| Objective: To conduct a cohort study of chronic diseases in natural population in a suburb of Xining City Qinghai Province,to understand the epidemic status of main chronic diseases in suburban residents in this area,explore the influencing factors of high-incidence chronic diseases,and explore the causal relationship between exposure factors and the incidence and mortality of chronic diseases through cohort follow-up.To provide the basis for the prevention strategies and measures of chronic diseases in suburban residents,so as to promote the health of the population in this area.Methods:The convenience sampling method was adopted in this study.In2018,3015 permanent residents aged 18 or older in a suburb of Xining City were selected to carry out a baseline survey.The demographic characteristics,dietary conditions,lifestyle,height,weight and Physiological,biochemical and other index data,theχ2 test or Fisher’s exact test was used to analyze the prevalence of chronic diseases,and on this basis,theχ2 trend test was used for trend analysis,and the multivariate Logistic regression model was used to analyze the influencing factors.Then,a two-year follow-up was conducted to collect the migration and loss of follow-up,new-onset chronic diseases,deaths due to chronic diseases,and changes in related influencing factors.The new-onset chronic diseases and deaths due to chronic diseases were used as the end points of the study,through the univariate K-M test,the variables with P<0.10 were included in the multivariate Cox regression model to determine the influencing factors,and the Cox regression multiplicative model and the additive model proposed by Rothman are used to analyze whether the multiplicative and additive interaction between the influencing factors.Results: 1.The prevalence of hypertension in suburban residents was 38.8%.In terms of gender,age,educational level,frequency of red meat intake,frequency of fruit intake,BMI,drink wine and physical exercise,the prevalence of hypertension among suburban residents was different,and the difference was statistically significant(P<0.05).After adjusting for confounding factors,it was found that male suburban residents(OR=1.63,95%CI=1.35～1.97)、elder age group(45～59 years and ≥60 years)(OR=2.48,95%CI=1.91～3.21 和 OR=3.40,95%CI=2.51～4.60)、never or rarely eat red meat(OR=1.97,95%CI=1.23～3.14)、overweight(OR=2.19,95%CI=1.80 ～ 2.66)、 obese(OR=3.39,95%CI=2.69 ～ 4.27)、 weekly drinking(OR=1.55,95%CI=1.15～2.11)、physical exercise(OR=1.33,95%CI=1.11～1.60)were the risk factors for hypertension in suburban residents.2.The prevalence of diabetes in suburban residents was 9.9%.In terms of gender,age,educational level,marital status,BMI and frequency of physical exercise,the prevalence of diabetes among suburban residents was different,and the difference was statistically significant(P<0.05).After adjusting for confounders,it was found that male suburban residents(OR=1.44,95%CI=1.08～1.90)、elder age group(45～59 years and ≥60 years)(OR=2.48,95%CI=1.46～4.22 和 OR=4.44,95%CI=2.49～7.91)、separation or divorce(OR=3.00,95%CI=1.39～6.48)、obesity(OR=2.16,95%CI=1.51～3.08)、physical exercise(OR=1.43,95%CI=1.05～1.95)were the risk factors for diabetes in suburban residents.3.The prevalence of dyslipidemia in suburban residents was 37.7%.There were differences in the prevalence of dyslipidemia in terms of gender,age,BMI and smoking,and the differences were statistically significant(P<0.05).After adjusting for confounding factors,it was found that male suburban residents(OR=1.72,95%CI=1.41～2.14)、elder age group(45～59 years and ≥60 years)(OR=1.42,95%CI=1.13 ～ 1.78 和 OR=1.64,95%CI=1.28 ～ 2.10)、 overweight(OR=1.68,95%CI=1.39～2.03)、obesity(OR=2.65,95%CI=2.1～3.32)were the risk factors for dyslipidemia in suburban residents.4.Male gender,age and obesity are common risk factors for major chronic diseases in suburban residents.The prevalence of chronic diseases in males is higher than that in females,and the prevalence of dyslipidemia in male residents is the most significant,with a prevalence rate of 47.1%.With the increase of age,the prevalence of chronic diseases in suburban residents is higher.Chronic diseases have the most serious impact on suburban residents over 60 years old,and the prevalence of hypertension is the most obvious,with a prevalence rate as high as 50.3%.5.There were 963 people did not suffer from chronic diseases in the baseline survey,and 22 people were found to have new chronic diseases at follow-up,with an incidence density of 13.0/1000 person-years.Age and educational level were related to the incidence of chronic diseases in suburban residents(P<0.05).After adjusting for confounders,it was found that age was an independent factor affecting the incidence of chronic diseases in suburban residents(P<0.05).Compared with suburban residents aged 60 and over,the risk of chronic disease among suburban residents aged 18～44 was significantly lower than that of suburban residents aged60 and over(HR=0.10,95%CI=0.01～0.85).6.There were 1852 chronic diseases in the baseline survey,and 24 deaths due to chronic diseases at follow-up,with a death density of 6.9/1000 person-years.Gender,age,frequency of red meat intake and frequency of intake of milk and dairy products were all associated with death from chronic diseases in suburban residents(P<0.05).After adjusting for confounders,the mortality risk of chronic diseases among male suburban residents was higher than that of female suburban residents(HR=5.37,95%CI=2.14 ～ 13.45).The mortality risk of chronic diseases among suburban residents who ate little or no red meat was higher than that of those who ate red meat every day(HR=6.52,95%CI=2.00～21.29).7.Never or minimal red meat intake and male sex have a positive synergistic effect on chronic disease mortality in suburban residents.Men who never or rarely eat red meat have a higher risk of death from chronic diseases than women who eat red meat daily(P<0.01);the risk of death from chronic diseases is higher when both are present The sum of death when they exist alone(RERI=38.09,95%CI=16.98～59.20);the synergistic effect is 10.94 times the sum of the effects of the two when they exist alone(S=10.94,95%CI=6.62～18.06).Conclusion:1.Male suburban residents are more likely to suffer from chronic diseases than female residents;as age increases,suburban residents have higher risk of chronic disease;never or very little red meat,being overweight,and drinking alcohol at least once a week were associated with increased risk of hypertension;separated/divorced individuals were at higher risk for diabetes;and overweight individuals were more likely to develop dyslipidemia.3.Age is an independent factor affecting the incidence of chronic diseases in suburban residents.Compared with suburban residents aged 60 and over,the risk of chronic disease among suburban residents aged 18～44was significantly lower than that of suburban residents aged 60 and over.Male sex and never or rarely eating red meat are risk factors for chronic disease mortality in suburban residents,and there is an additive interaction between the two on chronic disease mortality in suburban residents.The risk of death from chronic diseases when the two coexist is higher than the sum of the deaths when the two exist alone. |
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