| BackgroundThe study is part of "The research on index and standards of national health for Chinese population".The thesis analyzed the data collected among Han residents in 4 urban communities and 4 rural townships in 5 multi-ethnic mixed cities and counties in Xinjiang from June to August in 2013.ObjectiveTo understand the levels of blood lipids,prevalence of dyslipidemia and chronic metabolic disorders(including high blood pressure,abnormal fasting blood glucose and obesity),and the correlations of dyslipidemia with chronic metabolic disorders in urban and rural Han population in 5 cities and counties in Xinjiang.Methods1.Multi-stage stratified cluster sampling was used to recruit study participants aged 20-80 years old from 4 urban communities and 4 rural townships in Xinjiang.2.A face to face questionnaire survey was performed to collect demographic characteristics,individual history of disease and lifestyle information;We measured height,weight and blood pressures with standard methods in physical examination;A blood sample was drawn to test fasting 8 h venous blood glucose(FPG)and blood lipids(including total cholesterol(TC),triglycerides(TG),low density lipoprotein-cholesterol(LDL-C)and high density lipoprotein-cholesterol(HDL-C)).3.Statistic analysis:using SAS 9.2 software for statistical analysis.We calculated standardized prevalence of dyslipidemia for urban and rural samples using China population census data in 2000 as standard populations.To estimate the association of dyslipidemia with chronic metabolic disorders,we used multivariate logistic regression model with P<0.05 for statistically significant level.To estimate and compare the population attributable risk proportion of dyslipidemia to chronic metabolic disorders,we used formula[Pe(RR-1)]/[Pe(RR-1)+1]*100%to calculate PAR%for urban and rural samples,respectively.The prevalence of dyslipidemia(Pe)was estimated from age-gender specific prevalence of dyslipidemia of urban or rural samples in this study weighted by gender-age specific urban or rual population distribution from Xinjiang population census in 2010.The RR of dyslipidemia to chronic metabolic disorders was adjusted odds ratio of dyslipidemia to chronic metabolic disorders estimated by multivariate logistic regression model in this study.Results1.General characteristics of participantsThe study surveyed 3195 actually,the age does not meet the criteria on 6 and incomplete data on 94 were both excluded,3095 were involved in the analysis,including 1970 urban residents(63.65%).The average age of urban residents(47±14 years old)was lower than that of rural residents(49±11 years old),but the age variation was higher than that of rural group.The proportion of self-reported light physical labor,exercise often was higher in urban residents(accounted for 81.98%,46.58%,respectively);While the proportion of self-reported heavy physical labor,never exercise was higher in rural residents(accounted for 59.02%,65.16%,respectively).The prevalence of hypertension was 24.29%,which was higher in urban areas than in rural areas(26.23%vs.20.93,P=0.0010);the prevalence of diabetes was 8.60%,which was not significantly different between urban and rural areas(8.53%vs.8.71%,P=0.8644);the prevalence of obesity was 16.45%,which was also not significantly different between urban and rural areas(16.60%vs.16.19%,P=0.0564);the prevalence of hypertension and diabetes was rising with the increase of age,but the differences were not obvious between ages in prevalence of obesity.The awareness and control rate of hypertension was 71.98%,38.74%,repectively,which was both higher in urban areas than in rural areas(75.73%vs.63.83%,44.03%vs.27.23%,P<0.001).The awareness rate of diabetes was 78.57%,which was higher in urban areas than in rural areas(83.93%vs.69.39%,P<0.01);the control rate of diabetes was 32.33%,which was not significantly different between urban and rural areas(33.93%vs.29.59%,P>0.05).2.Blood lipid levels of participantsThe blood lipid levels of TC,TG,LDL-C,HDL-C was 4.76(0.99)mmol/L,1.71(1.75)mmol/L,2.76(0.77)mmol/L,1.44(0.31)mmol/L,repectively.The blood lipid levels of TC,LDL-C was higher in urban areas than that in rural areas(4.83(1.01)mmol/L vs.4.65(0.96)mmol/L,2.81(0.79)mmol/L vs.2.68(0.74)mmol/L,P>0.0001);In addition to LDL-C,there were significant differences between men and women in blood lipid levels of TC,TG,HDL-C;Blood lipid levels of TC,LDL-C