本文選題：成年早期 + 體重改變　； 參考：《廣州醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:體重的變化是影響慢性疾病發(fā)病的重要因素,其對疾病的影響相對滯后,從體重開始明顯增加到出現(xiàn)相應(yīng)疾病可能需要數(shù)年甚至十年以上,成年早期的體重改變可能會增加晚年時期罹患高血壓、糖尿病等慢性疾病的風(fēng)險,尤其是對于生活在一個經(jīng)歷過改革開放,生活條件、生活方式明顯改變的國家的人們,生活條件的改善導(dǎo)致體型發(fā)生變化,進而可能會增加晚年罹患高血壓、糖尿病的風(fēng)險,而目前對于這方面的研究較少。為此,本研究利用《廣州生物庫隊列研究》(Guangzhou biobank cohort study,GBCS)三期基線資料,探討成年后體重變化、出現(xiàn)體重變化的年齡等與晚年高血壓、糖尿病的相關(guān)性。方法:基于“廣州生物庫隊列研究”(GBCS)平臺,選取其中28926例50歲以上廣州中老年人為研究對象,通過問卷調(diào)查收集一般人口學(xué)資料,成年后(18歲)體重改變,保持最重體重的年齡等。利用協(xié)方差分析探討成年后體重改變、體質(zhì)指數(shù)(晚年體型)與收縮壓、舒張壓、平均動脈壓、脈壓差、空腹血糖等的相關(guān)性。采用多因素Logistic回歸模型,分析調(diào)整年齡、吸煙、飲酒、體力活動、教育程度、職業(yè)、居住地、體質(zhì)指數(shù)后成年后體重變化、保持最重體重時的年齡等與高血壓、糖尿病的關(guān)系。結(jié)果:研究對象平均年齡男性64.3±6.7歲,女性61.0±7.0歲,高血壓患病率男性(46.3%)高于女性(42.6%),糖尿病患病率男女基本一致(13.0%和13.6%)。成年后體重改變、體質(zhì)指數(shù)與血壓、血糖水平密切相關(guān),二者對男性收縮壓、舒張壓、平均動脈壓的影響具有交互作用,對女性舒張壓、平均動脈壓的影響具有交互作用。男女高血壓患病風(fēng)險均隨其成年后體重的增加而增加(趨勢檢驗P0.01),與體重基本不變組比,成年后體重增加20Kg以上組晚年高血壓患病風(fēng)險最高,風(fēng)險比分別為男性1.92(95%CI:1.55,2.38)和女性1.49(1.29,1.73)。保持最重體重的年齡與高血壓患病風(fēng)險相關(guān),以40至49歲達到最重體重組晚年高血壓患病風(fēng)險最高,風(fēng)險比分別為男性1.83(95%CI:1.17,2.85),女性1.69(1.41,2.03)。僅女性成年后體重減少與晚年患高血壓風(fēng)險下降有關(guān)。男女糖尿病患病風(fēng)險均隨其成年后體重增加而增加(趨勢檢驗P0.01),與體重基本不變組比,成年后體重增加20Kg以上組晚年患糖尿病風(fēng)險最高,風(fēng)險比分別為男性2.84(95%CI:2.02,3.99)和3.30(2.61,4.17)。保持最重體重的年齡也與糖尿病患病風(fēng)險相關(guān),以40至49歲達到最重體重組晚年糖尿病患病風(fēng)險最高,風(fēng)險比分別為男性4.32(95%CI:1.72,10.8),女性3.29(2.41,4.49)。男女成年后體重減少僅與晚年自報已患糖尿病有關(guān),與基線調(diào)查新發(fā)現(xiàn)糖尿病無關(guān)。結(jié)論:成年后體重增加可增加晚年高血壓、糖尿病的患病風(fēng)險,且患病風(fēng)險有隨體重增加而增加的趨勢,以40至49歲達到最重體重組晚年高血壓、糖尿病患病風(fēng)險最高,出現(xiàn)明顯增重到發(fā)生高血壓、糖尿病可能相隔10至20年。研究結(jié)果提示肥胖的防治工作應(yīng)提前,同時應(yīng)關(guān)注40~49歲年齡段人群的健康問題,保持一個相對勻稱的體型和相對穩(wěn)定的體重對預(yù)防慢性疾病的發(fā)生至關(guān)重要。
[Abstract]:Objective: the change of body weight is an important factor affecting the incidence of chronic diseases. Its impact on the disease is relatively lagging. It may take years or even more than ten years to increase the weight from the beginning of the body weight to the corresponding disease. The early adult weight change may increase the risk of chronic diseases such as high blood pressure and diabetes in the late years, especially in the late years. For people living in a country that has experienced reform and opening up, living conditions, and a significant change in life style, the improvement of living conditions leads to a change in body shape, which may increase the risk of hypertension and diabetes in the late years, and there are few studies on this. For this reason, this study uses the Guangzhou biologic database cohort study ( Guangzhou Biobank Cohort study, GBCS) three phase baseline data, to explore the relationship between body weight change, age of body weight change and age of hypertension and diabetes in late years. Methods: Based on the "Guangzhou biologic database cohort study" (GBCS) platform, 28926 of the subjects aged 50 and above were selected and investigated by questionnaire. The correlation between body weight change, body mass index (late year shape) and systolic pressure, diastolic pressure, mean arterial pressure, poor pulse pressure, and fasting blood glucose were investigated by covariance analysis. The multiple factor Logistic regression model