,于2006年采用分层整群随机抽样方法,对天津市3个城区、3个郊区共20 346名≥18岁且居住5年以上的常住人口进行调查.分析单纯收缩期高血压(ISH)、单纯舒张期高血压(IDH)和收缩期舒张期高血压(SDH)的患病率及其相关危险因素.采用SPSS 17.0软件进行统计学分析.结果 天津市≥18岁居民高血压实际调查患病率,ISH为7.16%(标化患病率为5.33%),IDH为7.09%(标化患病率为6.50%),SDH为13.61%(标化患病率为9.94%),其中ISH患病率低于全国成年人ISH患病率(7.6%),但IDH和SDH的患病率高于全国IDH患病率(4.4%)和SDH患病率(7.4%).经logistic回归分析显示,ISH、IDH和SDH三种类型高血压共同可疑危险因素的OR值及95%CI,农村分别为1.291(1.114～1.497)、1.790(1.533～2.091)和2.117(1.879～2.386),年龄分别为1.080(1.073～1.086)、1.015(1.010～1.020)和1.055(1.050～1.060),饮酒分别为1.244(1.036～1.492)、1.199(1.024～1.404)和1.532(1.345～1.744),超重分别为1.560(1.358～1.792)、1.634(1.429～1.869)和2.104(1.890～2.342),肥胖分别为2.216(1.861～2.640)、3.125(2.658～3.674)和3.852(3.383～4.385),空腹血糖受损分别为1.666(1.327～2.092)、1.440(1.126～1.841)和1.872(1.572～2.230)及文化程度较低.结论 天津市居民各亚型高血压患病率较高,应针对不同亚型高血压患者采取不同的预防和治疗措施.

Abstract：

Objective To investigate the prevalence rates of the different subtypes of hypertension and related risk factors in adults from Tianjin.Methods With multi-stage randomized cluster sampling method,20 346 people aged 18 years and over were selected from both urban and rural areas of six geographical regions in Tianjin in 2006.A cross-sectional study was conducted.The prevalence rate of isolated systolic hypertension (ISH),isolated diastolic hypertension (IDH),systolic and diastolic hypertension (SDH) and associated risk factors were analyzed with SPSS 17.0 software.Results The prevalence rates of hypertension in adults of Tianjin were 7.16% for ISH (standardized rate was 5.33%),7.09% for IDH (standardized rate was 6.50%),and 13.61% for SDH (standardized rate was 9.94%) respectively.The ISH prevalence rate was lower than that of national rate of 7.6%,but the prevalence rates of IDH and SDH were higher than that of national rates of 4.4% and 7.4% respectively.The results from logistic regression model analyses indicated that the odds ratio (ORs) for combined risk factors of ISH,IDH and SDH in Tianjin that associated with factors as:lower level of education,living in rural areas were 1.291 (95%CI:1.114-1.497),1.790 (95%CI:1.533-2.091) and 2.117(95%CI:1.879-2.386) respectively;ageing were 1.080(95%CI:1.073-1.086),1.015(95%CI:1.010-1.020) and 1.055(95%CI:1.050-1.060) respectively;alcohol assumption were 1.244(95%CI:1.036-1.492),1.199(95%CI:1.024-1.404) and 1.532(95%CI:1.345-1.744) respectively;overweight were 1.560 (95% CI:1.358-1.792),1.634 (95% CI:1.429-1.869) and 2.104 (95% CI:1.890-2.342) respectively;obesity were 2.216 (95%CI:1.861-2.640),3.125 (95%CI:2.658-3.674) and 3.852 (95% CI:3.383-4.385) respectively;impaired fasting glucose were 1.666 (95% CI:1.327-2.092),1.440 (95% CI:1.126-1.841) and 1.872 (95% CI:1.572-2.230) respectively.Conclusion The prevalence rate of the different subtypes of hypertension was quite high in the population of Tianjin city and different measurements on prevention and treatment should be taken according to different subtypes of hypertension.     

