关键词: 心脏代谢性共病, 中老年人, 生活方式, Logistic回归分析

Abstract: Background　With the increasing aging people in China, the prevalence of cardiometabolic multimorbidity among middle-aged and elderly individuals is gradually rising. There are fewer studies in China that focus on the association between integrate lifestyle and cardiometabolic multimorbidity in the middle-aged and elderly people. Objective　To investigate the prevalence of cardiometabolic comorbidities among Chinese adults aged 45 years and older, and to explore the association between integrate lifestyle factors and cardiometabolic comorbidities in this population. Methods　Data were obtained from the China Health and Retirement Longitudinal Study 2018 (CHARLS 2018), targeting individuals aged 45 and above. The prevalence of cardiometabolic comorbidities in this population was assessed. A comprehensive lifestyle index was constructed, incorporating smoking, alcohol consumption, physical activity, sleep, and social connections. Logistic regression models were used to investigate the association between these lifestyle factors and cardiometabolic comorbidities. Results　Among the 19,459 middle-aged and elderly individuals included, 4,548 (23.42%) had hypertension, and 5,443 (28.0%) had two or more cardiometabolic diseases. A total of 26.7% of participants adhered to 4-5 healthy lifestyle practices (i.e., non-smoking, moderate alcohol consumption, regular physical activity, healthy sleep, and adequate social connections), 65.7% had moderately healthy lifestyles, and 7.6% had unhealthy lifestyles. Age (55 to <65 years: OR=1.83, 95% CI=1.67-2.00, p<0.001; 65 to <75 years: OR=2.89, 95% CI=2.64-3.16, p<0.001; ≥75 years: OR=3.05, 95% CI=2.74-3.40, p<0.001), gender (male: OR=0.83, 95% CI=0.78-0.89, p<0.001), educational level (high school or above: OR=1.38, 95% CI=1.25-1.52, p<0.001), marital status (married: OR=0.70, 95% CI=0.64-0.76, p<0.001), residential type (rural: OR=0.67, 95% CI=0.63-0.72, p<0.001), and health insurance (insured: OR=1.57, 95% CI=1.28-1.93, p<0.001) were significant factors influencing the prevalence of cardiometabolic comorbidities (p<0.001). Logistic regression analysis revealed that, after adjusting for confounding factors, a healthy lifestyle was associated with a significantly lower risk of cardiometabolic comorbidities (OR=0.59, 95% CI=0.52-0.66). Stratified analyses by residential type (rural OR=0.58, p<0.001; urban OR=0.61, p<0.001), gender (male OR=0.44, p<0.001; female OR=0.71, p<0.05), and age (≥65 years OR=0.44, p<0.001; <65 years OR=0.69, p<0.001) consistently showed that a healthy lifestyle was associated with a reduced risk of cardiometabolic comorbidities. Conclusion　Adherence to a healthy lifestyle is associated with a reduced prevalence of cardiometabolic comorbidities among middle-aged and older adults in China. Strengthening lifestyle interventions in this population could improve cardiovascular health and contribute significantly to promoting healthy aging in China.

Key words: Cardiometabolic multimorbidity, Middle-aged elderly people, Lifestyle, Logistic regression analysis