A Study On Individual Health Risk Appraisal And Risk Factors Analysis Of Diabetes And Stroke At Community In Chongqing

Objective To investigate the prevalence and distribution of diabetes and stroke in an adult group over 15 years old at community of Shapingba District in Chongqing; To investigate the correlation risk factors of diabetes over 15 years old and stroke over 25 years old at community in Chongqing,setting a quantitative criteria for determining risk for diabetes and stroke respectively,so that potential risk of an individual dying from diabetes or stroke can be identified and to provide the basic data for predicting individual risk of diabetes and stroke. It creates a condition for the application of evaluation of health promotion by the method of health appraisal software to calculate the risk scores and the probability of disease.Method The method of mufti-step cluster sampling was adopted. 76958 adults over 15 years old were chosen as the sample from 2004 to 2005 at community of Shapingba District in Chongqing. The cross-sectional study surveys had played positive roles in understanding the demographic characteristics, comparing the prevalence and distributions of Diabetes mellitus(DM)and stroke in different sex, age, marital status, education level, occupation and consumption of diet and understanding the complication of diabetes and stroke.The cross-sectional study had played positive roles in understanding risk factors of type 2 DM and its population distributions. 863 cases and healthy people over 35-64 years of age were chose from Chongqing, which were interviewed with a uniform questionnaire. The risk factors of diabetes mellitus were analyzed with Logistic regression,collected the odds ratios(OR)of risk factors for diabetes,and different levels of risk exposure factors be converted into a risk scores by using statistical models. The related risk scores were added to obtain a combined risk score to predict the individual's risk of diabetes in the future.366 cases and healthy people over 35-64 years of age were chose from Chongqing,which were interviewed with a uniform questionnaire. The risk factors of stroke were analyzed with Logistic regression,collected the OR of risk factors for stroke, and different levels of risk exposure factors be converted into a risk scores by using statistical models. The related risk scores were added to obtain a combined risk score to predict the individual's risk of stoke in the future.Result The overall prevalence of Diabetes mellitus was 3.51% and 4.44% in male 2.72% in female. It showed an upgrade trend in the prevalence rate of diabetes with the increased of ages. The highest prevalence in marriage status is widowed; in different professional is the retired both in male and female. The prevalence is descend with the higher education, but with the increased of food consumption, it is increased. The prevalence of diabetes complicated with two and above diseases is 20.82%. A risk score conversion table (quantitative criteria for assessment) of main risk factors for diabetes were developed for men and women aged between 35 and 64, including education, smoking, liking sweets, eating overheating food, physical activity, Waist-hip ratio(WHR), family history of hypertension, family history of stroke, family history of diabetes, hypertension, hyperlipidemia and the level of consumption on diet. Individuals with all these risk factors had a risk score beyond 1.00, and risk score for those without them was equal to or below 1.00, which would increase with rise in one's risk level.The prevalence of stroke is 1.94%, which showed an upgrade trend with the increased of ages. It has the same trend with the diabetes in the marriages, education and professional. The prevalence of complications in stroke is: stroke complicated with hypertension is 57.59%. Stroke complicated with two and above diseases is 37.73%. A risk score conversion table (quantitative criteria for assessment) of main risk factors for stroke were developed for men and women aged between 35 and 64, including smoking, drinking, over-intaking salt, physical activity, Body Mass Index(BMI), diastolic blood pressure(DBP), family history of hypertension, family history of stroke, hypertension, diabetes and Hyperlipidemia. Individuals with all these risk factors had a risk score beyond 1.00, and risk score for those without them was equal to or below 1.00, which would increase with rise in one's risk level.It is complicated to calculate the combination of the risk scores by hand. Our team developed the health appraisal software. We apply the software on individual health risk assessment of stroke or diabetes, understanding the health status of individual as well as the risk factors. And we take measures to intervene the high risk groups to reduce the incidence of the disease.Conclusion The high prevalence rate of diabetes and stroke in Chongqing suggested more health education and leading of healthy life style are very necessary. The key point is to limit salt intake and balance nutrient. At the same time, we must pay more attention to the comprehensive prevention and treatment of various complicated diseases.Estimation of risk of morbidity from diabetes and stroke based on risk score conversion table of risk factors for diabetes and stroke, which could be used to predict individual potential risk of morbidity or death from diabetes and stroke in the following 10 years. It lays a foundation for health education to persuade people to change their life styles and behaviors, and could be used in community health services. It is simplified the process of the health risk evaluation by the software, made it use easily, which is worthy of promoting.