Study Of The Relationship Between Cardiovascular Health Behaviors And The Factors Associated With End-stage Renal Disease

Part 1 Meta analysis of the prevalence of ideal cardiovascular health behaviors and factors in the World populationObjective: To evaluate the prevalence of ideal CVH behaviors and factors in the global population,and to provide data support for the prevention of cardiovascular disease.Methods: PubMed,Springer,Elsevier,EMBase,SSCI,China biomedical literature retrieval system service system(CBM),Chinese Journal Full-text Database(CJFD),Wanfang database,China outstanding master's degree thesis database(CMFD)and Chinese important conference papers full-text database(CPFD),inclusion criteria:(1)according to AHA standards for all 7 ideal cardiovascular health behaviors and factors were defined;(2)the research object from a research method for the study population,case-control study,clear and similar type of research and research methods;(3)the number of occurrence to be given of sample size of the study,the ideal cardiovascular health behaviors and factors and the incidence,or according to the data to calculate the required values;(4)Language in English or Chinese.Exclusion criteria:(1)the data is incomplete,unclear or wrong;(2)the same research group repeated publication,repeat or similar data.The published literature is from January 2010 to March 2014.RevMan software 3.1.0 was used to analyze the results of Meta.The number of different gender ideal CVH behavior and factors were compared by subgroup analysis,people have a different number of ideal CVH behavior and factors of incidence were compared by Wilcoxon signed rank test,a =0.05 statistical test level.SPSS 18 statistical software was used to complete the comparison between groups,with P<0.05 as the difference was statistically significant.Results: 24 articles to be detected,according to the inclusion and exclusion criteria,excluding 14,At last 10 qualified papers in the literature,They are all in English,literature research types were investigated retrospectively,the study population from the Americas,Europe and asia.Included in the study time literature from 2005 to 2011,a span of 6 years;the research sample volume from 1933 to 356441 people,a median of 11786 people,a total of 520127 people,including the United States,Europe,the Mediterranean,China,Germany and South Korea in 5 countries and regions.The number of people who have all 7 ideal CVH behaviors and factors in the global population is 0.48%[95%CI(0.23%,1.05%),and the incidence of the patients with the ideal CVH behavior and factor from 5-7 is(16.29%[95%CI,11.2%-23.25%).Subgroup analysis showed that the number of women with 5-7 of the ideal CVH behavior and factors of the incidence of 23.28%[95%CI(19.36%,27.69%)],the number of men with 5-7 of the ideal CVH behavior and factors of the incidence of 8.05%[95%CI(4.52%,13.95%)],between different gender to incidence of CVH the behavior and factors,the difference was statistically significant z=-2.67,P=0.008).Conclusion:The incidence of ideal CVH behavior and factors in the global population is low,and the female is better than the male.Recommendations to focus on and take positive interventions to improve the level of ideal CVH.Part 2 Study of the prevalence of chronic kidney disease and risk factors in the study population of KailuanObjective: To study the prevalence and related risk factors in CKD of Kailuan study population.Methods: A cross-sectional investigation application,from June 2006 to October 2007 for the first time the health examination of workers in Kailuan Group(n=101510,81110 men,20400 women),as the study population,obtain the CVH behavior and factors through questionnaire survey,physical diagnosis,laboratory examination information.Serum creatinine by the central laboratory by enzymatic determination,estimated glomerular filtration rate(estimatedglomerular filtration rate,eGFR)by the United States CKD epidemiology collaborative research