不同性别无规律运动人群心血管事件危险度的比较研究
发布时间：2018-07-27 11:26
【摘要】：目的:本研究对不同性别35-59岁无规律运动人群未来10年发生缺血性心血管事件(ICVD)的绝对危险度进行评估,分析不同性别对35-39岁、40-44岁、45-49岁、50-54岁、55-59岁五个不同年龄段人群未来10年发生ICVD绝对危险度的影响程度及相关性,各危险因素尤其是性别因素与35-59岁人群未来10年发生ICVD绝对危险度的相关程度,为早期实施预防和治疗提供依据,对于减少缺血性心血管事件的患病率和死亡率具有现实意义。方法:随机选取西安市373名不同性别无规律运动人群为研究对象,其中男性受试者160名,女性受试者213名。采用国家“十五”攻关课题组所开发的“国人缺血性心血管病十年发病危险评估方法”对体检所得的血压、血脂、血糖、体质指数等危险因素进行分析评价,对男女各危险因素做独立样本t检验,并以各危险因素为自变量,绝对危险度为因变量再分别进行线性相关分析和多元回归分析。结果:(1)流行病学情况:各危险因素平均水平男女分别为:年龄(46.88±7.31、46.42±7.10);BMI(25.14±3.12 Kg/m2、23.71±3.55 Kg/m2);SBP(119.79±13.38 mmHg、109.93±14.22 mm Hg);DBP(79.89±9.36mmHg、71.30±9.24mm Hg);腰围(89.18±9.57cm、83.01±8.70 cm);臀围(95.02±5.92cm、94.13±6.16cm);FBG(4.61±1.42mmol/L、4.53±1.53mmol/L);WHR(0.94、0.88);TG(1.82±1.12mmol/L、1.27±0.79 mmol/L);HDL-C(1.25±0.31mmol/L、1.48±0.35mmol/L);LDL-C(3.01±0.779mmol/L、2.94±0.77mmol/L);TC(4.66±0.82mmol/L、4.64±0.83 mmol/L)。各危险因素男女异常指标所占百分比为:SBP≥130mm Hg(男29.38㳠、女14.55㳠);DBP≥85mmHg(男33.13㳠、女8.45㳠);FBG≥7.0mmol/L(男4.38㳠、女3.29㳠);TG≥1.7mmol/L(男43.75㳠、女15.49㳠);HDL-C1.04mmol/L(男25.63㳠、女9.39㳠);LDL-C≥3.37mmol/L(男30.00㳠、女27.23㳠);TC≥5.18mmol/L(男25.00㳠、女24.41㳠);BMI≥25(男49.38㳠、女28.64㳠);吸烟者(男62.50㳠、女8.45㳠)。(2)各年龄段(35-39岁、40-44岁、45-49岁、50-54岁、55-59岁)人群未来10年发生ICVD绝对危险度分别为:男性(0.99、1.34、2.60、2.94、4.03),其中男性45-49岁、50-54岁、55-59岁年龄段绝对危险高于国人平均危险;女性(0.19、0.35、0.58、1.30、2.36),其中50-54岁和55-59岁年龄段绝对危险高于国人参考标准。除55-59岁年龄段10年发生ICVD绝对危险度不同性别有显著性差异(P0.05)外,余下各年龄段不同性别比较均有非常显著性差异(P0.01)。(3)男性无规律运动人群ICVD绝对危险度构成比检出情况:危险度5㳠为88.90㳠;5㳠≤危险度10㳠为10.10㳠;10㳠≤危险度20㳠的为0.60㳠,危险度≥20㳠的为0.6㳠。女性无规律运动人群ICVD绝对危险度构成比检出情况:危险度5㳠为98.6㳠;5㳠≤危险度10㳠为0.5㳠;10㳠≤危险度20㳠的人群为0.9㳠。(4)35-59岁年龄段不同性别无规律运动人群各危险因素与未来10年发生ICVD绝对危险度的相关程度较高且具有显著性,其相关系数β值与P值分别为:男性人群:35-39岁人群(血压:β=0.331,P=0.000;吸烟:β=0.297,P=0.000;血脂:β=0.289,P=0.045);40-44岁人群(血压:β=0.425,P=0.000;BMI:β=0.315,P=0.000;吸烟:β=0.309,P=0.000);45-49岁人群(血压:β=1.463,P=0.000);50-54岁人群(血糖:β=1.179,P=0.043;血脂:β=0.844,P=0.039;血压:β=0.782,P=0.000;吸烟:β=0.745,P=0.000;BMI:β=0.726,P=0.009);55-59岁人群(血糖:β=1.903,P=0.000;BMI:β=1.058,P=0.000;血压:β=1.050,P=0.000;吸烟:β=1.010,P=0.005;血脂:β=0.929,P=0.008)。女性人群:35-39岁人群(血压:β=0.167,P=0.000);40-44岁人群(血压:β=0.338,P=0.000);45-49岁人群(血脂:β=0.299,P=0.005;血压:β=0.289,P=0.000);50-54岁人群(吸烟:β=0.982,P=0.001;血糖:β=0.769,P=0.000;血压:β=0.528,P=0.000;血脂:β=0.453,P=0.008);55-59岁人群(吸烟:β=2.343,P=0.000,血糖:β=1.918,P=0.000;血脂:β=0.867,P=0.042;血压:β=0.864,P=0.000)。(5)就整体而言,不同性别无规律运动人群各危险因素与10年发生ICVD的危险度相关程度从高到低分别为:男性(血糖:β=2.046,P=0.001;血压:β=0.943,P=0.000;年龄:β=0.664,P=0.000;吸烟:β=0.663,P=0.000)。女性(血糖:β=1.496,P=0.000;吸烟:β=1.432,P=0.000;血脂:β=0.506,P=0.000;血压:β=0.462,P=0.000;BMI:β=0.279 P=0.000;年龄:β=0.227 P=0.000)。结论:(1)以性别分组来看,各危险因素与10年发生ICVD的绝对危险相关程度由高到低依次为:男(血糖、血压、年龄、吸烟);女性(血糖、吸烟、血脂、血压、BMI、年龄)。(2)不同性别无规律运动人群除BMI、腰围、臀围、腰臀比高于正常范围外,血压、血糖、血脂四项(仅男性TG高于正常)等危险因素均在正常范围。(3)随着年龄增长,不同性别人群未来10年发生ICVD绝对危险度的平均水平整体呈上升趋势。男性无规律运动人群45-49岁、50-54岁及55-59岁年龄段人群未来10年发生ICVD的绝对危险均高于国人平均危险;女性无规律运动人群50-54岁及55-59岁这两个年龄段人群未来10年发生ICVD的绝对危险度均高于国人平均危险。(4)男性无规律运动人群未来10年发生ICVD的绝对危险度均大于女性,即未来10年男性无规律运动人群罹患心血管疾病的风险要高于女性。(5)以五个年龄段分层来看,各危险因素与10年发生ICVD绝对危险度的相关程度由高到低分别为:(1)35-39岁:男性为血压、吸烟、血脂;女性为血压;(2)40-44岁:男性为血压、BMI、吸烟;女性为血压;(3)45-49岁:男性为血压,女性为血脂、血压;(4)50-54岁:男性为血糖、血脂、血压、吸烟、BMI,女性为吸烟、血糖、血压、血脂;(5)55-59岁:男性为血糖、BMI、血压、吸烟、血脂,女性为吸烟、血糖、血脂、血压。由此可以推测,血压、血糖、吸烟可以作为心血管事件发生的主要参考指标,亦可作为心血管事件发生的独立危险因素。
