山东丘陵农村老年人群硒摄入水平与高血压关系的研究

卢晓地; 吕实波; 王秀红; 王园园; 李为波; 董淑瑶; 石峰; 种冠峰

doi:10.16766/j.cnki.issn.1674-4152.004106

山东丘陵农村老年人群硒摄入水平与高血压关系的研究

doi: 10.16766/j.cnki.issn.1674-4152.004106

1.
山东省疾病预防控制中心综合门诊部，山东济南 250014
2.
山东省疾病预防控制中心卫生检验检测所
3.
山东省疾病预防控制中心地方病防制所
4.
山东省疾病预防控制中心健康教育所

基金项目:

山东省医药卫生科技发展计划项目 202312071345

详细信息

通讯作者:
种冠峰，E-mail: cgffriends@126.com

中图分类号: R589.9 R544.1
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出版历程
- 收稿日期: 2024-04-09
- 网络出版日期: 2025-10-25

The correlation between selenium intake and hypertension among rural eldly in Shandong Hilly Region

1.
Outpatient Department, Shandong Center for Disease Control and Prevention, Jinan, Shandong 250014, China

摘要

摘要: 目的调查山东丘陵地区农村老年人群硒摄入量与高血压患病情况，探讨硒摄入水平与高血压的相关性，为制定适宜的高血压防治策略提供依据。方法于2023年2—11月采用多阶段分层抽样的方法，在山东丘陵地区13个县(市、区)抽取≥60周岁常住居民进行问卷调查和体格检查，利用膳食摄入量调查表，对调查对象进行近1年的回顾性膳食调查，计算每日硒摄入量，根据硒摄入量五分位数分为5组并进行χ²检验，对高血压危险因素行logistic回归分析。结果共调查2 068人，高血压病患者1 153人，高血压患病率为55.75%，标化患病率为58.46%。5组间高血压患病率差异有统计学意义(P＜0.05)，按照性别、年龄、饮酒、BMI、腹型肥胖、糖尿病、每周运动量分组，不同人群高血压患病率不同(P＜0.05)。Logistic回归分析显示，以硒摄入量第1五分位组作为对照，第2五分位组、第3五分位组、第4五分位组、第5五分位组OR值(95% CI)分别为0.945(0.903~1.051)、0.917(0.873~0.945)、0.891(0.854~0.939)、0.832(0.783~0.884)，随着每日硒摄入量的增加，OR值呈递减趋势。结论硒摄入水平与老年人群高血压患病率呈负相关关系，增加硒摄入量可降低高血压的发病风险。
- 硒 /
- 高血压 /
- 老年人群 /
- 农村
Abstract: Objective To investigate the selenium intake and hypertension prevalence among the elderly population in rural areas of the hilly region of Shandong Province, and to explore the correlation between selenium intake levels and hypertension, thereby providing a basis for formulating appropriate prevention and control strategies for hypertension. Methods From February to November 2023, the permanent residents aged ≥60 years old were selected in 13 counties/districts with stratified multistage cluster sampling. Questionnaires and physical examinations were conducted on the subjects. A one-year dietary questionnaire was used to compute the daily dietary intake of total selenium. They were divided into five groups according to the quintile of selenium intake and tested, The risk factors were analyzed by logistic regression. Results A total of 2 068 subjects were selected, 1 153 were detected with hypertension, the crude prevalence of hypertension was 55.75%, and the standardized prevalence rate was 58.46%. There was a significant difference in the prevalence of hypertension among the five groups (P < 0.05). According to gender, age, alcohol consumption, BMI, abdominal obesity, diabetes, and weekly exercise, the prevalence of hypertension in different populations was different(P < 0.05). The results of multivariate logistic regression analysis showed that the odds ratio (OR) of the P₂₁-P₄₀ group, P₄₁-P₆₀ group, P₆₁-P₈₀ group, P₈₁-P₁₀₀ group were 0.945 (0.903-1.051), 0.917 (0.873-0.945), 0.891 (0.854-0.939), 0.832(0.783-0.884) respectively compared to P₁-P₂₀ group. With the increase in daily selenium intake, the OR showed a decreasing trend. Conclusion Selenium intake is negatively correlated with the prevalence of hypertension in the elderly population. Increasing selenium intake can reduce the risk of hypertension.
- Selenium /
- Hypertension /
- Elderly population /
- Rural

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表 1 不同年龄与硒摄入量人群分布情况(人)

Table 1. Distribution of selenium intake across different age groups

年龄(岁)	第1五分位组(9.83~28.31 μg/d)	第2五分位组(28.32~38.75 μg/d)	第3五分位组(38.76~45.91 μg/d)	第4五分位组(45.92~56.23 μg/d)	第5五分位组(56.24~71.54 μg/d)	合计
60~	181	183	187	185	194	930
70~	142	144	145	151	142	724
80~	90	87	82	79	76	414
合计	413	414	414	415	412	2 068