group(CKD-EPI)formula,GFR<60ml/min defined as CKD.SPSS13.0(Chicago,for Windows)was used for statistical analysis.With normal distribution measurement data is expressed as Hs-CRP,TG,because of a skewed distribution measure of skewness distribution after log conversion after the analysis and comparison between the two groups were compared using independent sample t test and variance analysis;case count data(%)said,compared with 2 production rate test.Logistic regression analysis was used to analyze the factors affecting CKD,and the difference was statistically significant(P< 0.05).Results:1 1346 patients were excluded from the glomerular filtration rate data,and the final 100164 were included in the study,the male was 79985,and the female was 20179.13494 patients are in CKD,mean age 58.87±13.55 years,3206 women(23.8%),10288 men(76.2%);CKD group of age and sex(female),BMI,SBP,FBG,TG,LDL,HDL,Hs-CRP,antihypertensive drugs,physical exercise ratio is less than CKD group,and the difference was statistically significant(P<0.001).2 The different gender and age group the prevalence of CKD: the total population prevalence of CKD was 13.5%,the prevalence rate of male and female were 12.9% and 15.9%(P<0.05);divided by age: young group(< 40 years),middle age group(over 40 years old,less than 60 year old)and the elderly group(over 60 years old),with the increase of age,the prevalence rate of CKD increased(P<0.001),the prevalence rate of CKD was 6.7%,10.6%,25.6%,male and female prevalence rate were 6.3%,9.5%,24.4% and 7.6%,14.5%,34.1%.(see Table 2).3 Logistic CKD regression analysis showed that the risk factors of CKD were age(years),sex(female),SBP(mmHg),BMI(kg/m2),LDL(mmol/L),TG(mmol/L),the corresponding OR value(95% CI)were 1.055(1.053-1.057),1.780(1.712-1.943),1.010(1.009-1.011),1.021(1.015-1.027),1.345(1.319-1.372),1.323(1.263-1.385),physical exercise is a protective factor of CKD,the OR value(95% CI)0.827(0.785-0.872).4 The different gender stratification effects of Logistic CKD regression analysis shows that FBG is a risk factor for male patients with CKD,OR values(1.022,95% CI:1.000-1.045)(P<0.05),and for the female to no effect,the value of OR(0.988,95% CI:0.976-1.000)(P> 0.05).Conclusion: The prevalence of CKD in Kailuan study population is more common,The prevalence rate of CKD is increased with the increasing year.age,female,BMI,SBP,LDL,TG are the independent risk factors of CKD,FBG is a risk factor for male patients with CKD,and for the female to no effect.Part 3 Study of the relationship between cardiovascular health behaviors and the factors associated with end-stage renal disease.Objective: To study the epidemic situation of CVH behavior and factors of Kailuan population,To study protective effect of CVH behaviors and risk factors for ESRD.Methods: The study population is Kailuan Group employees whose first examinationwas from June 2006 to October 2007,health examination data collection every two years,they are 2006-2007,2008-2009,2010-2011 and 2012-2013,all subjects filled out questionnaires,including demographic characteristics,clinical data,medical history,laboratory examination results.The Kailuan study began in 2006,without a healthy diet in the questionnaire,combined with the ideal CVH standard put forward by Professor effects of salt on cardiovascular disease in Chinese population and Hu Dayi,healthy eating behavior this study content CVH AHA definition is replaced by salt intake in the.With the definition of AHA the study of CVH behavior score,which are as follows: CVH health behaviors:(1)Smoking:the ideal: No smoke or have quit more than 1 years;the intermediate who has quit smoking,for less than 1 years;the poor who is still smoking.(2)The body mass index(body mass index,BMI): the ideal:<25 kg/m2;the intermediate :25-30 Kg/m2;the poor: ?30 Kg/m2.(3)Physical exercise: the ideal: often(3 times,every time a week or more than 30 min);the intermediate: occasionally;the poor:none.