上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2024, Vol. 44 ›› Issue (5): 617-625.doi: 10.3969/j.issn.1674-8115.2024.05.010

• 论著 · 公共卫生 • 上一篇    

基于上海社区老年人群队列的心血管疾病和恶性肿瘤的危险因素流行特征分析

李萍1,2(), 蒋惠如2, 叶梦月3, 王雅玉1,2, 陈潇雨4, 袁安彩2, 徐文杰5, 戴慧敏6, 陈曦7, 闫小响8, 涂圣贤2, 郑元琦7, 张薇2,9(), 卜军2()   

  1. 1.蚌埠医科大学公共卫生学院，蚌埠 233030
    2.上海交通大学医学院附属仁济医院心内科，上海 200127
    3.浙江省宁波市杭州湾医院体检中心，宁波 315336
    4.上海交通大学医学院附属仁济医院临床研究中心，上海 200127
    5.上海市浦东新区合庆社区卫生服务中心中医科，上海 201201
    6.上海市浦东新区潍坊社区卫生服务中心全科医学科，上海 200122
    7.福建省三明市第一医院心内科，三明 365000
    8.上海交通大学医学院附属瑞金医院心内科，上海 200025
    9.上海市肿瘤研究所流行病学研究室，上海 200032
  • 收稿日期:2023-09-27 接受日期:2024-03-01 出版日期:2024-05-28 发布日期:2024-05-28
  • 通讯作者: 张薇,卜军 E-mail:lp239600@163.com;zhangwei050080@renji.com;punjun310@hotmail.com
  • 作者简介:李　萍（1998—），女，硕士生；电子信箱：lp239600@163.com。
  • 基金资助:
    上海市专业技术服务平台建设项目(22DZ2292400);上海市卫生健康委员会新兴交叉领域研究专项(2022JC013);上海市卫生健康委员会重中之重研究中心项目(2023ZZ02021);上海市卫生健康委员会临床重点专科建设项目(SHSLCZDZK06204);上海市加强公共卫生体系建设三年行动计划（2023—2025年）重点学科建设项目(GWVI-11.1-26);上海交通大学医学院高水平地方高校创新团队(SHSMU-ZDCX-2021-0700);浦东新区卫生健康委员会卫生科技项目(PW2023E-02);浦东新区卫生系统学科带头人培养计划(PWRd2022-06);浦东新区卫生健康委员会学科建设(PWYq2020-03);三明市科技计划联合资助项目(2022-S-56)

Analysis of epidemiological characteristics of risk factors for cardiovascular diseases and malignant tumors based on the Shanghai community elderly cohort

LI Ping1,2(), JIANG Huiru2, YE Mengyue3, WANG Yayu1,2, CHEN Xiaoyu4, YUAN Ancai2, XU Wenjie5, DAI Huimin6, CHEN Xi7, YAN Xiaoxiang8, TU Shengxian2, ZHENG Yuanqi7, ZHANG Wei2,9(), PU Jun2()   

  1. 1.School of Public Health, Bengbu Medical University, Bengbu 233030, China
    2.Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    3.Physical Examination Center, Ningbo Hangzhou Bay Hospital, Zhejiang Province, Ningbo 315336, China
    4.Center for Clinical Investigation, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    5.Department of Traditional Chinese Medicine, Heqing Community Health Service Center of Pudong New Area, Shanghai 201201, China
    6.Department of General Practice, Weifang Community Health Service Center of Pudong New Area, Shanghai 200122, China
    7.Department of Cardiology, Sanming First Hospital, Fujian Province, Sanming 365000, China
    8.Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    9.Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, China.
  • Received:2023-09-27 Accepted:2024-03-01 Online:2024-05-28 Published:2024-05-28
  • Contact: ZHANG Wei,PU Jun E-mail:lp239600@163.com;zhangwei050080@renji.com;punjun310@hotmail.com
  • Supported by:
    Professional Technical Service Platform Project of Shanghai(22DZ2292400);Emerging Interdisciplinary Research Project of Shanghai Municipal Health Commission(2022JC013);Project of Shanghai Health Commission Key Research Center(2023ZZ02021);Key Clinical Specialty of Shanghai Municipal Health Commission(SHSLCZDZK06204);Key Discipline Construction Project of Shanghai Three-year Action Plan to Strengthen Public Health System Construction (2023—2025)(GWVI-11.1-26);Innovative Research Team of High-level Local Universities in Shanghai(SHSMU-ZDCX-2021-0700);Health Science and Technology Research Project of Pudong New Area Health Commission(PW2023E-02);Discipline Leader Training Program of Health System in Pudong New area(PWRd2022-06);Discipline Construction of Pudong New Area Health Commission(PWYq2020-03);Jointly Funded Projects of Science and Technology Plan in Sanming City(2022-S-56)

