首頁資訊中國中老年人綜合生活方式與心臟代謝性共病之間的關聯性探究：基于CHARLS的橫斷面研究

中國中老年人綜合生活方式與心臟代謝性共病之間的關聯性探究：基于CHARLS的橫斷面研究

來源：泰然健康網時間：2025年09月25日 21:19

摘要： 背景　隨著我國人口老齡化發(fā)展加劇，中老年人群體中心臟代謝性疾病的共病率逐漸增高，國內現有關注綜合生活方式與心臟代謝性共病的關聯性研究較少。目的　了解我國中老年人(≥45歲)心臟代謝性疾病的共病情況，探究該群體中綜合生活方式與心臟代謝性共病之間的關聯。方法　利用2018年《中國健康與養(yǎng)老追蹤調查》 (CHARLS)的數據，選取45歲及以上的中老年人作為研究對象，了解中老年群體中心臟代謝性疾病的共患病情況。通過構建綜合生活方式指標（吸煙、飲酒、身體活動、睡眠、社會聯系），利用Logistic回歸模型探究綜合生活方式與心臟代謝性共病之間的關聯。結果　在納入的19,459名中老年人中，高血壓共病例數為4,548人(23.42%)，同時患有2種及以上心臟代謝性疾病的有5,443人（28.0%）。26.7%的中老年人堅持4-5種健康生活方式(即不吸煙、適度飲酒、定期身體活動、健康睡眠、適當社會聯系)，65.7%的中老年人有中等健康的生活方式，7.6%的中老年人有不健康的生活方式。年齡（55~<65：OR=1.83,95%CI=1.67-2.00，p<0.001;65~<75：OR=2.89,95%CI=2.64-3.16，p<0.001；≥75：OR=3.05,95%CI=2.74~3.40，p<0.001）、性別（男性：OR=0.83,95%CI=0.78-0.89，p<0.001）、教育程度（高中及以上：OR=1.38,95%CI=1.25-1.52，p<0.001）、婚姻狀況（已婚：OR=0.70,95%CI=0.64-0.76，p<0.001）、居住地類型（農村：OR=0.67,95%CI=0.63-0.72，p<0.001）、醫(yī)療保險（有：OR=1.57,95%CI=1.28-1.93，p<0.001）是中老年人心臟代謝性共病的患病影響因素，P<0.001。Logistic回歸分析結果顯示，調整混雜因素后，健康的生活方式與較低的心臟代謝性共病患病風險相關（OR=0.59, 95%CI：0.52-0.66）。按照居住類類型（農村OR=0.58，p<0.001；城鎮(zhèn)OR=0.61，p<0.001）、性別（男性OR=0.44，p<0.001；女性OR=0.71，p<0.05）以及年齡（≥65歲OR=0.44，p<0.001；<65歲=0.69，p<0.001）進行分層分析，研究結果均顯示健康的生活方式與更低的心臟代謝性共病患病風險相關。結論　堅持健康的生活方式與我國中老年人心臟代謝性共病的患病率降低有關。加強對中老年人的生活方式干預，能夠提高我國中老年人的心血管健康水平，對促進健康老齡化具有重要意義。

關鍵詞: 心臟代謝性共病, 中老年人, 生活方式, Logistic回歸分析

Abstract: Background　With the increasing aging people in China, the prevalence of cardiometabolic multimorbidity among middle-aged and elderly individuals is gradually rising. There are fewer studies in China that focus on the association between integrate lifestyle and cardiometabolic multimorbidity in the middle-aged and elderly people. Objective　To investigate the prevalence of cardiometabolic comorbidities among Chinese adults aged 45 years and older, and to explore the association between integrate lifestyle factors and cardiometabolic comorbidities in this population. Methods　Data were obtained from the China Health and Retirement Longitudinal Study 2018 (CHARLS 2018), targeting individuals aged 45 and above. The prevalence of cardiometabolic comorbidities in this population was assessed. A comprehensive lifestyle index was constructed, incorporating smoking, alcohol consumption, physical activity, sleep, and social connections. Logistic regression models were used to investigate the association between these lifestyle factors and cardiometabolic comorbidities. Results　Among the 19,459 middle-aged and elderly individuals included, 4,548 (23.42%) had hypertension, and 5,443 (28.0%) had two or more cardiometabolic diseases. A total of 26.7% of participants adhered to 4-5 healthy lifestyle practices (i.e., non-smoking, moderate alcohol consumption, regular physical activity, healthy sleep, and adequate social connections), 65.7% had moderately healthy lifestyles, and 7.6% had unhealthy lifestyles. Age (55 to <65 years: OR=1.83, 95% CI=1.67-2.00, p<0.001; 65 to <75 years: OR=2.89, 95% CI=2.64-3.16, p<0.001; ≥75 years: OR=3.05, 95% CI=2.74-3.40, p<0.001), gender (male: OR=0.83, 95% CI=0.78-0.89, p<0.001), educational level (high school or above: OR=1.38, 95% CI=1.25-1.52, p<0.001), marital status (married: OR=0.70, 95% CI=0.64-0.76, p<0.001), residential type (rural: OR=0.67, 95% CI=0.63-0.72, p<0.001), and health insurance (insured: OR=1.57, 95% CI=1.28-1.93, p<0.001) were significant factors influencing the prevalence of cardiometabolic comorbidities (p<0.001). Logistic regression analysis revealed that, after adjusting for confounding factors, a healthy lifestyle was associated with a significantly lower risk of cardiometabolic comorbidities (OR=0.59, 95% CI=0.52-0.66). Stratified analyses by residential type (rural OR=0.58, p<0.001; urban OR=0.61, p<0.001), gender (male OR=0.44, p<0.001; female OR=0.71, p<0.05), and age (≥65 years OR=0.44, p<0.001; <65 years OR=0.69, p<0.001) consistently showed that a healthy lifestyle was associated with a reduced risk of cardiometabolic comorbidities. Conclusion　Adherence to a healthy lifestyle is associated with a reduced prevalence of cardiometabolic comorbidities among middle-aged and older adults in China. Strengthening lifestyle interventions in this population could improve cardiovascular health and contribute significantly to promoting healthy aging in China.

Key words: Cardiometabolic multimorbidity, Middle-aged elderly people, Lifestyle, Logistic regression analysis