was showing a rising trend with the increase of age.3.The prevalence and the standardized prevalence of dyslipidemia in participantsThe total prevalence of dyslipidemia was 28.11%,which was higher in urban areas than in rural areas(30.00%vs.24.80%,P<0.01).Using gender-age specific residents data in 2000 national census as standard population,the standardized total prevalence of dyslipidemia was 26.10%,which was still higher in urban areas than in rural areas(27.76%vs.24.34%,P<0.0001).The total prevalence of dyslipidemia was higher in men than that in women;Besides HDL-C,the prevalence of dyslipidemia and other lipid indicators was all rising with the increase of age.4.The prevalence of chronic metabolic disorders in participantsThe research mainly collected three types of chronic metabolic disorders such as high blood pressure,diabetes,and obesity.The crude prevalence of chronic metabolic disorders only with one,two or more was 24.49%,11.64%,respectively.The crude prevalence of chronic metabolic disorders only with one was not significantly different between urban and rural areas(24.55%vs.24.39%,P>0.05),which with two or more was higher in urban areas than in rural areas(12.56%vs.10.04%,P<0.05).The crude prevalence of chronic metabolic disorders only with one,two or more was higher in men than that in women,which was also significantly different between all ages.Using gender-age specific residents data in urban and rural areas in 2010 Xinjiang census as standard population to adjust,the weighted prevalence of chronic metabolic disorders only with one,two or more was 20.46%,8.85%,respectively.5.The effect of dyslipidemia to chronic metabolic disorders in participantsMultivariate logistic regression was used to analyze the related factors with chronic metabolic disorders.After adjusting associated factors,only age and dyslipidemia were correlated with chronic metabolic disorders only with one,two or more significantly.Taken 20-29 age as control group,the adjusted OR of chronic metabolic disorders only with one,two or more was both rising with the increase of age.The risk of chronic metabolic disorders only with one,two or more in abnormal lipid levels was almost 2-3 times of normal lipid levels,respectively.The population attributable risk proportion of dyslipidemia to chronic metabolic disorders only with one,two or more was 12%,25%,respectively.Using gender-age specific residents data in urban and rural areas in 2010 Xinjiang census as standard population,the adjusted population attributable risk proportion of dyslipidemia to chronic metabolic disorders only with one,two or more was 17%,29%,respectively.Compared the unweighted population attributable risk proportion of dyslipidemia to chronic metabolic disorders in urban and rural areas,which seemed to be higher in urban areas than in rural areas.But after adjusting sex and age,the gap in population attributable risk proportion of dyslipidemia to chronic metabolic disorders between urban and rural areas was narrowed.Compared the population attributable risk proportion of dyslipidemia to chronic metabolic disorders in different age groups,found that the attribution of dyslipidemia to chronic metabolic disorders was greater in young and middle-aged people under 50 years old(16%,46%)than that in middle-aged and elderly people over 50 years old(5%,10%).ConclusionsThe blood lipid levels was higher in Han adults in 5 cities and counties in Xinjiang than the national average,the prevalence of obesity was also higher than the national average.However,the prevalence of hypertension and diabetes was relatively close to the national levels.Although the prevalence of dyslipidemia and hypertension was higher in urban areas than that in rural areas,the differences were not obvious between urban and rural areas in prevalence of diabetes and obesity.The prevalence of dyslipidemia,hypertension and diabetes was all higher in elderly people than that in young people,but the differences were not obvious between ages in prevalence of obesity.The prevalence of chronic disorders was slightly higher in urban areas than that in rural areas,and rising with the increase of age.There were some differences in demographic structure and lifestyle between urban and rural areas.So the issues related to chronic disease and preventive strategies will be different in urban and rural areas. |
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