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目的分析我国成年人膳食胆固醇摄入量对血压值及高血压发病的影响。方法利用中国健康与营养调查数据,研究对象为1993-2011年至少参加两轮调查且在进入队列时血压值正常年龄18~60岁的成人,共7754(男性3756、女性3998)人。应用三水平混合效应模型进行分析:模型1,只纳入膳食胆固醇摄入量;模型2,在模型1的基础上,纳入个人水平变量;模型3,在模型2的基础上,纳入社区变量。结果与不摄入膳食胆固醇的男女性相比,膳食胆固醇摄入量最高组收缩压增加了1.87(男性,95%CI 1.01~2.73,P<0.05)、1.44mm Hg(女性,95%CI0.54~2.35,P<0.05);舒张压升高了2.04(男性,95%CI 1.40~2.67,P<0.05)、0.82mm Hg(女性,95%CI0.21~1.44,P<0.05);男性和女性发生高血压的相对危险分别是1.78(95%CI 1.29~2.45,P<0.05)和1.23(95%CI0.87~1.74,P=0.25)。在调整了个体水平、社区水平、基线血压值和基线年龄后,与不摄入膳食胆固醇组相比,胆固醇摄入量与男性收缩压和舒张压呈正相关,与女性收缩压和舒张压呈负相关,男性和女性的膳食胆固醇摄入水平最高组发生高血压的相对危险分别增加,但都无统计学意义。结论无论男性还是女性,膳食胆固醇摄入对血压值和高血压发病风险可能没有影响。
Objective To analyze the effects of dietary cholesterol intake on the blood pressure and the incidence of hypertension in our country. Methods Using data from the China Health and Nutrition Surveys, the study population consisted of 7754 (3756 males and 3998 females) adults who participated in at least two rounds of surveys during 1993-2011 and had normal blood pressure values of 18 to 60 years of age at entry into the cohort. The three-level mixed effects model was used for analysis: model 1, which included only dietary cholesterol intake; model 2, which incorporated individual level variables based on model 1; and model 3, which incorporated community variables based on model 2. Results Compared with men and women who did not consume dietary cholesterol, the systolic blood pressure increased by 1.87 (95% CI 1.01-2.73, P <0.05), 1.44 mm Hg (95% CI0. 54 to 2.35, P <0.05); diastolic blood pressure increased 2.04 (male, 95% CI 1.40-2.67, P <0.05) and 0.82 mm Hg (95% CI0.21-1.44, P <0.05) The relative risk for hypertension in women was 1.78 (95% CI 1.29-2.45, P <0.05) and 1.23 (95% CI 0.87-1.74, P = 0.25), respectively. After adjusting for individual, community, baseline blood pressure, and baseline age, cholesterol intake was positively correlated with male systolic and diastolic blood pressure, and negative with systolic and diastolic blood pressure Related, men and women in the highest dietary intake of cholesterol in the relative risk of hypertension were increased, but not statistically significant. Conclusions Dietary cholesterol intake may have no effect on blood pressure and the risk of developing hypertension, whether male or female.