四川省3.6万成年居民健康生活方式遵循情况

查雨欣; 邓颖; 何君; 左明良; 李希; 崔建兰; 张岩; 许巍; 何予晋; 秦小雲; 王卓

doi:10.16462/j.cnki.zhjbkz.2024.06.007

四川省3.6万成年居民健康生活方式遵循情况

doi: 10.16462/j.cnki.zhjbkz.2024.06.007

查雨欣¹,
邓颖¹,
何君¹,
左明良²,
李希³,
崔建兰³,
张岩³,
许巍³,
何予晋¹,
秦小雲¹,
王卓^1, ,

1.
四川省疾病预防控制中心慢性非传染性疾病预防控制研究所，成都 610041
2.
四川省医学科学院，四川省人民医院心血管超声及心功能科，成都 610072
3.
国家心血管病中心，北京 102308

基金项目:

中央财政转移支付地方卫生计生服务项目——心血管病高危人群早期筛查与综合干预 2014

详细信息

通讯作者:
王卓，E-mail: alice_wangzhuo@qq.com

中图分类号: R154.4⁺1
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- 被引次数: 0
出版历程
- 收稿日期: 2023-09-26
- 修回日期: 2024-05-11
- 网络出版日期: 2024-07-13
- 刊出日期: 2024-06-10

The healthy lifestyle compliance of 36 000 adult residents in Sichuan Province

1.
Sichuan Center for Disease Control and Prevention, Institute of Chronic Non-communicable Diseases, Chengdu 610041, China
2.
Department of Cardiovascular Ultrasound and Cardiac Function, Sichuan Provincial People′s Hospital, Sichuan Provincial Academy of Medical Sciences, Chengdu 610072, China
3.
National Center for Cardiovascular Diseases, Beijing 102308, China

Funds:

Central Financial Transfer Payment Local Health and Family Planning Service Project—Early Screening and Comprehensive Intervention Program for High-risk Population of Cardiovascular Disease 2014

More Information

Corresponding author: WANG Zhuo, E-mail: alice_wangzhuo@qq.com

摘要

摘要: 目的了解四川省成年居民4种健康生活方式的遵循情况和相关影响因素，分析其对全因死亡的潜在健康益处，并提出有针对性的健康促进策略。方法采用多阶段整群抽样的方法，随机抽取四川省8个县(区)，调查参与2015年9月―2019年11月心血管病高危人群早期筛查与综合干预项目的成年居民的4种健康生活方式情况，包括不吸烟、不饮酒或适量饮酒、充足的身体活动、健康饮食。采用多变量回归模型对个人特征与遵循4种健康生活方式的关系进行分析，利用Cox回归模型对全因死亡风险比(hazard ratio, HR)及其95% CI进行估计。结果本研究共纳入36 066名35~＜75岁常住居民，调查对象中不吸烟者占74.6%、不饮酒或适量饮酒者占96.2%、有充足身体活动者占29.2%、遵循健康饮食者占6.2%，仅有2.7%的调查对象遵循上述所有的4种健康生活方式。女性、老年人、非农民、城市居民、高收入或高学历人群、有心血管病史的对象更有可能遵循所有4种健康生活方式(均P＜0.001)。在随访2.4年后发现，坚持≥3种健康生活方式、坚持充足身体活动和不吸烟的人群有更低的全因死亡率风险[调整年龄和性别后，HR=0.47(95% CI: 0.22~0.96), HR=0.63 (95% CI: 0.52~0.75), HR=0.79 (95% CI: 0.64~0.98)]。结论四川省成年居民对充足身体活动和健康饮食的遵循情况不理想，应作为健康促进的重点方向，并针对不同的危险因素采取针对性措施，以取得更好的防控效果。
- 健康生活方式 /
- 死亡率 /
- 健康促进
Abstract: Objective To explore the adherence of four healthy lifestyles, related influencing factors, and potential health benefits for all-cause deaths among adult residents in Sichuan Province, and propose targeted health promotion strategies. Methods Using the multi-stage cluster sampling method, 8 counties (districts) in the province were randomly selected for the four healthy lifestyle conditions of the surveyed residents from 2015 to 2019, including non-smoking, non-drinking or moderate drinking, adequate physical activity, and healthy diet. The relationship between individual characteristics and following the four healthy lifestyle was analyzed using multivariable regression models, and Cox regression models estimated the risk ratios of all-cause deaths (HR) and their 95% confidence intervals. Results A total of 36 066 permanent residents aged 35 to 75 years were included in this study. Among the respondents, 74.6% were non-smokers, 96.2% were non-alcoholic or moderate alcohol, 29.2% had sufficient physical activity, 6.2% followed a healthy diet, and only 2.7% of the respondents followed all the above four healthy lifestyles. Women, the elderly, non-farmers, urban residents, people with high income or high education, or people with a history of cardiovascular disease were more likely to follow all four healthy lifestyles (P < 0.001). After 2.4 years of follow-up, those adhering to three or more healthy lifestyles, adherence to adequate exercise, and non-smoking had lower all-cause mortality [adjusting for age and sex, HR=0.47 (95% CI: 0.22-0.96), HR=0.63 (95% CI: 0.52-0.75), and HR =0.79 (95% CI: 0.64-0.98)]. Conclusions Compliance with adequate physical activity and a healthy diet for adult residents in Sichuan Province is not ideal, which should be the focus of health promotion, and targeted measures should be taken to control different risk factors to achieve better prevention and control effects.
- Healthy lifestyle /
- Mortality /
- Health promotion