温州市10社区居民高血压病现状及危险因素的流行病学调查

目的了解温州市35岁以上居民高血压病患病现状及相关危险因素,为制定高血压病防治策略提供科学依据。方法采用多阶段整群随机抽样的方法,抽取年龄在35周岁以上居民13 507人,随机抽样的调查方法进行问卷调查、体格检查和实验室检测。结果温州市35周岁以上居民高血压病患病率为40.28%,高血压病患病率男性高于女性(P=0.00),高血压病患病率有随年龄增高而上升的趋势;高血压病知晓率、服药率、控制率、治疗者血压控制率分别为51.25%,28.32%、10.53%、22.10%。多因素非条件logistic回归显示高血压病的危险因素为超重肥胖、文化程度低、糖尿病、口味重、经常饮酒等。结论高血压病已成为影响35岁以上居民身体健康的重要公共卫生问题,要加强社区综合干预工作,有效防控高血压病以及心脑血管疾病的发生发展。     

岱山县海岛渔农村居民高血压现状及危险因素流行病学调查

目的：了解海岛渔农村居民高血压患病情况和相关危险因素,为制定高血压防治策略提供科学依据。方法：采用多阶段整群随机抽样的方法,抽取岱山县18岁以上渔农村居民1149人,进行高血压患病情况调查,并对高血压患病的影响因素进行单因素和多因素非条件logistic回归分析。结果：海岛渔农村18岁以上居民高血压患病率为21．58％,标化率14．43％;其中男性患病率20．56％,标化率13．23％;女性患病率22．38％,标化率15．52％,男女性差异无统计学意义（X2=0．55,P〉0．05）。高血压患病率有随着年龄的增大而上升的趋势;高血压知晓率、治疗率和控制率分别为60．48％、43．95％和25．81％。多因素非条件logistic回归分析显示年龄、高血压家族史、高甘油三酯、高总胆固醇、糖尿病和超重或肥胖为高血压危险因素。结论：海岛渔农村居民的高血压患病率低于全国基本患病率,但知晓率、治疗率和控制率仍较低。要加强社区综合干预工作,有效控制高血压及心脑血管疾病的发生发展。     

学龄期单纯性肥胖儿童高血压的家庭相关因素分析

【目的】 研究影响肥胖学龄期儿童的血压升高的家庭相关危险因素,为儿童肥胖以及相关高血压的预防和治疗提供依据。 【方法】 采用Cox比例风险模型对124例肥胖儿童进行高血压的家庭相关因素分析。 【结果】 多因素Cox回归分析结果显示,母亲肥胖、父亲肥胖、家族高血压人数和出生体重在肥胖儿童发生高血压的相对危险度分别为2.117、1.969、1.828和1.777,P值均<0.05。 【结论】 父母肥胖、有高血压家族史以及出生体重巨大的肥胖儿童是早期发生高血压的高危人群。     

煤矿工人高血压危险因素流行病学调查

目的探讨煤矿工人高血压危险因素,为制订控制对策提供依据。方法对研究对象进行问卷调查和体格检查,应用多因素回归进行危险因素分析。结果不同年龄、工种和工龄高血压患病率差异存在显著性;工龄、缺乏运动、吸烟、饮酒、超重、家族史及高盐饮食与高血压发病显著关联。结论不同的工作环境和内容是影响发病的重要因素;工龄、缺乏运动、超重、家族史及不良生活方式是高血压的危险因素。     

Independent risk factors for endometrial polyps: diabetes,hypertension, and obesity

ObjectiveTo study the role of diabetes, hypertension and obesity in etiology of endometrial polyps.MethodsA total of 250 patients with endometrial polyp and 256 patients normal endometrial cavity were included, who applied to our outpatient clinic. We recorded the age, fertility state, body mass index, number of polyps, hypertension and diabetes status of the patients by using SPSS Windows 16.0. All patients in polyp group were verified by post-operative pathology report.ResultsNo significant difference was found in patients with diabetes and obesity, but hypertension was a significant factor in patients who had endometrial polyp comparing to total patient population (n=526).ConclusionsThis finding may alert the physician to consider the endometrial cavity in hypertensive patients who applied with abnormal uterine bleeding.     