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摘要：

目的·基于上海社区老年人群队列，分析心血管疾病和恶性肿瘤的危险因素流行特征。方法·选择2019年2—8月建立的上海社区老年人群队列（17 948人）为研究对象。根据基线调查时自我报告的有无肿瘤和/或心血管疾病将其分为4组，即无肿瘤无心血管疾病组、心血管疾病单患组、肿瘤单患组和肿瘤心血管疾病共患组。收集并比较4组受试者在人口学特征与生理指标、日常生活习惯（吸烟、饮茶、饮用咖啡、饮用碳酸饮料、饮酒、久坐时长、体力活动水平、睡眠质量）、既往疾病史、心理状况（抑郁、焦虑）、膳食达标情况等方面的差异。结果·研究对象中，有60.1%的肿瘤患者合并心血管疾病。4组受试者在年龄、性别、教育水平、退休前职业、腰围、臀围和体质量指数间差异具有统计学意义（均P<0.05）。与无肿瘤无心血管疾病组相比，心血管疾病单患组、肿瘤单患组、肿瘤心血管疾病共患组患者在吸烟、高体力活动水平的比例较低（均P<0.05），久坐时长>4 h/d、睡眠质量差的比例较高（均P<0.05）；心血管疾病单患组、肿瘤心血管疾病共患组患者合并高脂血症、外周血管疾病、内分泌系统疾病、呼吸系统疾病、泌尿系统疾病、消化系统疾病的比例较高（均P<0.05），抑郁、焦虑比例亦较高（均P<0.05）。同时，与无肿瘤无心血管疾病组相比，心血管疾病单患组患者在禽肉类、鱼类、水果和液态奶的达标率较低（均P<0.05）。4组中仅蔬菜摄入量的达标率均超过了50%，禽肉类、鱼类、水果、液态奶、薯类的达标率均低于20%。结论·上海社区老年人群中，超过一半的恶性肿瘤患者合并有心血管疾病。心血管疾病、肿瘤以及肿瘤心血管疾病共患的人群普遍存在不健康的日常生活习惯。社区老年人群多种食物的摄入量未达《中国居民膳食指南》推荐水平。

关键词: 恶性肿瘤, 心血管疾病, 危险因素, 流行特征, 队列

Abstract:

Objective ·To analyze the epidemiological characteristics of risk factors for cardiovascular diseases and malignant tumors based on the Shanghai community elderly cohort. Methods ·The study subjects were selected from the Shanghai community elderly cohort established from February to August 2019, with a total of 17 948 people. The study subjects were divided into 4 groups according to self-reported presence or absence of tumors and/or cardiovascular diseases during the baseline survey: tumor-free and non-cardiovascular disease group, single cardiovascular disease group, single tumor group and tumor cardiovascular disease co-occurrence group. The differences among the four groups of subjects were collected and compared in terms of demographic characteristics and physiological indicators, daily living habits (smoking, drinking tea, drinking coffee, drinking carbonated drink, drinking alcohol, sedentary time, physical activity level and sleep quality), past medical history, psychological status (depression and anxiety) and dietary compliance. Results ·Among the study subjects, 60.1% of tumor patients were complicated with cardiovascular diseases. The differences among the four groups of subjects in age, gender, educational level, pre-retirement occupation, waist circumference, hip circumference and body mass index were statistically significant (all P<0.05). Compared with the tumor-free and non-cardiovascular disease group, the single cardiovascular disease group, single tumor group and tumor cardiovascular disease co-occurrence group all exhibited lower proportions of smoking and high physical activity levels (all P<0.05), and higher proportion of sedentary time exceeding 4 h/d and poor sleep quality (all P<0.05); the proportion of subjects with past medical histories including hyperlipidemia, peripheral vascular disease, endocrine system disease, respiratory system disease, urinary system disease and digestive system disease of the single cardiovascular disease group and the tumor cardiovascular disease co-occurrence group was higher (all P<0.05), and the proportion of subjects with depression and anxiety was also higher (all P<0.05). Furthermore, compared with the tumor-free and non-cardiovascular disease group, the single cardiovascular disease group had lower compliance rates of poultry, fish, fruit and liquid milk (all P<0.05). Among the four groups, only the compliance rate of vegetable intake exceeded 50%, while the compliance rates of poultry, fish, fruit, liquid milk and tubers were all below 20%. Conclusion ·In the elderly population of Shanghai communities, over half of malignant tumor patients are concomitant with cardiovascular diseases. Unhealthy daily habits are prevalent among those with cardiovascular diseases, tumors and tumor-cardiovascular disease co-occurrence. The intake of many foods in the elderly of the community do not reach the levels recommended by Chinese Dietary Guidelines.

Key words: malignant tumor, cardiovascular disease, risk factor, epidemiological characteristics, cohort

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