The association between physical activity and the risk of hypertension and diabetes among adults in Liaoning Province in 2016
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摘要:
目的 分析辽宁省成年居民身体活动水平与高血压、糖尿病的相关性，为高血压和糖尿病的预防与控制提供依据。 方法 2016年7-9月，采用多阶段分层随机整群抽样的方法，对辽宁省34 989名常住居民进行面对面调查及体格测量，采用Logistic回归分析模型分析身体活动水平与高血压及糖尿病的关系。 结果 辽宁省成年居民的高血压和糖尿病患病率分别为26.9%和11.3%，标化患病率分别为23.0%和9.8%。每周总身体活动时间为490(210, 1 000) min，交通性及中等强度职业性身体活动时间分别为150(0, 420) min和40(0, 420) min，休闲性身体活动时间较少。身体活动活跃、充分和不足人群的比例分别为38.1%、35.8%和26.1%。在调整混杂因素后，身体活动不足人群较身体活动活跃人群患高血压(OR=1.146, 95% CI: 1.076~1.220, P < 0.001)和糖尿病(OR=1.148, 95% CI: 1.055~1.249, P=0.001)的风险高。 结论 2016年辽宁省成年居民高血压患病率为中等水平，糖尿病患病率较高，身体活动不足者占比较高。身体活动不足是高血压和糖尿病患病的危险因素。老年、低文化程度、城市人群应作为防控的重点对象，提示应提高居民的身体活动水平以预防高血压和糖尿病的发生。 Abstract:Objective To survey the association between physical activity and the risk of hypertension and diabetes among adults in Liaoning Province, and to provide evidence for prevention of hypertension and diabetes. Methods 34 989 samples were selected through multistage stratified and clustered random sampling from July to September 2016. A face-to-face standard questionnaire and physical examination were applied to each sample. Logistic regression analysis model was applied to explore the association between physical activity and the risk of hypertension and diabetes. Results The prevalence of hypertension and diabetes was 26.9% and 11.3%, and standardized prevalence was 23.0% and 9.8%. The median of total physical activity time, traffic physical activity time and moderate professional physical activity time was 490(210, 1 000) min, 150(0, 420) min and 40(0, 420) min per week, respectively. The rates of residents with active, sufficient and insufficient physical levels were 38.1%, 35.8% and 26.1%, respectively. After adjusting confounding factors, logistic regression analysis models showed that residents with insufficient level of physical activity were significantly more likely to have hypertension (OR=1.146, 95% CI: 1.076-1.220, P < 0.001) and diabetes (OR=1.148, 95% CI: 1.055-1.249, P=0.001). Conclusions The prevalence of hypertension is moderate among adults in Liaoning Province, while the prevalence of diabetes is relatively high. The proportion of residents with insufficient physical activity is relatively high. Insufficient physical activity is a risk factor for hypertension and diabetes. Increasing physical activity level in residents of senior, low-education or urban groups should be integrated into hypertension and diabetes prevention strategies. -
Key words:
- Physical activity /
- Hypertension /
- Diabetes
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表 1 2016年辽宁省成年居民高血压、糖尿病患病情况[n(%)]
Table 1. The distribution of hypertension and diabetes among adults in Liaoning Province in 2016 [n(%)]
