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河南省郏县老年女性糖尿病患者妊娠次数和生活方式与心血管疾病患病关系横断面调查

Relationships of the number of pregnancies and lifestyle with the prevalence of cardiovascular diseases among elderly female diabetic patients in Jiaxian county, Henan province：a cross-sectional survey

    摘要
  • 摘要:
    目的 了解河南省郏县老年女性糖尿病患者妊娠次数和生活方式与心血管疾病（CVD）患病的关系，为制定个体化CVD预防策略提供科学依据。
    方法 于2023年7月1日—8月31日采用整群抽样方法在河南省郏县15个乡镇卫生院/社区卫生服务中心抽取21 379名≥65岁且在该地区居住≥6个月的就诊患者进行问卷调查。排除生活方式信息不全、男性和非糖尿病患者后最终纳入4 133例老年女性糖尿病患者进行分析。应用多因素非条件logistic回归模型分析该地区老年女性糖尿病患者妊娠次数和生活方式与CVD患病的关系。
    结果 河南省郏县纳入分析的4 133例老年女性糖尿病患者中，患CVD者1 712例，CVD患病率为41.4%；妊娠≤2次者1 099例（26.6%），3次者1 190例（28.8%），≥4次者1 844例（44.6%）；生活方式不健康者2 183例（52.8%），健康者1 950例（47.2%）。在调整年龄、民族、文化程度、婚姻状况和家庭年收入等混杂因素后，多因素非条件logistic回归分析结果显示，河南省郏县生活方式不健康老年女性糖尿病患者CVD患病风险为生活方式健康老年女性糖尿病患者的1.521倍（95%CI=1.341～1.726）；交互作用分析结果显示，妊娠≤2次但生活方式不健康老年女性糖尿病患者CVD患病风险为妊娠≤2次且生活方式健康老年女性糖尿病患者的1.432倍（95%CI=1.121～1.829），妊娠3次且生活方式不健康老年女性糖尿病患者CVD患病风险为妊娠≤2次且生活方式健康老年女性糖尿病患者的1.571倍（95%CI=1.237～1.996），妊娠≥4次且生活方式不健康老年女性糖尿病患者CVD患病风险为妊娠≤2次且生活方式健康老年女性糖尿病患者的1.674倍（95%CI=1.340～2.091）。
    结论 妊娠次数和不健康的生活方式存在相乘协同作用，可增加河南省郏县老年女性糖尿病患者CVD的患病风险。

     

    Abstract:
    Objective To understand the relationships of the number of pregnancies and lifestyle with the prevalence of cardiovascular diseases (CVD) among elderly female diabetic patients in Jiaxian county, Henan province and provide a scientific basis for developing individualized CVD prevention strategies.
    Methods From July 1 to August 31, 2023, a cluster sampling method was employed to conduct a questionnaire survey among 21 379 patients aged ≥ 65 years who had lived in Jiaxian county, Henan province for at least six months and treated in 15 township hospitals or community health service centers. After individuals with incomplete lifestyle information, males, and non-diabetic patients were excluded, a total of 4 133 elderly female diabetic patients were included in the final analysis. A multivariable unconditional logistic regression model was adopted to examine the associations of the number of pregnancies and lifestyle with the prevalence of CVD among these patients.
    Results Among the 4 133 elderly female diabetic patients included in the analysis from Jiaxian county, Henan province, 1 712 were diagnosed with CVD, resulting in a CVD prevalence of 41.4%. A total of 1 099 (26.6%), 1 190 (28.8%), and 1 844 (44.6%) patients had ≤ 2, 3, and ≥ 4 pregnancies, respectively. Regarding lifestyle, 2 183 (52.8%) patients were classified as having an unhealthy lifestyle, while 1 950 (47.2%) had a healthy lifestyle. After adjustment for confounding factors such as age, ethnicity, education background, marital status, and annual household income, multivariable unconditional logistic regression analysis showed that the elderly female diabetic patients with an unhealthy lifestyle had a 1.521-fold higher risk of CVD compared to those with a healthy lifestyle (OR = 1.521, 95%CI: 1.341–1.726). Interaction analysis further revealed that compared to the patients with ≤ 2 pregnancies and a healthy lifestyle, those with ≤ 2 pregnancies and an unhealthy lifestyle had a 1.432-fold higher risk of CVD (OR = 1.432, 95%CI: 1.121–1.829), those with 3 pregnancies and an unhealthy lifestyle had a 1.571-fold higher risk (OR = 1.571, 95%CI: 1.237–1.996), and those with ≥ 4 pregnancies and an unhealthy lifestyle had a 1.674-fold higher risk (OR = 1.674, 95%CI: 1.340–2.091).
    Conclusions A multiplicative interaction was observed between the number of pregnancies and unhealthy lifestyle, contributing to an elevated risk of CVD among elderly female diabetic patients in Jiaxian county, Henan province.

     

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