(4)Healthy diet: the ideal: low salt diet;the intermediate: moderate;the poor: high salt diet.CVH health factors:(1)Total cholesterol(TC): the ideal: untreated TC< 200 mg/dL;the intermediate:TC: 200-239 mg/dL or treated TC<200 mg/dL;the poor: TC?240 mg/dL;(2)Blood pressure(BP),the ideal: untreated BPuntreated SBP mmHg<120 and DBP<80 mmHg(1 mmHg=0.133 kPa);the intermediate:untreated SBP 120~139 mmHg or DBP 80-89 mmHg or treated BP< 140/90 mmHg;the poor: SBP?140 mmHg or DBP?90 mmHg;(3)Fasting blood glucose(FBG): the ideal: unreated FBG<100 mg/dL;the intermediate: FBG 100-125 mg/dL ortreated FBG<100 mg/dL;the poor: FBG?126 mg/dL.Each health behavior or factors are divided into three grades and given the corresponding score: the ideal =2 points,the intermediate =1 points,poor =0 points,the total score of 0-14 points,according to the score will be divided into three groups 0-4 group,5-9 group,10-14 grouping.The serum Cr was determined by enzyme assay in the central laboratory,and eGFR was calculated by the CKD epidemiology cooperative research group(CKD-EPI)in the United States.eGFR was defined as 15ml/min(ESRD).Application of SPSS13.0(SPSS Inc.,Chicago,for Windows)for statistical analysis.Mean±standard deviation of normal measurement data.Because Hs-CRP and TG were skewed distribution,the measurement indexes of skewness distribution were analyzed and compared by log transformation,and the single factor analysis of variance was used to compare the data between different groups.Enumeration data were expressed by n(%),and chi square test was used for comparison between groups.The risk of using Cox proportional hazard model analysis and ESRD score of cardiovascular health factors and behavior than(hazard ratios,HR and 95%CI),a Cox proportional hazards model adjusted for age and gender;further correction model 2 levels of education,income,alcohol;model three further correction of glomerular filtration rate.The difference was statistically significant(P<0.05).Results: There were 101510 cases of workers participated in the health examination of Kailuan staff of 2006 to 2007 year,exclude the previous history of myocardial infarction and / or stroke in 3669 cases,6006 cases of CVH at baseline health behaviors and factors of missing data,139 patients with baseline Cr deletion,116 cases of eGFR<15ml/min at baseline,91580 were included in the final analysis.1 The basic situation of different CVH factors and behavior scores: in the 91580 cases observed,aged 18 to 98 years old,the average age(53.01 ±12.35)years,72722 males,mean age(53.68±12.50)years old,female 18858 cases,average age(50.43±11.36)years old.Cardiovascular health factors and behavior of the average score was 8.83±1.95 points,of which the male was 8.55±1.90,and the female was 9.92±1.74.The subjects were divided into three groups according to different CVH factors and behavior scores,namely: 10-14 group(n=35883),5-9 group(n=53878),0-4 group(n=1819).Compared with 5-9 group and 0-4 group,10-14 group,the proportion of men with high sensitivity C-reactive protein and income of 800-1000 yuan / month and the proportion of alcohol(once a day)were lower(P< 0.05);and 10-14 group of Education(University)is higher than the proportion of 5-9 and 0-4 groups(P< 0.05);5-9 group the highest average age(54.18±11.61),10-14 group(51.26±13.29)minimum age(with statistical significance,P< 0.05).2 The different CVH factors and behaviors scores of each group and the incidence of ESRD risk: in an average follow-up of 7.05 years,ESRD occurred in 284 cases.10-14,5-9,0-4 group ESRD cases and incidence rate were 79 cases(2.20 per thousand),193 cases(3.58 per thousand),12 cases(6.60 per thousand),and the difference was statistically significant(P<0.05).Analysis of Cox proportional hazards model,compared with 10-14 group,the risk of 0-4 packet and 5-9 packet ESRD ratio(95%CI)were 3.021(1.645-5.547)and 1.640(1.261-2.133);the risk after adjustment for age and sex ratio(95%CI)were 3.276(1.769-6.607)and 1.738(1.323-2.84);further risk correction the level of education,income,alcohol and high