本文選題：社會經(jīng)濟(jì)地位 + 教育程度�。� 參考：《北京協(xié)和醫(yī)學(xué)院》2015年碩士論文

【摘要】：研究背景代謝綜合征(Metabolic Syndrome, MS),作為心血管疾病等慢性疾病的重要危險因素,已成為全球性公共衛(wèi)生問題。近年來,我國MS患病率逐年增高,嚴(yán)重威脅到我國人群的健康,造成了巨大的疾病負(fù)擔(dān)。國外已有大量的流行病學(xué)研究證實(shí)社會經(jīng)濟(jì)地位(Socioeconomic Status, SES)是MS重要的危險因素。而國內(nèi)相關(guān)的研究證據(jù)較為缺乏,且都是一些局部地區(qū)的橫斷面調(diào)查,結(jié)果也并不一致。本研究利用大樣本的前瞻性隨訪研究的數(shù)據(jù),探討中國成年人群SES與MS發(fā)病風(fēng)險的關(guān)系。研究方法本研究以參加中國心血管病流行病學(xué)多中心協(xié)作研究和中國心血管健康多中心合作研究的27020名35-74歲成人作為研究對象。基線調(diào)查分別開始于1 998年和2000-2001年,收集研究對象的人口學(xué)特征、社會經(jīng)濟(jì)狀況和生活方式等資料,并進(jìn)行體格檢查和生化指標(biāo)檢測。2007-2008年進(jìn)行隨訪調(diào)查,收集MS患病情況和其他相關(guān)信息。最終有12608名(男性6112名,女性6496名)研究對象符合要求并納入分析。本研究使用受教育水平、收入水平和職業(yè)類型作為SES的衡量指標(biāo),并且依據(jù)三者的評分構(gòu)建SES復(fù)合指標(biāo),用三分位法將其分成低(4)、中(4-8)和高(8)三個組。應(yīng)用二分類logistic回歸模型分析受教育水平、收入水平、職業(yè)類型以及SES復(fù)合指標(biāo)與MS發(fā)病風(fēng)險的關(guān)系。研究結(jié)果本研究平均隨訪8.1年,共新發(fā)2716例MS(男性1151例,女性1 565例)。多因素調(diào)整后,在女性中,以未上學(xué)者作為參照,小學(xué)、初中、高中/中專和大專及以上者M(jìn)S發(fā)病風(fēng)險的相對危險度(Relative Ratio, RR)及其95%置信區(qū)間(Confidence Interval, CI)分別為1.19(0.99-1.44)、1.13(0.92-1.41)、0.81(0.63-1.04)和0.54(0.38-0.75),P趨勢0.001；受教育水平與男性MS發(fā)病風(fēng)險的關(guān)系無統(tǒng)計(jì)學(xué)意義。多因素調(diào)整后,在男性中,與家庭人均月收入300元者相比,收入水平為300-499元、500-799元、800-1199元、1200元者M(jìn)S發(fā)病風(fēng)險的RR (95%CI)分別為1.20(1.01-1.43)、1.35(1.11-1.62)、1.37(1.07-1.74)和1.58(1.15-2.15),P趨勢0.001；收入水平與女性MS發(fā)病風(fēng)險的關(guān)系無統(tǒng)計(jì)學(xué)意義。多因素調(diào)整后,在女性中,以無業(yè)者為對照,農(nóng)民、工人/服務(wù)人員、退休人員、個體經(jīng)營者/技術(shù)人員和管理者/干部MS發(fā)病風(fēng)險的RR(95%CI)分別為0.69(0.55-0.86)、0.83(0.66-1.05)、1.03(0.82-1.30)、0.69(0.54-0.88)和0.62(0.48-0.81),P趨勢=0.001；在男性中,職業(yè)類型與MS發(fā)病風(fēng)險的關(guān)系無統(tǒng)計(jì)學(xué)意義。多因素調(diào)整后,與低SES者相比,中、高SES者M(jìn)S發(fā)病風(fēng)險的RR(95%CI)在男性中分別為1.46(1.20-1.76)和1.52(1.21-1.91),P趨勢=0.003；在女性中分別為1.01(0.87-1.17)和0.75(0.61-0.92),P趨勢=0.004。研究結(jié)論受教育水平、收入水平、職業(yè)類型以及SES復(fù)合指標(biāo)與MS的發(fā)病風(fēng)險密切相關(guān),且存在性別差異。預(yù)防和控制MS等心血管疾病危險因素要考慮人群的SES水平特點(diǎn),從而采取更有效的措施防控措施。
[Abstract]:Background Metabolic Syndrome (MSM), as an important risk factor for chronic diseases such as cardiovascular diseases, has become a global public health problem. In recent years, the prevalence of MS in China has been increasing year by year, which has seriously threatened the health of Chinese population and caused a huge burden of disease. A large number of epidemiological studies abroad have confirmed that socioeconomic status (SESs) is an important risk factor for MS. But the domestic related research evidence is relatively lack, and is some local area cross-sectional investigation, the result is also not consistent. In this study, we investigated the association between SES and MS risk in Chinese adults by using large sample prospective follow-up data. Methods in this study, 27020 adults aged 35 to 74 were enrolled in a multi-center collaborative study on cardiovascular epidemiology in China and a multi-center study on cardiovascular health in China. The baseline survey, which began in 1998 and 2000-2001, collected the demographic