Parent-child obesity and cardiovascular risk factors

Blood pressure, cholesterol, high density lipoprotein cholesterol, and triglycerides were studied in obese children and obese parents selected to participate in a weight treatment program. The relationships between parent and child risk levels, as well as the relationship between child and parent weight and risk factors, were established. Results showed that children's cholesterol and triglycerides were related to parental lipid levels, independent of weight. Children's blood pressure readings were strongly related to their weight, but not to parental blood pressure. High density lipoprotein cholesterol levels were negatively related to weight in both child and parent female populations, and weakly positively related to weight for male children. Implications of these risk factor patterns for intervention are discussed.     

Epidemiology of hypertension in adolescence and factors influencing blood pressure

The authors summarize the determining and influencing factors of adolescent hypertension. An overview of the definition and prevalence of hypertension in adolescence is given and the predictive role of the adolescent hypertension on the incidence of adult cardiovascular diseases is pointed out. According to the previous literature data, adult hypertension is more frequent in those people who have had hypertension in their adolescence. There are no widely used, population-based nomograms of adolescent hypertensives available. According to the opinion of the authors, a population-based hypertension screening program would help in delineating the factors influencing adolescent blood pressure, and the most frequent risk factors for hypertension in Hungary. With the follow-up and appropriate treatment of the hypertensives the reduction of target-organ damages may be possible.     

重庆市小学生超重肥胖及高血压流行现状

了解重庆市小学生超重、肥胖及高血压流行现状,为制定相关干预措施提供科学依据.方法 采取分层整群抽样方法,按经济水平好、中、差抽取重庆市渝中区、荣昌县和开县3 225名一~六年级在校小学生于2013年10-12月对其进行身高、体重、腰围、血压等体格检查.结果 受检学生超重率为11.8%,肥胖率为8.4%;高血压初筛检出率为6.1%,确诊率为2.1%.人均GDP水平高的渝中区小学生超重(19.2%)、肥胖率(15.3%)、高血压(3.5%)确诊率均高于人均GDP水平低的荣昌县和开县(7.4%,3.9%,1.5%),城区小学生超重(14.3%)、肥胖率(10.5%)均高于农村小学生(9.3%,6.2%),男生超重(13.6%)、肥胖率(10.8%)均高于女生(10.0%,5.9%),差异均有统计学意义(P值均<0.05);高血压确诊率的城乡(2.1%,2.0%)、性别(2.2%,2.0%)差异均无统计学意义(P值均>0.05);体重超重者(3.4%)、肥胖者(11.8%)高血压确诊率均高于体重正常者(0.9%),差异均有统计学意义(P值均<0.05).结论 重庆市小学生超重、肥胖及高血压检出率较高.应培养和引导儿童形成受益终生的健康生活方式、行为和技能,从儿童期着手预防或延迟慢性病发生,实现慢性病防控关口前移.     

社区高血压病患者血压控制率的相关影响因素分析

目的了解社区高血压病患者的血压控制现况及影响血压控制的主要因素,从而在社区中更有针对性地开展高血压的防治工作,提高高血压的控制率。方法采用流行病学现况调查的方法,由经过统一培训的社区医生对研究对象进行问卷调查、体格测量及血生化检查。研究对象为社区中自愿参加高血压规范化管理的高血压病患者4 721人,并通过对服药情况进行分组来分析不同组别中高血压患者血压控制率的影响因素。所有资料使用EpiData 3.2录入,采用SPSS 13.0软件进行分析。率的比较采用χ2检验,P〈0.01为差异有统计学意义。结果按医嘱规律服用降压药组血压控制率57.5%,显著高于未按医嘱规律服用降压药组的43.2%（χ2=54.625,P〈0.001）。吸烟、饮酒、运动、膳食高盐、膳食高脂以及体质指数与高血压病患者血压控制率有关,差异均有统计学意义。结论高血压病患者的行为生活方式对其高血压的控制有显著影响。对患者普及高血压防治基本知识并督促其形成健康生活方式可有效提高高血压的控制率。     