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表 1 四川省总体特征和健康生活方式遵循情况

Table 1. Overall characteristics and healthy lifestyle in Sichuan

特征 Characteristic	调查总人数 ^① Total ^① (n=36 066)	遵循健康生活方式的数量 ^① Number of people following healthy lifestyle ^①					F/χ² 值vaule	P值 vaule
特征 Characteristic	调查总人数 ^① Total ^① (n=36 066)	0 (n=505)	1 (n=4 654)	2 (n=19 568)	3 (n=10 121)	4 (n=1 218)	F/χ² 值vaule	P值 vaule
年龄/岁Age /years	58.5±9.5	58.1±9.0	58.8±9.5	58±9.7	59±9.1	59.8±8.9	14.631	＜0.001
已婚Married	32 973(91.4)	466(92.3)	4 231(90.9)	17 963(91.8)	9213(91.0)	1 100(90.3)	9.458	0.194
参加社会医疗保险Participate in social medical insurance	35 575(98.6)	497(98.4)	4 604(98.9)	19 316(98.7)	9 956(98.4)	1 202(98.7)	36.301	0.025
性别Gender
男性Male	13 373(37.1)	489(96.8)	4 304(92.5)	5 925(30.3)	2 400(23.7)	255(20.9)	8 194.212	＜0.001
女性Female	22 693(62.9)	16(3.2)	350(7.5)	13 643(69.7)	7 721(76.3)	963(79.1)
城乡Area
农村Rural	18 824(52.2)	386(76.4)	3 472(74.6)	12 409(63.4)	2 365(23.4)	192(15.8)	6 061.386	＜0.001
城市Urban	17 242(47.8)	119(23.6)	1 182(25.4)	7 159(36.6)	7 756(76.6)	1 026(84.2)
文化程度Education
小学及以下学历Primary school and below	20 293(56.3)	294(58.2)	2 858(61.4)	12 551(64.1)	4 239(41.9)	351(28.8)	5 762.541	＜0.001
初中学历Junior school	10 141(28.1)	144(28.5)	1 219(26.2)	4 735(24.2)	3 588(35.5)	455(37.4)
高中学历senior high school	3 627(10.1)	41(8.1)	376(8.1)	1 409(7.2)	1 504(14.9)	297(24.4)
大学及以上学历College and above	1 534(4.3)	22(4.4)	164(3.5)	617(3.2)	628(6.2)	103(8.5)
职业Occupation
农民Farmer	15 398(42.7)	309(61.2)	2 944(63.3)	10 644(54.4)	1 437(14.2)	64(5.3)	6 028.397	＜0.001
非农民Non-farmers	20 356(56.4)	193(38.2)	1 688(36.3)	8 761(44.8)	8 571(84.7)	1 143(93.8)
家庭年收入/万元Annual household income/ 10 000 yuan
＜1	7 302(20.2)	145(28.7)	1 303(28.0)	4 691(24.0)	1 107(10.9)	56(4.6)	5 764.541	＜0.001
1~＜5	21 301(59.1)	282(55.8)	2 654(57.0)	11 073(56.6)	6 558(64.8)	734(60.3)
≥5	3 471(9.6)	49(9.7)	331(7.1)	1 296(6.6)	1 470(14.5)	325(26.7)
自报疾病史Disease history
有高血压或糖尿病史Hypertension/Diabetes	8 225(22.8)	92(18.2)	981(21.1)	4 327(22.1)	2 502(24.7)	323(26.5)	49.889	＜0.001
有心肌梗塞和中风病史Myocardial infarct/Paralytic stroke	894(2.5)	13(2.6)	149(3.2)	463(2.4)	233(2.3)	36(3.0)	13.556	0.009
注：健康的生活方式被定义为不吸烟、不饮酒或适量饮酒、充足身体活动和健康饮食。 ①以人数(占比/%)或x±s表示。 Note：A healthy lifestyle is defined as not smoking, not drinking alcohol or drinking in moderation, getting enough physical activity, and eating a healthy diet. ① Number of people (proportion/%) or x±s.