[Abstract]:Objective: To evaluate the absolute risk of ischemic cardiovascular events (ICVD) in the next 10 years of 35-59 year olds with different sex, and to analyze the degree and correlation of the influence of different sex on the absolute risk of ICVD in the next 10 years of 35-39, 40-44, 45-49, 50-54 and 55-59 years old and five different age groups. The correlation between the risk factors, especially the sex factors and the absolute risk of ICVD in the 35-59 year old population in the next 10 years, provides the basis for the early implementation of prevention and treatment, and is of practical significance for reducing the morbidity and mortality of ischemic cardiovascular events. Methods: 373 people with different sex irregular movements in Xi'an were selected randomly. The subjects were 160 male subjects and 213 female subjects. The risk factors, such as blood pressure, blood lipid, blood sugar and body mass index, were analyzed and evaluated by the national "fifteen" group of "fifteen" task group. The risk factors of blood pressure, blood lipid, blood sugar and body mass index were evaluated, and the independent sample of the risk factors of men and women was t. The results were: (1) the average levels of the risk factors were: age (46.88 + 7.31,46.42 + 7.10), BMI (25.14 + 3.12 Kg/m2,23.71 + 3.55 Kg/m2), SBP (119.79 + 13.38 mmHg, 109.93 +, 109.93 +), respectively. 14.22 mm Hg), DBP (79.89 + 9.36mmHg, 71.30 + 9.24mm Hg), waist circumference (89.18 + 9.57cm, 83.01 + 8.70 cm), hip circumference (95.02 + 5.92cm, 94.13 + 6.16cm), FBG (4.61 + 1.42mmol/L, 4.53 + 83.01); TC (4.66 + 0.82mmol/L, 4.64 + 0.83 mmol/L). The percentage of abnormal indicators of male and female risk factors: SBP > 130mm Hg (male 29.38?, female 14.55?); DBP more than 85mmHg (male 33.13?, female 8.45?); FBG > 7.0mmol/L (men 4.38?, 3.29?); TG > 1.7mmol/ (male 43.75, 15.49?); male 25.63? Female 9.39?) Female 27.23?); TC > 5.18mmol/L (male 25?, female 24.41?); BMI > 25 (male 49.38, female 28.64?); smokers (62.50 men, 8.45?). (2) each age group (35-39, 40-44 years, 45-49, 50-54 years, 55-59 years old) in the future, the risk of male (0.99,1.34,2.60,2.94,4.03), male (0.99,1.34,2.60,2.94,4.03) The absolute risk of the segment was higher than the national average risk; women (0.19,0.35,0.58,1.30,2.36), of which the absolute risk of 50-54 and 55-59 years old was higher than the national reference standard. There were significant differences in the absolute risk of ICVD in the 55-59 year old age group (P0.05). (P0.01). (3) the ICVD absolute risk constitution ratio detection of male irregular movement population: risk degree 5? 88.90?; 5? (10?) risk degree 10?; 10? (20?), 0.60? The risk factors of 20? (4) were 0.9? (4) the risk factors of different sex unregulated groups in the age group of 35-59 years were higher and significantly correlated with the absolute risk of ICVD in the next 10 years. The correlation coefficient beta and P were: the male population: the 35-39 year old group (blood pressure: beta =0.331, P=0.000; smoking: beta =0.297, P=0.000; blood lipid: Beta =0.289, P=0.045); 40-44 year old people (blood pressure: beta =0.425, P=0.000; BMI: beta =0.315, P=0.000; smoking: beta =0.309, P=0.000); 45-49 years old people (blood pressure: beta =1.463, P=0.000); blood glucose: beta blood pressure: Beta Beta =1.903, P=0.000; BMI: beta =1.058, P=0.000; blood pressure: beta =1.050, P=0.000; smoking: beta =1.010, P=0.005; blood lipids: beta =0.929, P=0.008). Female population (blood pressure: beta =0.167, =1.058); 45-49 year old people (blood pressure: beta blood pressure: beta blood pressure, beta); people (smoking: beta: beta, smoking, beta) P=0.001; blood glucose: beta =0.769, P=0.000; blood pressure: beta =0.528, P=0.000; blood lipid: beta =0.453, P=0.008); 55-59 year old people (smoking: beta =2.343, P=0.000, beta =1.918, P=0.000; beta =0.867, blood pressure, beta). (5) in the whole body, the risk factors of different sex irregular movement groups are related to the risk correlation of 10 years. From high to low, male (blood sugar: beta =2.046, P=0.001; blood pressure: beta =0.943, P=0.000; age: beta =0.664, P=0.000; smoking: beta =0.663, P=0.000). According to the group, the degree of risk factors associated with the absolute risk of ICVD in 10 years from high to low was male (blood sugar, blood pressure, age, smoking); women (blood sugar, smoking, blood lipid, blood pressure, BMI, age). (2) except BMI, waist circumference, hip circumference, waist hip ratio above normal range, blood pressure, blood sugar, blood fat four items (only male) The risk factors such as TG are higher than normal. (3) as the age increases, the average level of the absolute risk of ICVD in the next 10 years of the different sexes is rising. The male irregular movement population is 45-49 years old, and the absolute risk of the occurrence of ICVD in the 50-54 and 55-59 year olds is higher than the average risk of the people in the next 10 years. The absolute risk of ICVD in the next 10 years of the two age groups of 50-54 and 55-59 years old is higher than the national average risk. (4) the absolute risk of ICVD in the next 10 years of the male irregular movement population is greater than that of the female. That is, the risk of cardiovascular disease in the male irregular movement population in the next 10 years is higher than that in the next 10 years. (5) in five age groups, the correlation between the risk factors and the absolute risk of ICVD in 10 years was from high to low: (1) 35-39 years old: men were blood pressure, smoking, blood lipid; women were blood pressure; (2) 40-44 years old: men were blood pressure, BMI, smoking; women were blood pressure; (3) 45-49 years old: men were blood pressure, women were blood lipids, blood pressure; (4) 50-54 Age: men are blood sugar, blood fat, blood pressure, smoking, BMI, and women are smoking, blood sugar, blood pressure, blood lipid; (5) 55-59 years old: male is blood sugar, BMI, blood pressure, smoking, blood lipid, women are smoking, blood sugar, blood lipid, blood pressure. Thus, it can be speculated that blood pressure, blood sugar, smoking can be the main reference index of cardiovascular events, and may also be used as cardiovascular events. Independent risk factors.
【学位授予单位】：西安体育学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：G804.49
