Relationship between lifestyle risk factors and comorbidity of chronic diseases among male elderly populations in Oroqen Autonomous Banner
ZHANG Ziwei1, HUA Yumeng1, CHEN Yangyang1, MA Xiaochuan1, HAN Bingjie2, LIU Aiping1
1. Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China; 2. Dayangshu Community Health Service Center of Oroqen Autonomous Banner, Hulun Buir, Inner Mongolia 165456, China
Abstract：Objective To investigate the association between lifestyle risk factors and comorbidity of chronic diseases among male elderly populations in Oroqen Autonomous Banner, Inner Mongolia Autonomous Region, so as to provide insights into improvements of lifestyles and prevention of comorbidity of chronic diseases among male elderly populations. Methods Male residents at ages of 65 years and older that participated in community healthy examinations were sampled from 16 villages (communities) in Oroqen Autonomous Banner using a multi-stage cluster random sampling method from July to December, 2020. Participants' demographic data, lifestyle risk factors and disease history were collected using questionnaire surveys, and healthy examinations data were collected through the grassroots healthcare service information system for community health service centers, including waist circumference, blood pressure, fasting blood glucose and blood lipid. The correlation between lifestyle risk factors and comorbidity of chronic diseases were examined among males at ages of 65 years and older using a multivariable ordered logistic regression model. Results Totally 761 male elderly populations were included, with a mean age of (73.61±6.74) years. There were 216 participants with central obesity (28.38%), 179 with smoking (23.52%), 194 with alcohol consumption (25.49%), 412 with a low frequency of physical activities (54.14%), 347 with one type of lifestyle risk factor (45.60%) and 268 with two and more types of lifestyle risk factors (35.22%), 404 with hypertension, 170 with diabetes and 321 with dyslipidemia. There were 347 participants with one type of chronic disease (45.60%), 199 with two types of chronic diseases (26.15%) and 50 with three types of chronic diseases (6.57%), and the prevalence of comorbidity of chronic diseases was 32.72% among the participants. Multivariable ordered logistic regression analysis showed an increased risk of developing comorbidity of chronic diseases among participants with central obesity (OR=2.442, 95%CI: 1.804-3.307), and a reduced risk of comorbidity of chronic diseases among participants with less than two types of lifestyle risk factors (one type, OR=0.607, 95%CI: 0.451-0.820; none, OR=0.675, 95%CI: 0.460-0.990). Conclusions Central obesity and number of lifestyle risk factors are factors affecting comorbidity of chronic diseases among the male elderly populations at ages of 65 years and older in Oroqen Autonomous Banner.
 刘帅帅,张露文,陆翘楚,等.中国中老年人多重慢性病现状调查与健康损失因素探究:基于CHARLS 2018数据[J].实用医学杂志,2021,37(4):518-524. LIU S S,ZHANG L W,LU Q C,et al.The prevalence of multimorbidity and related functional limitation among middle-aged and senior population in China:nationally evidence from CHARLS 2018[J].J Pract Med,2021,37(4):518-524.  蔺婧,徐富升,刘建康,等.我国老年人睡眠时间与心肺疾病的关联性研究[J].中国慢性病预防与控制,2022,30(4):256-260. LIN J,XU F S,LIU J K,et al.Correlation between sleep duration and cardiopulmonary diseases among elderly in China[J].Chin J Prev Contr Chron Dis,2022,30(4):256-260.  ROSAMOND W,FLEGAL K,FRIDAY G,et al.Heart disease and stroke statistics-2007 update:a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee[J].Circulation,2007,115:e69-e171.  