sensitive C reactive protein(95%CI)after the ratio were 3.579(1.912-6.699)and 1.792(1.360-2.361);further correction eGFR risk ratio(95%CI)were 3.022(1.612-5.663)and 1.637(1.243-2.156).CVH factor and behavioral score increased by one point,the incidence of ESRD decreased by 17.3%.The results showed that with the increase of CVH factors and behavior scores,the incidence of ESRD was gradually reduced,and the trend test was statistically significant(P<0.001).3 The different groups of CVH factors and behaviors scores and the risk of ESRD: during follow-up,women and men have ESRD incidence and morbidity were 62 cases(3.05 per thousand)and 222 cases(3.29 per thousand);10-14 and 5-9,the number and incidence of 0-4 group ESRD cases were 31 cases(2.60 per thousand),30 cases(4.36 per thousand),1 cases(15.63 per thousand)and 48 cases(2 per thousand),163 cases(3.47 per thousand),11 cases(6.27)%,and the differences were statistically significant(P<0.05),adjusting for age,education level,income,drinking,Hs-CRP,and eGFR,CVH factors and behavior score each,ESRD risk were reduced by 17.1% and 17.4% in men and women(P<0.05).In the age of less than 60 years old and >60 years old group ESRD cases and incidence rate were 189 cases(3.21 per thousand)and 95 cases(2.90 per thousand),including 10-14,5-9,the number and incidence of 0-4 packet ESRD cases were 53 cases(2.18 per thousand),126 cases(3.80 per thousand),10 cases(7.77 per thousand)and 26 cases(2.26 per thousand),67 cases(3.24 per thousand),2 cases(3.76 per thousand),and the differences were statistically significant(P<0.05),the same score CVH behavior and ESRD risk factors,population 60 years of age or above age >60 years of age.Correction of gender,education level,income,alcohol,Hs-CRP,eGFR,CVH factors and behavior score each,ESRD risk at the onset age younger than 60 years old and >60 years old group decreased by 18.6% and 11.9%,and the differences were statistically significant(P<0.05).4 we also analyzed the influence factors and behavior for each CVH ESRD risk: smoking: risk of ESRD ideal and bad state population(95%CI)were 0.748(0.537-1.043),0.938(0.601-1.463),1;the salt: ESRD risk ideal,general and poor state populations(95%CI)were 0.544(0.299-0.989),0.881(0.606-1.281),1;the physical exercise: the risk of ESRD ideal and bad state population(95%CI)were 0.783(0.478-1.282),0.816(0.544-1.223),1;TC: the risk of ESRD ideal and bad state population(95%CI)were 0.673(0.482-0.940),0.632(0.434-0.920),1;the blood pressure: the risk of ESRD ideal and bad state population(95%CI)were 0.531(0.366-0.771),0.514(0.389-0.677)1,FBG: ESRD;the risk of ideal and bad state population(95%CI)were 0.330(0.247-0.443),0.351(0.214-0.578),1;BMI;ESRD: the risk of ideal and bad state population(95%CI)were 1.053(0.682-1.626),1.042(0.671-1.617),1.Conclusion: CVH behavior and factors are protective factors in the pathogenesis of ESRD,with the CVH behavior and factors increase the risk of ESRD decreased gradually,CVH behavioral and factors,the ideal state of salt,BP,FBG and TC are protective factors in the pathogenesis of ESRD.Conclusion:1 The prevalence state of ideal CVH behavior and factors is low in Kailuanstudy populationcompared with the epidemic situation in global population,The ideal CVH behavior and factors of Chinese northern people needs to be improved.2 The total incidence rate of CKD was 13.5% in Kailuan population during 2006-2007 years,compared with the 2000-2001 China population sampling survey general population the incidence of CKD was 2.53%,there was a rapid increase.The risk factors of Kailuan men in CKD were age,SBP,BMI,FBG,LDL,TG;risk factors among women in CKD were age,SBP,BMI,LDL,TG.Physical exercise is a protective factor for CKD.3 CVH behavior and factors have a protective effect on the incidence of ESRD,with the CVH behavioral and factor scores increased,the incidence of ESRD decreased gradually.CVH behavioral and factors which the ideal state of salt,blood pressure,FBG,TC are the protective factors ofESRD.