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表 2 高血压患病影响因素的单因素分析

Table 2. Univariate analysis of factors influencing hypertension

变量	调查数	患病率(%)	χ²值	P值
性别			4.162	0.041
男性	956	556(58.16)
女性	1 112	597(53.69)
年龄(岁)			7.334	0.026
60~69	930	493(53.01)
70~79	724	408(56.35)
≥80	414	252(60.87)
吸烟情况			2.901	0.089
是	623	365(58.59)
否	1 445	788(54.53)
饮酒情况			8.968	0.003
是	497	306(61.57)
否	1 571	847(53.91)
BMI			13.727	0.001
BMI＜24	952	492(51.68)
24≤BMI＜28	744	430(57.80)
28＜BMI	372	231(62.10)
腹型肥胖			9.541	0.002
是	862	515(59.74)
否	1 206	638(52.90)
糖尿病			24.356	< 0.001
是	365	246(67.39)
否	1 703	907(53.26)
每周运动时间(h)			13.029	0.001
＜0.5	452	280(61.95)
0.5~1.5	643	367(57.08)
＞1.5	973	506(52.00)
硒摄入量(μg/d)			11.224	0.024
第1五分位组	413	252(61.02)
第2五分位组	414	240(57.97)
第3五分位组	414	233(56.28)
第4五分位组	415	219(52.77)
第5五分位组	412	209(50.73)

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表 3 不同硒摄入组高血压患病率比较

Table 3. Comparison of hypertension prevalence among different selenium intake groups

组合	组1	组2	χ²值	P值
1	第1五分位组	第2五分位组	0.675	0.411
2	第1五分位组	第3五分位组	1.722	0.189
3	第1五分位组	第4五分位组	5.407	0.020
4	第1五分位组	第5五分位组	8.443	0.004
5	第2五分位组	第3五分位组	0.178	0.674
6	第2五分位组	第4五分位组	2.062	0.151
7	第2五分位组	第5五分位组	4.079	0.043
8	第3五分位组	第4五分位组	0.893	0.345
9	第3五分位组	第5五分位组	2.340	0.126
10	第4五分位组	第5五分位组	0.269	0.604
注：校正检验水准α=0.005。

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表 4 高血压患病影响因素的多因素logistic回归分析

Table 4. Multivariate logistic regression analysis of factors influencing hypertension

变量	B	SE	Waldχ²	P值	OR值	95% CI
性别
男性	0.182	0.089	4.182	0.041	1.199	1.007~1.428
年龄(岁)
70~79	0.869	0.112	60.201	＜0.001	2.386	2.827~1.834
≥80	1.506	0.063	571.438	＜0.001	4.507	3.926~5.034
吸烟情况
吸烟	0.156	0.103	2.294	0.122	1.169	0.960~1.423
饮酒情况
饮酒	0.147	0.089	2.728	0.091	1.158	0.923~1.313
BMI
24~28	0.704	0.128	30.250	＜0.001	2.023	1.578~2.614
≥28	1.338	0.083	260.497	＜0.001	3.813	3.252~4.503
腹型肥胖
有	1.146	0.093	151.846	＜0.001	3.144	2.587~3.722
糖尿病
有	1.266	0.086	216.706	＜0.001	3.548	2.929~4.106
运动时间(h/周)
0.5~1.5	-0.081	0.019	18.175	＜0.001	0.923	0.891~0.960
>1.5	-0.127	0.031	16.784	＜0.001	0.881	0.832~0.936
硒摄入量(μg/d)
第2五分位组	-0.056	0.038	2.172	0.144	0.945	0.903~1.051
第3五分位组	-0.087	0.021	17.163	< 0.001	0.917	0.873~0.945
第4五分位组	-0.115	0.024	22.960	< 0.001	0.891	0.854~0.939
第5五分位组	-0.184	0.031	35.229	< 0.001	0.832	0.783~0.884
注：赋值方法如下，女性=0，男性=1；年龄60~69岁=0，70~79岁=1，≥80岁=2；不吸烟=0，吸烟=1；不饮酒=0，饮酒=1；BMI＜24=0，BMI 24~28=1，BMI≥28=2；无腹型肥胖=0，腹型肥胖=1；无糖尿病=0，糖尿病=1；运动时间(h/周)＜0.5=0，0.5~1.5=1，>1.5=2；硒摄入量，第1五分位组=0，第2五分位组=1，第3五分位组=2，第4五分位组=3，第5五分位组=4。各变量均以赋值为0的类别为参照组。

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