变量 例数 高血压 糖尿病 是 否 χ2值 P值 是 否 χ2值 P值 性别 12.689 < 0.001 5.073 0.024 男 17 081(48.8) 4 740(27.8) 12 341(72.2) 1 866(10.9) 15 215(89.1) 女 17 908(51.2) 4 667(26.1) 13 241(73.9) 2 093(11.7) 15 815(88.3) 年龄(岁) 4 922.633 < 0.001 1 525.286 < 0.001 18~ < 30 6 480(18.5) 476(7.3) 6 004(92.7) 249(3.8) 6 231(96.2) 30~ < 40 6 167(17.6) 708(11.5) 5 459(88.5) 305(4.9) 5 862(95.1) 40~ < 50 6 881(19.7) 1 428(20.8) 5 453(79.2) 609(8.9) 6 272(91.1) 50~ < 60 7 670(21.9) 2 756(35.9) 4 914(64.1) 1 132(14.8) 6 538(85.2) ≥60 7 791(22.3) 4 039(51.8) 3 752(48.2) 1 664(21.4) 6 127(78.6) 受教育程度 1 485.616 < 0.001 298.536 < 0.001 小学及以下 5 191(14.9) 2 241(43.2) 2 950(56.8) 863(16.6) 4 328(83.4) 初中 13 935(39.9) 4 239(30.4) 9 696(69.6) 1 704(12.2) 12 231(87.8) 高中 7 967(22.8) 1 768(22.2) 6 199(77.8) 824(10.3) 7 143(89.7) 大专及以上 7 842(22.4) 1 141(14.5) 6 701(85.5) 563(7.2) 7 279(92.8) 城乡 1.331 0.249 45.447 < 0.001 城市 30 643(87.6) 8 207(26.8) 22 436(73.2) 3 599(11.7) 27 044(88.3) 农村 4 346(12.4) 1 200(27.6) 3 146(72.4) 360(8.3) 3 986(91.7) 收入 216.323 < 0.001 34.734 < 0.001 低 9 465(27.2) 3 087(32.6) 6 378(67.4) 1 225(12.9) 8 240(87.1) 中 24 522(70.4) 6 062(24.7) 18 460(75.3) 2 620(10.7) 21 902(89.3) 高 824(2.4) 223(27.1) 601(72.9) 92(11.2) 732(88.8) 吸烟 118.453 < 0.001 6.598 0.010 否 26 852(76.7) 6 838(25.5) 20 014(74.5) 2 974(11.1) 23 878(88.9) 是 8 137(23.3) 2 569(31.6) 5 568(68.4) 985(12.1) 7 152(87.9) 饮酒 37.382 < 0.001 0.591 0.442 否 26 730(76.7) 6 965(26.1) 19 765(73.9) 3 036(11.4) 23 694(88.6) 是 8 100(23.3) 2 389(29.5) 5 711(70.5) 895(11.0) 7 205(89.0) BMI(km/m2) 1 460.740 < 0.001 362.355 < 0.001 < 18.5 1 498(4.4) 267(17.8) 1 231(82.2) 92(6.1) 1 406(93.9) 18.5~＜24 18 802(54.0) 3 752(20.0) 15 050(80.0) 1 710(9.1) 17 092(90.9) 24~＜28 11 498(33.0) 3 908(34.0) 7 590(66.0) 1 565(13.6) 9 933(86.4) ≥28 2 999(8.6) 1 422(47.4) 1 577(52.6) 565(18.8) 2 434(81.2) 身体活动 33.613 < 0.001 35.413 < 0.001 活跃 13 322(38.1) 3 603(27.0) 9 719(73.0) 1 464(11.0) 11 858(89.0) 充分 12 536(35.8) 3 172(25.3) 9 364(74.7) 1 311(10.5) 11 225(89.5) 不足 9 131(26.1) 2 632(28.8) 6 499(71.2) 1 184(13.0) 7 947(87.0) 
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表 2 2016年辽宁省成年居民身体活动时间分布[M (P25, P75), min]
Table 2. The distribution of the duration of physical activity among adults in Liaoning Province in 2016 [M (P25, P75), min]
变量 职业性身体活动 休闲性身体活动 交通性身体活动 合计 高强度 中等强度 高强度 中等强度 性别 男 0(0, 0) 0(0, 240) 0(0, 0) 0(0, 60) 150(0, 420) 490(210, 1020) 女 0(0, 0) 140(0, 420) 0(0, 0) 0(0, 0) 150(0, 420) 510(240, 960) Z值 6.121 16.101 3.901 1.528 1.453 3.982 P值 < 0.001 < 0.001 < 0.001 0.019 0.029 < 0.001 年龄(岁) 18~ < 30 0(0, 0) 0(0, 240) 0(0, 0) 0(0, 0) 180(0, 420) 420(200, 840) 30~ < 40 0(0, 0) 30(0, 360) 0(0, 0) 0(0, 0) 180(0, 420) 525(220, 1 000) 40~ < 50 0(0, 0) 90(0, 