was used to analyze age, smoking, and the correlation between body mass index (body mass index) and systolic pressure, diastolic pressure, mean arterial pressure, poor pulse pressure, and fasting blood glucose. The relationship between alcohol consumption, physical activity, education, occupation, residence, body mass index after adult weight change and the age of the heaviest weight was associated with hypertension and diabetes. Results: the average age of the male was 64.3 + 6.7 years, the female was 61 + 7 years old, the male (46.3%) of the hypertensive patients (46.3%) was higher than that of the female (42.6%), and the prevalence rate of diabetes was in the male and female basis. This Agreement (13% and 13.6%). Body weight change after adult, body mass index is closely related to blood pressure and blood glucose level. The two have interaction effect on male systolic pressure, diastolic pressure and mean arterial pressure. The influence on diastolic pressure and mean arterial pressure has interaction. The risk of male and female hypertension is all with the increase of weight after adult. The increase (trend test P0.01), compared with the basic body weight group, was the highest risk of high blood pressure in later years of adult body weight gain and more than 20Kg. The risk ratio was 1.92 (95%CI:1.55,2.38) and 1.49 (1.29,1.73) for women respectively. The age of maintaining the heaviest weight was associated with the risk of hypertension, and reached the most heavy body of high blood pressure from 40 to 49 years old. The risk was the highest, the risk ratio was 1.83 (95%CI:1.17,2.85) and 1.69 (1.41,2.03) for women. Only female adult weight loss was associated with lower risk of hypertension in later years. The risk of diabetes in both men and women increased with the increase of adult weight (trend test P0.01), compared with the basic body weight group, and the weight of adult increased by 20Kg. The highest risk of diabetes in the upper group was 2.84 (95%CI:2.02,3.99) and 3.30 (2.61,4.17), respectively. The age of maintaining the heaviest weight was also associated with the risk of diabetes, and the highest risk of diabetes in the most severe reorganized age of 40 to 49 years was 4.32 (95%CI:1.72,10.8) and 3.29 (2.41,4.49) for women respectively. The weight loss of men and women is associated with diabetes in the later years and is not related to diabetes in the later years. Conclusion: the increase in weight can increase the risk of late age and diabetes, and the risk of diabetes increases with the increase of weight, from 40 to 49 years old to the heaviest body of late years of high blood pressure, diabetic patients. The highest risk of disease, a significant increase in weight to high blood pressure, and diabetes may be separated from 10 to 20 years. The results of the study suggest that the prevention and treatment of obesity should be ahead of time. At the same time, we should pay attention to the health problems of the 40~49 age group, and maintain a relatively symmetrical body shape and relatively stable weight to prevent the occurrence of chronic diseases.

【學(xué)位授予單位】：廣州醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R544.1;R587.1

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