2009-2018年中国九省不同职业类型人群心血管代谢危险因素趋势OA

[Background]With China's socioeconomic development,significant lifestyle changes have oc-curred among occupational groups,leading to alterations in cardiovascular metabolic risk fac-tors.However,few studies have examined the secular trends of these risk factors in China's working population. [Objective]To analyze the trends in cardiovascular metabolic risk factors among the occupational population in nine provinces of China from 2009 to 2018,and to explore the associations between different occupational types and these risk factors,along with their clustering patterns,thereby providing evidence for targeted interventions. [Methods]This study utilized data from the China Health and Nutrition Survey(CHNS)in 2009,2015,and 2018.The dataset covered 13 274 employed individuals aged 18-59 years.Only participants with complete blood test results and physical measurement data were included in the final analysis.The average annual percentage change(AAPC)in the positive rates of risk factors was calculated using Joinpoint re-gression to analyze temporal trends.Multinomial logistic regression and binary logistic regression models were employed to examine the cross-sectional associations between occupational types(categorized as white-collar workers,agricultural workers,blue-collar workers,service workers,and others)and nine cardiovascular metabolic risk factors and their clustering(defined as having≥2 risk factors)in 2018. [Results]A total of 8 451 participants were included.From 2009 to 2018,significant increasing trends(AAPC>0,P<0.05)were observed for overweight,obesity,central obesity,borderline elevated triglycerides(TG),borderline elevated to elevated total cholesterol(TC),bor-derline elevated low-density lipoprotein cholesterol(LDL-C),elevated blood pressure and hypertension,diabetes.The most rapid increases were found for obesity(AAPC=6.07%,95%CI:3.42%,8.88%),hypertension(AAPC=4.10%,95%CI:0.62%,7.77%),and central obesity(AAPC=3.27%,95%CI:1.24%,5.36%).The clustering rate of risk factors increased from 62.3%in 2009 to 73.2%in 2018(AAPC=1.87%,95%CI:1.02%,2.73%).The cross-sectional analysis in 2018,after adjusting for confounders,showed that compared with white-collar workers,blue-collar workers had a significantly lower risk of overweight(OR=0.67,95%CI:0.48,0.95),central obesity(OR=0.65,95%CI:0.45,0.92),and borderline high TG(OR=0.54,95%CI:0.35,0.82).In contrast,agricultural workers had a higher risk of hypertension(OR=1.76,95%CI:1.14,2.72). [Conclusion]Between 2009 and 2015,the burden of most cardiometabolic risk factors increases significantly among the Chinese occupa-tional population,with the rate of increase slowing by 2018.Risks vary across occupational types,among which blue-collar workers report lower target outcomes.Targeted interventions focusing on the rapidly increasing risk factors and high-risk occupational groups are rec-ommended.