characteristics, social and economic status and lifestyle of the subjects, and carried out a follow-up survey between 2008 and 2008. Collect MS prevalence and other relevant information. Finally, 12608 subjects (6112 males and 6496 females) met the requirements and were included in the analysis. In this study, the education level, income level and occupation type were used as the index of SES, and the composite index of SES was constructed according to their scores. The composite index was divided into three groups by using the three-position method. Two classification logistic regression model was used to analyze the relationship between education level, income level, occupation type and the risk of MS. Results the average follow-up was 8.1 years. A total of 2716 cases (male 1151, female 1 565) were newly developed MSS. After multivariate adjustment, the relative risk of MS risk in primary school, junior middle school, high school / secondary school, junior high school and above were 1.190.9-1.441.130.92-1.410.61 ~ (0.63-1.04) and 0.54g / 0.38-0.750.75P trend respectively, after multivariate adjustment, the relative risk of MS risk was 1.190.9-1.44 (r) and 0.54 (0.38-0.75) P trend. There was no significant correlation between education level and male risk of MS. After multivariate adjustment, the RR 95CIs of MS risk in men with an income level of 300-499 Yuan / 500-799 Yuan / $800-1199 Yuan / RMB1200 were 1.20 / 1.01-1.43 / 1.35 / 1.351.11-1.62n / 1.371.07-1.74) and 1.581.15-2.15 / 1 / 1 respectively (P = 0.001), compared with the average monthly income of 300 yuan / month in the household (RMB300-499 / RMB500-799 / RMB1200). There was no significant correlation between income level and female risk of MS. After multifactorial adjustment, the RRG95CIIs of MS risk for farmers, workers / service workers, retirees, self-employed managers / technicians and managers / cadres were 0.69, 0.55-0.86, 0.830.66-1.05N 1.030.362-1.300.690.54-0.88 among women, and 0.62A0.48-0.81P trend for men, respectively. There was no significant correlation between occupational type and MS risk. After multifactorial adjustment, the RRG95 CI of MS in middle and high SES patients were 1.46 ~ 1.20-1.76) and 1.52 ~ 1.21-1.91 ~ (-1) P trend 0.003 in men, and 1.01T 0.87-1.17) and 0.750.61-0.92P trend 0.004 in women respectively, compared with those with low SES, the RRG95 CI in middle and high SES patients were 1.46 ~ 1.20 ~ 1.76) and 1.52 ~ 1.21 ~ 1.91 ~ (-1) P trend respectively, and 0.750.61-0.92P trend was 0.004 in women. Conclusion the educational level, income level, occupation type and SES compound index are closely related to the risk of MS, and there are gender differences. In order to prevent and control cardiovascular disease risk factors such as MS, the characteristics of SES level should be taken into account, and more effective measures should be taken to prevent and control cardiovascular diseases.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R589

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本文編號：2034833