兰州市青少年超重与肥胖现状及影响因素分析

目的了解兰州市青少年超重与肥胖的患病状况和影响因素,为预防和控制超重与肥胖提供科学依据。方法采取多阶段随机整群抽样法,抽取兰州市兰化一中和五十一中初一至高三1 400名学生作为调查对象,分别对其进行体格检查和流行病学调查,并对肥胖的影响因素采用Logistic回归分析。结果兰州市男、女生超重率分别为14.73%,4.13%,肥胖率分别为3.08%,1.54%;标准化后男生超重率和肥胖率均高于女生。超重肥胖的主要危险因素是性别、饮酒、吸烟、睡眠时间不足、每周多次吃鱼(OR值均>1),保护因素有锻炼、充足的睡眠(OR值均<1)。结论青少年超重、肥胖检出率高。应尽快采取措施,在青少年人群中开展超重和肥胖干预工作。     

基于三种统计学方法构建的超重及肥胖人群高血压发病预测模型的分析比较

目的 利用CRT分类树、logistic回归、BP神经网络构建超重及肥胖人群高血压发病预测模型。方法 抽取出3150名超重及肥胖人群（体质指数≥24kg/m²）。分别应用CRT分类树、logistic回归、BP神经网络构建超重及肥胖人群高血压发病预测模型,筛选出高危因素,采用受试者工作特征曲线（ROC）对三种统计学方法构建的预测模型进行特异性、敏感性及准确性评估。结果 三种方法构建的预测模型筛选出的高危因素包括非酒精性脂肪性肝病(NAFLD)、空腹血糖(FPG)、年龄、甘油三酯(TG)、尿酸(UA)、低密度脂蛋白胆固醇(LDL-c)。CRT分类树模型、logistic回归模型、BP神经网络模型ROC曲线下面积(AUC)值分别为0.721、0.734、0.733,敏感性分别为61.63%、76.59%、82.85%,特异性分别为77.58%、60.44%、52.00%,Youden指数分别为39.20%、37.02%、34.85%。结论 本研究筛选的危险因素包括NAFLD、FPG、年龄、TG、UA、LDL-c,基于危险因素应用三种统计学方法构建的预测模型具有中等预测价值,对超重及肥胖人群高血压发病具有较好的预测能力。     

Frequency and risk factors of obesity in Tunisian adolescent

The aim of the study was to determine the prevalence and the risk factors of obesity in Tunisian adolescent. METHODS: This prospective study included 1050 adolescents (aged 13 to 17 years) from two high schools according to the socioeconomic status. The aim was to evaluate the prevalence and the main risk factors of obesity in this studied group. The weight and height of every adolescent were measured and the Body Mass Index (BMI) was calculated for each of them. Using this criteria and referring to the curves of this Index for the age established by the National Health and Nutrition Examination Survey (NHANES) we found 49 obese adolescents. We evaluated the spontaneous food intake for each of them during three days. The results showed that the frequency of obesity is 5.1% without significant difference between the two schools. The highest obesity frequency is noticed at age 13 and 14 years in the two sexes. The obesity frequency is significantly more important in males of the high socioeconomic status. Family history of obesity was noticed in 51% of obese adolescents. Most of them (96%) had abnormal alimentary behavior. 52% of them had an excess of caloric intake and 82% an excess of lipid without significant difference between the two schools.     

