血脂异常及高血压对脑卒中的交互作用分析

目的研究血脂异常和高血压与脑卒中的关系以及二者对脑卒中患病的交互作用模式与交互作用强度。方法基于2009-08/2009-12中国健康与营养调查的横断面数据中6236名40~80岁中老年人群样本资料,采用Logistic回归探讨血脂异常和高血压与脑卒中患病风险之间的相关性。其中一个模型通过交互作用因素不同暴露组合下的OR值和Delta法计算相加交互作用系数--交互效应超额相对危险度(RERI)、交互作用归因比例(API)和交互作用指数(SI);另一个模型通过纳入血脂异常和高血压的乘积项计算其相乘交互作用系数(IOR)。结果调整了年龄、性别、教育程度、吸烟、饮酒、超重、身体活动、蔬菜水果摄入和糖尿病史后,相对于无血脂异常和无高血压的人群,同时存在血脂异常和高血压对脑卒中患病的风险增加了(OR 5.16,95%CI:3.35-7.79),RERI、API、SI和IOR及其95%置信区间依次为1.62(0.01~3.24)、0.31(0.05~0.58)、1.64(1.12~2.16)和1.34(0.68~2.64)。结论血脂异常和高血压同时暴露增加了脑卒中的患病风险,结果提示血脂异常和高血压可能存在相加模式交互作用。

The Interaction between Dyslipidemia and Hypertension On Stroke

Objective To explore the relationship and interaction of dyslipidemia and hypertension on stroke.Methods Based on the data of 6236 people aged 40-80 from the China Health and Nutrition Survey conducted from August 2009 to December 2009,the study performed the logistic regression analysis to explore the main effect of dyslipidemia and hypertension on the risk of stroke.One model calculated the additive interaction coefficient--relative excess risk of interaction(RERI),attributable proportions of interaction(API)and synergy index(SI)--considering the OR value under different exposure combinations of interaction factors and through the Delta method.Another model calculated its interaction of OR(IOR)by incorporating the product term of dyslipidemia and hypertension.Results Under the adjustment for age,gender,education level,smoking,drinking,overweight,physical activity,fruits and vegetables intake and the history of diabetes,the risk of stroke in the group with hypertension and dyslipidemia was higher than that of the group without dyslipidemia and hypertension(OR:5.16,95%CI:5.16~3.35).The RERI,API,SI and IOR values(and 95%CIs)were 1.62(0.01~3.24),0.31(0.05~0.58),0.05(1.12~2.16)and 1.34(0.68~2.64),respectively.Conclusion The OR for stroke in dyslipidemic and hypertensive group was much higher than that of the group without dyslipidemia and hypertension.The results indicated the additive interactions between dyslipidemia and hypertension,which increased the risk of stroke in Chinese middle-aged and elderly people.