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表 2 不同性别、城乡人群遵循健康生活方式的情况

Table 2. Different gender, urban and rural people follow healthy lifestyle

自变量Variable	总数 ^① Total ^① (n=36 066)	女性 ^① Male ^① (n=22 693)	男性 ^① Female ^① (n=13 373)	χ²值 vaule	P_性别值 vaule	农村 ^① Rural ^① (n=18 824)	城市 ^① Urban ^①	χ²值 vaule	P_居住地值 vaule
4种健康生活方式遵循状况Four healthy lifestyles
不吸烟Non-smokers	29 393(74.6)	22 463(98.9)	6 930(51.1)	12 413.811	＜0.001	14 661(72.6)	14 732(76.6)	14 563.497	＜0.001
不饮酒或适量饮酒Non-alcoholic/moderate alcohol	34 956(96.2)	22 356(98.8)	12 600(93.8)	250.420	＜0.001	18 100(95.2)	16 856(97.3)	12 728.385	＜0.001
充足身体活动Sufficient physical activity	12 373(29.2)	8 243(31.7)	4 130(26.8)	110.524	＜0.001	2 851(15.5)	9 522(44.1)	25 331.726	＜0.001
健康饮食Healthy diet	2 303(6.2)	1 589(6.8)	714(5.6)	38.931	＜0.001	541(3.0)	1 762(9.7)	2 7275.900	＜0.001
饮食情况Dietary conditions
每周每天进食水果Eat fruit every day	9 631(27.4)	6 613(31.1)	3 018(23.7)	185.752	＜0.001	2 878(17.9)	6 753(37.7)	23 610.078	＜0.001
每周每天进食蔬菜Eat vegetables every day	28 788(78.9)	18 258(79.9)	10 530(78.0)	15.379	＜0.001	14 349(76.4)	14 439(81.6)	14 888.476	＜0.001
每周每天进食谷物Eat grain every day	5 983(15.3)	3 812(15.7)	2 171(14.9)	1.934	0.164	2 520(12.4)	3 463(18.4)	20 292.117	＜0.001
每周进食豆类≥4 d Eat beans for ≥4 days per week	4 505(12.7)	2 859(12.3)	1 646(13.0)	0.648	0.421	1 198(6.7)	3 307(19.1)	25 803.597	＜0.001
每周进食鱼类≥1 d Fish intake ≥1 day per week	9 253(28.9)	5 832(28.1)	3 421(29.7)	0.062	0.804	3 650(22.1)	5 603(36.4)	20 640.153	＜0.001
每周进食红肉＜7 d Eat red meat for＜7 days per week	6 450(17.1)	4 070(17.6)	2 380(16.7)	0.109	0.741	4 426(22.9)	2 024(10.9)	13 013.846	＜0.001
遵循健康生活方式数量Follow a healthy lifestyle in quantity
0	505(2.0)	16(0.1)	489(3.9)	783.794	＜0.001	386(2.8)	119(1.2)	8 680.554	＜0.001
≥1	35 561(98.0)	22 677(99.9)	12 884(96.1)	783.794	＜0.001	18 438(97.2)	17 123(98.8)	8 680.554	＜0.001
≥2	30 907(79.8)	22 327(98.5)	8 580(61.7)	8 041.933	＜0.001	14 966(74.9)	15 941(85.0)	11 043.562	＜0.001
≥3	11 339(25.7)	8 684(34.0)	2 655(17.8)	1 323.618	＜0.001	2 557(13.1)	8 782(39.6)	72 132.000	＜0.001
4	1 218(2.7)	963(3.7)	255(1.7)	140.808	＜0.001	192(1.1)	1 026(4.4)	30 242.024	＜0.001
注：表中的频次是基于标化前的统计的数据，而百分比则是在2010年全国人口普查数据的基础上对年龄和性别进行标准化后的数据。 ①以人数(占比/%)表示。 Note：The frequency in the table is based on the pre-calibration statistics, while the percentage is based on the age and sex standardization on the basis of the 2010 national census data. ① Number of people (proportion/%).

