比较藏族、汉族血脂水平的Meta分析

发布时间：2018-05-18 02:28

本文选题：藏族 + 汉族　；参考：《青海大学》2017年硕士论文

【摘要】：【研究目的】立足于循证医学,系统的评价藏族、汉族血脂水平及不同海拔高度两民族的血脂水平,从而更好地指导不同海拔地区藏汉族居民的生活方式、饮食习惯、合理锻炼等,使机体内血脂水平达到稳态平衡。【研究方法】计算机检索Pub Med,CNKI,VIP,Wan Fang Data,CALIS青海省信息中心等中英文数据库,搜集关于藏族、汉族血脂水平比较的RCT的研究,检索数据库时其时间限定范围从开始建立各自数据库截止到2016年10月。同时,将纳入研究的所有参考文献也一并搜集,并翻阅记录了关于藏族、汉族血脂水平比较的会议、学术论文,以全面补充搜集所需资料。之后研究者依照制定的纳入及排除标准挑选文献,确定能否纳入研究,最后纳入的文献用自己制作的资料提取表填写相关指标,应用Rev Man 5.3软件进行此次Meta分析,比较藏族、汉族体内血脂代谢情况及不同海拔高度下两民族脂质代谢情况。【研究结果】纳入Meta分析的文献数据共22篇随机对照试验(RCT),22673个人,其中汉族有12536人、藏族10137人,结局指标均为血脂四项,即总胆固醇(TCH)、甘油三酯(TG)、高密度脂蛋白(HDL-C)及低密度脂蛋白(LDL-C)。同时,22篇文献中,超高海拔(海拔3500—5500m)的有7篇,共4495个人,其中汉族有1726人、藏族2769人;高海拔(海拔1500—3500m)11篇,共13486个人,其中汉族有8084人、藏族5402人;低海拔(海拔1500m)2篇,共1402个人,其中汉族有1202人、藏族200人。因此本文将按血脂四项分成4组,且按不同海拔分类标准分成3个亚单元,分别进行Meta分析、亚组分析、敏感性分析及评价其发表偏倚,其结果如下:1.比较藏族、汉族TCH1.1TCH的Meta分析结果:SMD=0.18,95%CI[0.08,0.28],P=0.0006,差别有统计学意义。1.2TCH亚组分析结果:(1)超高海拔:SMD=0.31,95%CI[0.16,0.46],P0.0001,差别有统计学意义。(2)高海拔:SMD=0.08,95%CI[-0.09,0.25],P=0.35,差别无统计学意义。(3)低海拔:SMD=-0.57,95%CI[-1.99,0.86],P=0.44,差别无统计学意义。2.比较藏族、汉族TG2.1TG的Meta分析结果:SMD=-0.04,95%CI[-0.20,0.12],P=0.61,差别无统计学意义。2.2TG亚组分析结果:(1)超高海拔:SMD=0.01,95%CI[-0.20,0.22],P=0.92,差别无统计学意义。(2)高海拔:SMD=-0.10,95%CI[-0.22,0.02],P=0.09,差别无统计学意义。(3)低海拔:SMD=-0.06,95%CI[-0.21,0.10],P=0.46,差别无统计学意义。3.比较藏族、汉族HDL-C3.1HDL-C的Meta分析结果:SMD=-0.08,95%CI[-0.20,0.04],P=0.20,差别无统计学意义。3.2HDL-C亚组分析结果:(1)超高海拔:SMD=0.03,95%CI[-0.19,0.25],P=0.79,差别无统计学意义。(2)高海拔:SMD=-0.09,95%CI[-0.28,0.09],P=0.32,差别无统计学意义。(3)低海拔:SMD=-0.03,95%CI[-0.44,0.37],P=0.88,差别无统计学意义。4.比较藏族、汉族LDL-C4.1LDL-C的Meta分析结果:SMD=0.35,95%CI[0.18,0.51],P0.0001,差别有统计学意义。4.2LDL-C亚组分析结果:(1)超高海拔:SMD=0.55,95%CI[0.25,0.85],P=0.0003,差别有统计学意义。(2)高海拔:SMD=0.11,95%CI[-0.24,0.47],P=0.54,差别无统计学意义。(3)低海拔:SMD=-0.61,95%CI[-1.85,0.64],P=0.34,差别无统计学意义。总结:1.藏族的平均TCH、LDL-C水平比汉族的高。2.藏族、汉族的平均TG、HDL-C水平之间无差异。3.超高海拔地区藏族的平均TCH、LDL-C水平比汉族的高。4.超高海拔地区藏族、汉族的平均TG、HDL-C水平之间无差异。5.高海拔地区藏、汉族的平均TCH、TG、HDL-C、LDL-C水平之间无差异。6.低海拔地区藏、汉族的平均TCH、TG、HDL-C、LDL-C水平之间无差异。【研究结论】1.此次Meta分析显示:藏族、汉族体内血脂代谢有差异,且不同海拔高度下两民族脂质代谢有各自特点。2.在TCH、LDL-C、HDL-C方面:和汉族相比,藏族具有发生高TCH、高LDL-C、低HDL-C血症的倾向。3.在TG方面:汉族较藏族具有发生高TG血症的倾向。4.随着海拔的升高,上述结论的倾向更加明显,可能与超高海拔居民的生活方式及饮食习惯有关系。
[Abstract]:[Objective] to evaluate the blood lipid level of the two ethnic groups in Tibetan, Han, Han and different altitudes, based on evidence-based medicine, so as to better guide the living style, eating habits and reasonable exercise of Tibetan and Han residents at different altitudes, so as to make the level of blood lipids in the body reach steady state balance. Pub Med, CNKI, CNKI, VIP, Wan Fang Data, CALIS Qinghai Information Center, and other Chinese and English databases, collect the study on the blood lipid level of the Tibetans and Han people. When retrieving the database, the limits of their time limit from the beginning of the establishment of their respective databases to October 2016. After reading and recording the conference on the blood lipid level of the Tibetans and Han people, the academic papers were used to collect the information needed. The researchers selected the documents according to the standard of inclusion and exclusion and determined whether they could be included in the study. The final included documents were presented with their own data to fill out the related indexes and apply the Rev Man 5.3 software. In this Meta analysis, the lipid metabolism in the Tibetan and Han nationalities and the lipid metabolism of the two ethnic groups at different altitudes were compared. [results] there were 22 randomized controlled trials (RCT) and 22673 people in the literature of Meta analysis. Among them, there were 12536 Han and 10137 Tibetans, and the outcome indexes were four blood lipids, that is, total cholesterol (TCH), Gump. Oil three ester (TG), high density lipoprotein (HDL-C) and low density lipoprotein (LDL-C). At the same time, there are 7 articles in the super