420) 0(0, 0) 0(0, 0) 150(0, 420) 540(240, 1 120) 50~ < 60 0(0, 0) 120(0, 420) 0(0, 0) 0(0, 90) 150(0, 420) 600(240, 1 113) ≥60 0(0, 0) 30(0, 420) 0(0, 0) 0(0, 90) 100(0, 420) 470(210, 900) H值 161.349 345.619 647.763 116.798 85.900 176.28 P值 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 受教育程度 小学及以下 0(0, 0) 120(0, 540) 0(0, 0) 0(0, 0) 0(0, 315) 540(150, 1 260) 初中 0(0, 0) 120(0, 420) 0(0, 0) 0(0, 0) 120(0, 420) 600(240, 1 260) 高中 0(0, 0) 0(0, 280) 0(0, 0) 0(0, 90) 200(0, 420) 450(210, 840) 大专及以上 0(0, 0) 0(0, 210) 0(0, 0) 0(0, 120) 210(0, 420) 420(220, 810) H值 356.017 962.389 756.435 256.846 618.251 476.025 P值 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 城乡 城市 0(0, 0) 0(0, 300) 0(0, 0) 0(0, 60) 180(0, 420) 450(210, 840) 农村 0(0, 0) 420(0, 1 260) 0(0, 0) 0(0, 0) 0(0, 210) 1 260(420, 2 100) Z值 8.325 24.210 2.786 8.645 20.220 22.881 P值 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 收入 低 0(0, 0) 60(0, 420) 0(0, 0) 0(0, 0) 180(0, 420) 500(210, 1 050) 中 0(0, 0) 0(0, 400) 0(0, 0) 0(0, 0) 140(0, 420) 490(210, 980) 高 0(0, 0) 0(0, 420) 0(0, 0) 0(0, 55) 0(0, 350) 490(150, 1 020) H值 1.131 5.920 28.418 3.718 101.109 1.799 P值 0.568 0.052 < 0.001 0.156 < 0.001 0.407
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表 3 2016年辽宁省成年居民身体活动水平分布[n(%)]
Table 3. The distribution of physical activity levels among adults in Liaoning Province in 2016 [n(%)]
特征 身体活动水平 Z/H值 P值 活跃 充分 不足 性别 -0.412 0.680 男 6 635(38.9) 5 864(34.3) 4 582(26.8) 女 6 687(37.3) 6 672(37.3) 4 549(25.4) 年龄(岁) 90.370 < 0.001 18~ < 30 2 264(34.9) 2 391(36.9) 1 825(28.2) 30~ < 40 2 340(37.9) 2 214(35.9) 1 613(26.2) 40~ < 50 2 760(40.1) 2 402(34.9) 1 719(25.0) 50~ < 60 3 167(41.3) 2 660(34.7) 1 843(24.0) ≥60 2 791(35.8) 2 869(36.8) 2 131(27.4) 受教育程度 197.207 < 0.001 小学及以下 2 101(40.5) 1 430(27.5) 1 660(32.0) 初中 6 094(43.7) 4 379(31.4) 3 462(24.9) 高中 2 676(33.6) 3 210(40.3) 2 081(26.1) 大专及以上 2 436(31.1) 3 501(44.6) 1 905(24.3) 城乡 -33.869 < 0.001 城市 10 395(33.9) 11 940(39.0) 8 308(27.1) 农村 2 927(67.4) 596(13.7) 823(18.9) 收入 3.521 0.172 低 3 664(38.7) 3 183(33.6) 2 618(27.7) 中 9 297(37.9) 9 011(36.8) 6 214(25.3) 高 319(38.7) 251(30.5) 254(30.8)
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表 4 2016年辽宁省成年居民不同身体活动水平对高血压、糖尿病的影响
Table 4. The influence of physical activity levels on hypertension and diabetes among adults in Liaoning Province in 2016
疾病 模型 身体活动活跃 身体活动充分 身体活动不足 OR值 OR(95% CI)值 P值 OR(95% CI)值 P值 高血压 模型1 1.000 1.010(0.953~1.072) 0.729 1.077(1.012~1.146) 0.020 模型2 1.000 1.067(1.006~1.131) 0.032 1.146(1.076~1.220) < 0.001 糖尿病 模型1 1.000 0.939(0.865~1.018) 0.128 1.118(1.028~1.216) 0.009 模型2 1.000 0.945(0.870~1.025) 0.173 1.148(1.055~1.249) 0.001 注：模型1：调整性别、年龄、受教育程度、城乡、收入、吸烟及饮酒；模型2：在模型1基础上调整BMI分级。
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