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表 3 个人特征与健康生活方式之间的相关性

Table 3. Correlations between personal characteristics and a healthy lifestyle

变量variable	不吸烟 Non-smokers OR值value (95% CI)	不饮酒或适量饮酒 Non-alcoholic/moderate alcohol OR值value (95% CI)	充足身体活动 Sufficient physical activity OR值value (95% CI)	健康饮食 Healthy diet OR值value (95% CI)	4种健康生活方式 Four healthy lifestyles OR值value (95% CI)
性别(对照组=女性) Gender (control group=female)
男性Male	0.01(0.01~0.01) ^①	0.67(0.55~0.82) ^①	0.84(0.78~0.90) ^①	0.79(0.70~0.90) ^①	0.38(0.33~0.45) ^①
年龄组/岁(对照组=35~＜45岁) Age group/years (control group=35~＜45 years)
45~＜55	0.93(0.80~1.09)	0.56(0.42~0.74) ^①	1.74(1.57~1.93) ^①	1.11(0.92~1.34)	1.71(1.29~2.27) ^①
55~＜65	1.00(0.86~1.17)	0.55(0.41~0.73) ^①	2.63(2.37~2.92) ^①	1.34(1.11~1.61) ^①	2.48(1.88~3.27) ^①
65~＜75	1.38(1.18~1.62) ^①	0.72(0.53~0.97) ^①	3.14(2.81~3.50) ^①	1.40(1.16~1.70) ^①	3.11(2.34~4.13) ^①
职业(对照组=农民) Occupation (control group=farmer)
非农民Non-farmers	1.18(1.05~1.34) ^①	0.87(0.71~1.06)	3.50(3.23~3.80) ^①	2.05(1.70~2.45) ^①	4.37(3.22~5.92) ^①
文化程度(对照组=小学及以下学历) Education (control group=primary school or below)
初中学历Junior school	1.08(0.98~1.19)	1.08(0.92~1.27)	1.40(1.31~1.49) ^①	1.56(1.38~1.75) ^①	1.69(1.45~1.97) ^①
高中学历Senior high school	1.11(0.97~1.27)	1.03(0.81~1.32)	1.56(1.43~1.71) ^①	2.07(1.80~2.39) ^①	2.42(2.02~2.89) ^①
大学及以上学历College and above	1.54(1.28~1.85) ^①	1.15(0.80~1.63)	2.00(1.75~2.28) ^①	1.82(1.49~2.22) ^①	2.33(1.80~3.00) ^①
家庭年收入/万元(对照组=年收入＜1万元) Annual household income/10 000 yuan (control group=annual income＜10 000 yuan)
1~＜5	1.06(0.96~1.18)	1.05(0.89~1.24)	1.18(1.09~1.29) ^①	1.54(1.28~1.85) ^①	1.79(1.34~2.39) ^①
≥5	1.09(0.93~1.28)	0.88(0.67~1.16)	1.29(1.15~1.45) ^①	2.40(1.94~2.96) ^①	2.84(2.08~3.88) ^①
婚姻状况(对照组=未婚) Marital status(control group=unmarried)
已婚Married	1.33(1.14~1.55)	0.94(0.73~1.19)	1.03(0.93~1.14)	0.98(0.83~1.17)	0.97(0.78~1.20)
社会医疗保险(对照组=未参保) Social medical insurance (control group=uninsured)
参保Insured	1.31(0.80~2.13)	1.17(0.56~2.42)	1.33(0.96~1.84)	0.72(0.44~1.19)	1.15(0.52~2.56)
代谢疾病(对照组=否) Metabolic disease (control group=no)
是Yes	0.99(0.91~1.09)	1.32(1.12~1.55) ^①	1.23(1.16~1.32) ^①	1.04(0.93, ~1.17)	1.14(0.99~1.31)
心血管病患病史(对照组=否) Cardiovascular patient history (control group=no)
是Yes	0.67(0.54~0.84) ^①	1.06(0.72~1.57)	1.11(0.93~1.32) ^①	1.43(1.08~1.91) ^①	1.52(1.07~2.18) ^①
居住地(对照组=农村) Residence(control group=rural)
城市Urban	1.35(0.65~2.80)	1.39(0.79~2.47)	5.09(2.26~11.5) ^①	1.59(0.89~2.85) ^①	2.66(1.69~4.17) ^①
注：① P＜0.05。 Note: ① P＜0.05.