GU J,CHAO J,CHEN W,et al.Multimorbidity in the community-dwelling elderly in urban China[J].Arch Gerontol Geriatr,2017,68:62-67.  NUNES B P,FLORES T R,MIELKE G I,et al.Multimorbidity and mortality in older adults:a systematic review and meta-analysis[J].Arch Gerontol Geriatr,2016,67:130-138.  BARNETT K,MERCER S W,NORBURY M,et al.Epidemiology of multimorbidity and implications for health care,research,and medical education:a cross-sectional study[J].Lancet,2012,380(9836):37-43.  TUGWELL P,KNOTTNERUS J A.Multimorbidity and Comorbidity are now separate MESH headings[J].J Clin Epidemiol,2019,105:Ⅵ-Ⅷ.  HAN Y,HU Y,YU C,et al.Lifestyle,cardiometabolic disease,and multimorbidity in a prospective Chinese study[J].Eur Heart J,2021,42(34):3374-3384.  金琇泽,路云.中国老年人共病状况及其对医疗卫生支出的影响研究[J].中国全科医学,2019,22(34):4166-4172. JIN X Z,LU Y.Prevalence of comorbidity among the elderly and its impact on healthcare expenditure in China[J].Chin Gen Pract,2019,22(34):4166-4172.  中国高血压防治指南修订委员会,高血压联盟(中国),中华医学会心血管病学分会,等.中国高血压防治指南(2018年修订版)[J].中国心血管杂志,2019,24(1):24-56. Writing Group of 2018 Chinese Guidelines for the Management of Hypertension,Chinese Hypertension League,Chinese Society of Cardiology,et al.2018 Chinese guidelines for the management of hypertension[J].Chin J Cardiovasc Med,2019,24(1):24-56.  中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华糖尿病杂志,2021,13(4):315-409. Chinese Diabetes Society.Guidelines for the prevention and control of type 2 diabetes in China(2020 editon)[J].Chin J Diabetes Mellit,2021,13(4):315-409.  中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-953. Joint Committee Issued Chinese Guideline for the Management of Dyslipidemia in Adults.2016 Chinese guideline for the management of dyslipidemia in adults[J].Chin Circ J,2016,31(10):937-953.  中华人民共和国卫生部.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社,2006. Ministry of Health of the People's Republic of China.Guidelines for the prevention and control of overweight and obesity in adults in China[M].Beijing:People's Medical Publishing House,2006.  World Health Organisation.Guidelines for controlling and monitoring the tobacco epidemic[M].Geneva:World Health Organisation,1997.  PELLINO T A,WILLENS J,POLOMANO R C,et al.The American Society of Pain Management Nurses practice analysis:role delineation study[J].Pain Manag Nurs,2002,3(1):2-15.  HUANG Z T,LUO Y,HAN L,et al.Patterns of cardiometabolic multimorbidity and the risk of depressive symptoms in a longitudinal cohort of middle-aged and older Chinese[J/OL].J Affect Disord,2022,301[2022-08-26].http://doi.org/10.1016/j.jad.2022.01.030.  张美霞,邓俊芬,隋小帆,等.内蒙古中西部地区老年高脂血症流行病学调查研究[J].中国预防医学杂志,2020,21(11):1201-1204. ZHANG M X,DENG J F,SUI X F,et al.Epidemiological characteristics of hyperlipidemia in the elderly in central and western Inner Mongolia[J].Chin Prev Med,2020,21(11):1201-1204.  SMITH U.Abdominal obesity:a marker of ectopic fat accumulation[J].J Clin Invest,2015,125(5):1790-1792.  郑帅印,李富业,谢尔瓦妮古丽·阿卜力米提,等.克拉玛依市35~75岁体检人群高血压、糖尿病、血脂异常调查[J].预防医学,2022,34(3):232-239.  吴梦怡,胡劲松,黄霜,等.湖南省30岁及以上社区居民高血压、糖尿病、高血脂共病的影响因素分析[J].预防医学,2021,33(2):157-161. WU M Y,HU J S,HUANG S,et al.Prevalence and comorbidity factors of hypertension,diabetes and hyperlipidemia among community residents aged 30 years or over in Hunan Province[J].Prev Med,2021,33(2):157-161.  DE ALMEIDA M G N,NASCIMENTO-SOUZA M A,LIMA-COSTA M F,et al.Lifestyle factors and multimorbidity among older adults(ELSI-Brazil)[J].Eur J Ageing,2020,17(4):521-529.  HINNOUHO G M,CZERNICHOW S,DUGRAVOT A,et al.Metabolically healthy obesity and risk of mortality:does the definition of metabolic health matter?[J].Diabetes Care,2013,36(8):2294-2300.