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

摘要： 背景　随着我国人口老龄化发展加剧，中老年人群体中心脏代谢性疾病的共病率逐渐增高，国内现有关注综合生活方式与心脏代谢性共病的关联性研究较少。目的　了解我国中老年人(≥45岁)心脏代谢性疾病的共病情况，探究该群体中综合生活方式与心脏代谢性共病之间的关联。方法　利用2018年《中国健康与养老追踪调查》 (CHARLS)的数据，选取45岁及以上的中老年人作为研究对象，了解中老年群体中心脏代谢性疾病的共患病情况。通过构建综合生活方式指标（吸烟、饮酒、身体活动、睡眠、社会联系），利用Logistic回归模型探究综合生活方式与心脏代谢性共病之间的关联。结果　在纳入的19,459名中老年人中，高血压共病例数为4,548人(23.42%)，同时患有2种及以上心脏代谢性疾病的有5,443人（28.0%）。26.7%的中老年人坚持4-5种健康生活方式(即不吸烟、适度饮酒、定期身体活动、健康睡眠、适当社会联系)，65.7%的中老年人有中等健康的生活方式，7.6%的中老年人有不健康的生活方式。年龄（55~<65：OR=1.83,95%CI=1.67-2.00，p<0.001;65~<75：OR=2.89,95%CI=2.64-3.16，p<0.001；≥75：OR=3.05,95%CI=2.74~3.40，p<0.001）、性别（男性：OR=0.83,95%CI=0.78-0.89，p<0.001）、教育程度（高中及以上：OR=1.38,95%CI=1.25-1.52，p<0.001）、婚姻状况（已婚：OR=0.70,95%CI=0.64-0.76，p<0.001）、居住地类型（农村：OR=0.67,95%CI=0.63-0.72，p<0.001）、医疗保险（有：OR=1.57,95%CI=1.28-1.93，p<0.001）是中老年人心脏代谢性共病的患病影响因素，P<0.001。Logistic回归分析结果显示，调整混杂因素后，健康的生活方式与较低的心脏代谢性共病患病风险相关（OR=0.59, 95%CI：0.52-0.66）。按照居住类类型（农村OR=0.58，p<0.001；城镇OR=0.61，p<0.001）、性别（男性OR=0.44，p<0.001；女性OR=0.71，p<0.05）以及年龄（≥65岁OR=0.44，p<0.001；<65岁=0.69，p<0.001）进行分层分析，研究结果均显示健康的生活方式与更低的心脏代谢性共病患病风险相关。结论　坚持健康的生活方式与我国中老年人心脏代谢性共病的患病率降低有关。加强对中老年人的生活方式干预，能够提高我国中老年人的心血管健康水平，对促进健康老龄化具有重要意义。

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