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表 4 全因死亡的危险比值

Table 4. Hazard ratio of all-cause death

变量Variable	HR值value(95% CI)	P值vaule
不做调整No adjustment
健康生活方式数量(参照组=0) Number of healthy lifestyles (ref=0)
1	1.07(0.59~1.95)	0.816
2	0.65(0.36~1.15)	0.140
3	0.42(0.23~0.76)	0.004 ^①
4	0.39(0.18~0.85)	0.017 ^①
不吸烟Non-smokers	0.52(0.44~0.62)	＜0.001 ^①
不饮酒或适量饮酒Non-alcoholic/moderat alcohol	0.91(0.57~1.43)	0.674
充足身体活动Sufficient physical activity	0.66(0.55~0.79)	＜0.001 ^①
健康饮食Healthy diet	0.72(0.50~1.05)	0.088
调整年龄和性别Adjusting for age and gender
健康生活方式数量(参照组=0) Number of healthy lifestyles (ref=0)
1	1.01(0.56~1.84)	0.965
2	0.84(0.47~1.50)	0.546
3	0.54(0.29~0.98)	0.044 ^①
4	0.47(0.22~0.96)	0.041 ^①
不吸烟Non-smokers	0.79(0.64~0.98)	0.029 ^①
不饮酒或适量饮酒Non-alcoholic/moderat alcohol	1.04(0.66~1.65)	0.854
充足身体活动Sufficient physical activity	0.63(0.52~0.75)	＜0.001 ^①
健康饮食Healthy diet	0.74(0.51~1.07)	0.109
注：① P＜0.05。 Note: ① P＜0.05.