[Abstract]:Objective: To evaluate the absolute risk of ischemic cardiovascular events (ICVD) in the next 10 years of 35-59 year olds with different sex, and to analyze the degree and correlation of the influence of different sex on the absolute risk of ICVD in the next 10 years of 35-39, 40-44, 45-49, 50-54 and 55-59 years old and five different age groups. The correlation between the risk factors, especially the sex factors and the absolute risk of ICVD in the 35-59 year old population in the next 10 years, provides the basis for the early implementation of prevention and treatment, and is of practical significance for reducing the morbidity and mortality of ischemic cardiovascular events. Methods: 373 people with different sex irregular movements in Xi'an were selected randomly. The subjects were 160 male subjects and 213 female subjects. The risk factors, such as blood pressure, blood lipid, blood sugar and body mass index, were analyzed and evaluated by the national "fifteen" group of "fifteen" task group. The risk factors of blood pressure, blood lipid, blood sugar and body mass index were evaluated, and the independent sample of the risk factors of men and women was t. The results were: (1) the average levels of the risk factors were: age (46.88 + 7.31,46.42 + 7.10), BMI (25.14 + 3.12 Kg/m2,23.71 + 3.55 Kg/m2), SBP (119.79 + 13.38 mmHg, 109.93 +, 109.93 +), respectively. 14.22 mm Hg), DBP (79.89 + 9.36mmHg, 71.30 + 9.24mm Hg), waist circumference (89.18 + 9.57cm, 83.01 + 8.70 cm), hip circumference (95.02 + 5.92cm, 94.13 + 6.16cm), FBG (4.61 + 1.42mmol/L, 4.53 + 83.01); TC (4.66 + 0.82mmol/L, 4.64 + 0.83 mmol/L). The percentage of abnormal indicators of male and female risk factors: SBP > 130mm Hg (male 29.38?, female 14.55?); DBP more than 85mmHg (male 33.13?, female 8.45?); FBG > 7.0mmol/L (men 4.38?, 3.29?); TG > 1.7mmol/ (male 43.75, 15.49?); male 25.63? Female 9.39?) Female 27.23?); TC > 5.18mmol/L (male 25?, female 24.41?); BMI > 25 (male 49.38, female 28.64?); smokers (62.50 men, 8.45?). (2) each age group (35-39, 40-44 years, 45-49, 50-54 years, 55-59 years old) in the future, the risk of male (0.99,1.34,2.60,2.94,4.03), male (0.99,1.34,2.60,2.94,4.03) The absolute risk of the segment was higher than the national average risk; women (0.19,0.35,0.58,1.30,2.36), of which the absolute risk of 50-54 and 55-59 years old was higher than the national reference standard. There were significant differences in the absolute risk of ICVD in the 55-59 year old age group (P0.05). (P0.01). (3) the ICVD absolute risk constitution ratio detection of male irregular movement population: risk degree 5? 88.90?; 5? (10?) risk degree 10?; 10? (20?), 0.60? The risk factors of 20? (4) were 0.9? (4) the risk factors of different sex unregulated groups in the age group of 35-59 years were higher and significantly correlated with the absolute risk of ICVD in the next 10 years. The correlation coefficient beta and P were: the male population: the 35-39 year old group (blood pressure: beta =0.331, P=0.000; smoking: beta =0.297, P=0.000; blood lipid: Beta =0.289, P=0.045); 40-44 year old people (blood pressure: beta =0.425, P=0.000; BMI: beta =0.315, P=0.000; smoking: beta =0.309, P=0.000); 45-49 years old people (blood pressure: beta =1.463, P=0.000); blood glucose: beta blood pressure: Beta Beta =1.903, P=0.000; BMI: beta =1.058, P=0.000; blood pressure: beta =1.050, P=0.000; smoking: beta =1.010, P=0.005; blood lipids: beta =0.929, P=0.008). Female population (blood pressure: beta =0.167, =1.058); 45-49 year old people (blood pressure: beta blood pressure: beta blood pressure, beta); people (smoking: beta: beta, smoking, beta) P=0.001; blood glucose: beta =0.769, P=0.000; blood pressure: beta =0.528, P=0.000; blood lipid: beta =0.453, P=0.008); 55-59 year old people (smoking: beta =2.343, P=0.000, beta =1.918, P=0.000; beta =0.867, blood pressure, beta). (5) in the whole body, the risk factors of different sex irregular movement groups are related to the risk correlation of 10 years. From high to low, male (blood sugar: beta =2.046, P=0.001; blood pressure: beta =0.943, P=0.000; age: beta =0.664, P=0.000; smoking: beta =0.663, P=0.000). According to the group, the degree of risk factors associated with the absolute risk of ICVD in 10 years from high to low was male (blood sugar, blood pressure, age, smoking); women (blood sugar, smoking, blood lipid, blood pressure, BMI, age). (2) except BMI, waist circumference, hip circumference, waist hip ratio above normal range, blood pressure, blood sugar, blood fat four items (only male) The risk factors such as TG are higher than normal. (3) as the age increases, the average level of the absolute risk of ICVD in the next 10 years of the different sexes is rising. The male irregular movement population is 45-49 years old, and the absolute risk of the occurrence of ICVD in the 50-54 and 55-59 year olds is higher than the average risk of the people in the next 10 years. The absolute risk of ICVD in the next 10 years of the two age groups of 50-54 and 55-59 years old is higher than the national average risk. (4) the absolute risk of ICVD in the next 10 years of the male irregular movement population is greater than that of the female. That is, the risk of cardiovascular disease in the male irregular movement population in the next 10 years is higher than that in the next 10 years. (5) in five age groups, the correlation between the risk factors and the absolute risk of ICVD in 10 years was from high to low: (1) 35-39 years old: men were blood pressure, smoking, blood lipid; women were blood pressure; (2) 40-44 years old: men were blood pressure, BMI, smoking; women were blood pressure; (3) 45-49 years old: men were blood pressure, women were blood lipids, blood pressure; (4) 50-54 Age: men are blood sugar, blood fat, blood pressure, smoking, BMI, and women are smoking, blood sugar, blood pressure, blood lipid; (5) 55-59 years old: male is blood sugar, BMI, blood pressure, smoking, blood lipid, women are smoking, blood sugar, blood lipid, blood pressure. Thus, it can be speculated that blood pressure, blood sugar, smoking can be the main reference index of cardiovascular events, and may also be used as cardiovascular events. Independent risk factors.
【学位授予单位】：西安体育学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：G804.49
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