high altitude (elevation 3500 - 5500m), including 4495 people, including 1726 Han, 2769 Tibetans, 11 at high altitude (elevation 1500 to 3500m), 13486 people, including 8084, Tibetan 5402, and low altitude (1500m) 2, A total of 1402 people, including 1202 Han and 200 Tibetans, will be divided into 4 groups according to four blood lipids, and are divided into 3 subunits according to the classification standards at different altitudes. Meta analysis, subgroup analysis, sensitivity analysis and evaluation of their publication bias are made as follows: the results are as follows: 1. compared with the Tibetan and Han TCH1.1TCH Meta analysis results: SMD=0.18,95%CI[0 .08,0.28], P=0.0006, the difference of statistical significance.1.2TCH subgroup analysis results: (1) ultra high altitude: SMD=0.31,95%CI[0.16,0.46], P0.0001, the difference is statistically significant. (2) high altitude: SMD=0.08,95%CI[-0.09,0.25], P=0.35, the difference is not statistically significant. (3) low sea pull: SMD=-0.57,95%CI[-1.99,0.86], P=0.44, the difference is not statistically significant.2. comparison of.2. Tibetan and Han TG2.1TG Meta analysis results: SMD=-0.04,95%CI[-0.20,0.12], P=0.61, there is no statistically significant.2.2TG subgroup analysis results: (1) ultra high altitude: SMD=0.01,95%CI[-0.20,0.22], P=0.92, the difference is not statistically significant. (2) Gao Haiba: SMD=-0.10,95%CI[-0.22,0.02], P=0.09, the difference is not statistically significant. (3) low altitude: SMD=-0.06,95%C I[-0.21,0.10], P=0.46, the difference is not statistically significant.3. comparison of Tibetan and Han HDL-C3.1HDL-C Meta analysis results: SMD=-0.08,95%CI[-0.20,0.04], P=0.20, there is no statistical significance.3.2HDL-C subgroup analysis results: (1) ultra high altitude: SMD=0.03,95%CI[-0.19,0.25], P= 0.79, the difference is not statistically significant. (2) Gao Haiba: SMD=-0.09,95%CI[-0.28,0. 09], P=0.32, the difference is not statistically significant. (3) low altitude: SMD=-0.03,95%CI[-0.44,0.37], P=0.88, the difference is not statistically significant.4. comparison of Tibetan, the Han nationality LDL-C4.1LDL-C Meta analysis results: SMD=0.35,95%CI[0.18,0.51], P0.0001, the difference is statistically significant.4.2LDL-C subgroup analysis results: (1) ultra high altitude: SMD=0.55,95%CI[0.25,0.85], P=0.0003 The difference was statistically significant. (2) Gao Haiba: SMD=0.11,95%CI[-0.24,0.47], P=0.54, the difference was not statistically significant. (3) low altitude: SMD=-0.61,95%CI[-1.85,0.64], P=0.34, the difference was not statistically significant. 1. the average TCH of the Tibetans, LDL-C level was higher than the Han nationality, the average TG, the HDL-C level was no difference between.3. ultra high altitude. The average TCH, LDL-C level of the Tibetan region is higher than the Han's high.4. high altitude region Tibetan, the Han's average TG, the HDL-C level has no difference.5. high altitude area, there is no difference between the average TCH, TG, HDL-C, LDL-C level between the Han and the.6. low altitude region, and there is no difference between the average TCH, the average, and the level of the Han nationality. [Conclusion] 1. this time Meta analysis showed that the metabolism of blood lipids in the Tibetan and Han nationalities was different, and the lipid metabolism of the two ethnic groups at different altitudes had their own characteristics.2. in TCH, LDL-C, HDL-C: compared with the Han nationality, the Tibetan had a high TCH, high LDL-C, and low HDL-C, the tendency of.3. in TG: the Han nationality had a tendency.4. with higher TG hyperemia with the altitude. The tendency of the above conclusion is more obvious, which may be related to the lifestyle and eating habits of the residents at the high altitude.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R589.2

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