Abstract
BACKGROUND: The COVID-19 pandemic prompted over 170 countries to implement lockdowns, significantly altering lifestyles and potentially impacting cardio-cerebrovascular risk factors (CCVRFs). This study evaluates changes in CCVRFs before, during, and after the lockdown, stratified by population subgroups. We aim to mitigate the lockdown's impact on CCVRFs, address knowledge gaps, and inform future health management strategies. METHODS: This cross-sectional study analyzed preventive health assessment data of individuals at the Health Management Center of Shengjing Hospital, China Medical University. The study covers three timeframes: pre-pandemic (January 1, 2017, to December 31, 2019), during the pandemic lockdown (January 1, 2020, to December 31, 2022), and after the pandemic lockdown (January 1, 2023, to December 31, 2023). The primary outcome was the change in prevalence of hypertension, dyslipidemia, diabetes mellitus, systemic inflammation index, and insulin resistance index before, during, and after the COVID-19 pandemic lockdown. Additionally, multivariate linear or logistic regression analysis the association between changes in CCVRFs and the COVID-19 pandemic lockdown. RESULTS: This study included 46,958 participants: 21,062 pre-pandemic, 18,164 during lockdown, and 7732 post-lockdown. Compared to pre- and post-lockdown periods, diabetes mellitus incidence significantly increased during lockdown. Systemic immune indicators (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], systemic immune-inflammation index [SII]) and insulin resistance markers (triglyceride-glucose index [TyG], TyG-body mass index [TyG-BMI]) also increased significantly. Subgroup analyses revealed more pronounced changes in CCVRFs among individuals over 60 during lockdown. Multivariate analysis showed a significant association between lockdown and CCVRFs, with adjusted odds ratios (OR) and β values (95% confidence intervals) as follows: diabetes mellitus 1.37 (1.28-1.47), PLR 5.44 (4.77-6.11), NLR 0.05 (0.04-0.06), SII 5.28 (1.91-8.65), TyG 0.03 (0.02-0.05), and TyG-BMI 4.16 (3.47-4.84). CONCLUSIONS: In this cross-sectional study, the prevalence of diabetes mellitus, systemic inflammation index, and insulin resistance index increased during the COVID-19 pandemic lockdown, highlighting the importance of proactively managing CCVRFs during and after the pandemic lockdowns.