Dietary patterns of adolescents and risk of obesity and hypertension

Increasingly, measures of dietary patterns have been used to capture the complex nature of dietary intake and investigate its association with health. Certain dietary patterns may be important in the prevention of chronic disease; however, there are few investigations in adolescents. The aim of this study was to describe the dietary patterns of adolescents and their associations with sociodemographic factors, nutrient intakes, and behavioral and health outcomes. Analysis was conducted using data collected in the 1995 Australian National Nutrition Survey of participants aged 12-18 y who completed a 108-item FFQ (n = 764). Dietary patterns were identified using factor analysis and associations with sociodemographic factors and behavioral and health outcomes investigated. Factor analysis revealed 3 dietary patterns labeled a fruit, salad, cereals, and fish pattern; a high fat and sugar pattern; and a vegetables pattern, which explained 11.9, 5.9, and 3.9% of the variation in food intakes, respectively. The high fat and sugar pattern was positively associated with being male (P < 0.001), the vegetables pattern was positively associated with rural region of residence (P = 0.004), and the fruit, salad, cereals, and fish pattern was inversely associated with age (P = 0.03). Dietary patterns were not associated with socioeconomic indicators. The fruit, salad, cereals, and fish pattern was inversely associated with diastolic blood pressure (P = 0.0025) after adjustment for age, sex, and physical activity in adolescents > or = 16 y. This study suggests that specific dietary patterns are already evident in adolescence and a dietary pattern rich in fruit, salad, cereals, and fish pattern may be associated with diastolic blood pressure in older adolescents.     

Epidemiology and risk factors of pneumonia in critically ill patients

Risk factors for pneumonia were analysed in a large population of critically ill patients, collected in two prospective multicentre pneumonia studies in Italy. Twenty-three intensive care units were involved and the study time was 150 unit months. Only patients without previous pulmonary infection, with intensive care unit stay 48 hours and no rapidly irreversible illness at admission were included. The incidence of pneumonia in the 1475 selected patients was 15% (220 cases). 239 patients died in ICU; the mortality rate was significantly higher in patients developing pneumonia (p<0.0001); pneumonia was found to be an independent highly significant risk factor for death in critically ill patients (OR = 3.88; p<0.0001).Multivariate analysis of seven risk factors for pneumonia showed a significantly higher risk in patients with neuromuscular disease (OR = 3.8, p<0.002), impairment of airway reflexes at admission (OR = 2.93, p<0.0001), and 24h respiratory assistance (OR=3.05, p<0.0001). Impairment of airway reflexes at admission to the emergency room or intensive care unit identifies the population who will experience 3/4 of the overall lower respiratory tract infections.Rapid recognition of at-risk patients seems clinically important and may improve awareness programs and preventive approaches.Intensive Care Unit Group for Infection Control (I.C.U.G.I.C.), a list of participating physician co-authors of the paper is reported at the endCorresponding author.     

儿童肥胖的早期危险因素

过去几十年间,全球儿童肥胖率显著上升.肥胖不仅影响儿童的身心健康,且与成年期代谢综合征的发生密切相关.儿童肥胖的早期危险因素主要包括孕前父母超重或肥胖、母孕期体重增长过多、孕期不良的生活方式、妊娠期糖尿病或高血压、剖宫产、巨大儿、人工喂养及缺乏身体活动等.本文拟对孕前和生命早期(母孕期至2岁)阶段中儿童肥胖的危险因素进...     

Cardiovascular risk factors in essential hypertension

Authors analysed the cardiovascular risk factors, their relationship to each other, the rate of multiple appearance in 1476 patients (774 men, 702 women) with essential hypertension. They produced a special questionnaire and risk factor analysing program for performing static and dynamic investigations on the base of international and domestic experiences. The data of their investigations verified, that the occurrence of obesity is very frequent and is associated with abnormal cholesterol and triglyceride values. The appearance of glucose metabolism disorder was in 44% of patients. The rate of metabolic syndrome can be estimated on 25-30% in the hypertensive population.