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特征 Characteristic	调查总人数 ^① Total ^① (n=36 066)	遵循健康生活方式的数量 ^① Number of people following healthy lifestyle ^①					F/χ² 值vaule	P值 vaule
特征 Characteristic	调查总人数 ^① Total ^① (n=36 066)	0 (n=505)	1 (n=4 654)	2 (n=19 568)	3 (n=10 121)	4 (n=1 218)	F/χ² 值vaule	P值 vaule
年龄/岁Age /years	58.5±9.5	58.1±9.0	58.8±9.5	58±9.7	59±9.1	59.8±8.9	14.631	＜0.001
已婚Married	32 973(91.4)	466(92.3)	4 231(90.9)	17 963(91.8)	9213(91.0)	1 100(90.3)	9.458	0.194
参加社会医疗保险Participate in social medical insurance	35 575(98.6)	497(98.4)	4 604(98.9)	19 316(98.7)	9 956(98.4)	1 202(98.7)	36.301	0.025
性别Gender
男性Male	13 373(37.1)	489(96.8)	4 304(92.5)	5 925(30.3)	2 400(23.7)	255(20.9)	8 194.212	＜0.001
女性Female	22 693(62.9)	16(3.2)	350(7.5)	13 643(69.7)	7 721(76.3)	963(79.1)
城乡Area
农村Rural	18 824(52.2)	386(76.4)	3 472(74.6)	12 409(63.4)	2 365(23.4)	192(15.8)	6 061.386	＜0.001
城市Urban	17 242(47.8)	119(23.6)	1 182(25.4)	7 159(36.6)	7 756(76.6)	1 026(84.2)
文化程度Education
小学及以下学历Primary school and below	20 293(56.3)	294(58.2)	2 858(61.4)	12 551(64.1)	4 239(41.9)	351(28.8)	5 762.541	＜0.001
初中学历Junior school	10 141(28.1)	144(28.5)	1 219(26.2)	4 735(24.2)	3 588(35.5)	455(37.4)
高中学历senior high school	3 627(10.1)	41(8.1)	376(8.1)	1 409(7.2)	1 504(14.9)	297(24.4)
大学及以上学历College and above	1 534(4.3)	22(4.4)	164(3.5)	617(3.2)	628(6.2)	103(8.5)
职业Occupation
农民Farmer	15 398(42.7)	309(61.2)	2 944(63.3)	10 644(54.4)	1 437(14.2)	64(5.3)	6 028.397	＜0.001
非农民Non-farmers	20 356(56.4)	193(38.2)	1 688(36.3)	8 761(44.8)	8 571(84.7)	1 143(93.8)
家庭年收入/万元Annual household income/ 10 000 yuan
＜1	7 302(20.2)	145(28.7)	1 303(28.0)	4 691(24.0)	1 107(10.9)	56(4.6)	5 764.541	＜0.001
1~＜5	21 301(59.1)	282(55.8)	2 654(57.0)	11 073(56.6)	6 558(64.8)	734(60.3)
≥5	3 471(9.6)	49(9.7)	331(7.1)	1 296(6.6)	1 470(14.5)	325(26.7)
自报疾病史Disease history
有高血压或糖尿病史Hypertension/Diabetes	8 225(22.8)	92(18.2)	981(21.1)	4 327(22.1)	2 502(24.7)	323(26.5)	49.889	＜0.001
有心肌梗塞和中风病史Myocardial infarct/Paralytic stroke	894(2.5)	13(2.6)	149(3.2)	463(2.4)	233(2.3)	36(3.0)	13.556	0.009
注：健康的生活方式被定义为不吸烟、不饮酒或适量饮酒、充足身体活动和健康饮食。 ①以人数(占比/%)或x±s表示。 Note：A healthy lifestyle is defined as not smoking, not drinking alcohol or drinking in moderation, getting enough physical activity, and eating a healthy diet. ① Number of people (proportion/%) or x±s.

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四川省3.6万成年居民健康生活方式遵循情况

doi: 10.16462/j.cnki.zhjbkz.2024.06.007

通讯作者:
王卓，E-mail: alice_wangzhuo@qq.com

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The healthy lifestyle compliance of 36 000 adult residents in Sichuan Province

Corresponding author: WANG Zhuo, E-mail: alice_wangzhuo@qq.com

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留言板

四川省3.6万成年居民健康生活方式遵循情况

doi: 10.16462/j.cnki.zhjbkz.2024.06.007

通讯作者: 王卓，E-mail: alice_wangzhuo@qq.com

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The healthy lifestyle compliance of 36 000 adult residents in Sichuan Province

Corresponding author: WANG Zhuo, E-mail: alice_wangzhuo@qq.com

计量

出版历程

目录

通讯作者:
王卓，E-mail: alice_wangzhuo@qq.com