某农村人群脂质代谢异常的发病率及其危险因素的队列研究

发布时间：2018-10-26 10:45

【摘要】：目的:调查某农村人群脂质代谢异常的发病率及其危险因素,为干预计划的制定提供科学依据。方法:本研究选择河南省某县的两个镇为研究现场,以自然村为单位,采用整群抽样的方法,于2007年7—8月和2008年7—8月对20194名18岁以上农村居民进行问卷调查、体格检查、空腹血糖及脂质谱检测。2013年7—8月和2014年7—10月进行与基线相同内容的随访研究,共随访到17265名研究对象。最终纳入研究对象7720名。应用logistic回归模型分析血脂异常的危险因素,并将得到的OR值转化为RR值。Δ表示随访时的值与相对应的基线值之差。结果:1、该农村地区18岁及以上居民6年内血脂异常的累积发病率为36.61%(95%CI:35.53~37.69),其中男性(39.62%[95%CI:37.74~41.53])高于女性(35.07%[95%CI:33.76~36.40])。低高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、高甘油三酯(triglyceride,TG)、高总胆固醇(total cholesterol,TC)和高低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)血症的累积发病率分别为28.71%(95%CI:27.70~29.74)、11.24%(95%CI:10.54~11.96)、2.54%(95%CI:2.20~2.91)和2.14%(95%CI:1.82~2.48)。2、对研究对象基线的性别、年龄、受教育水平、婚姻状况及人均月收入调整后,多因素logistic回归分析显示:(1)超重/肥胖(RR=1.12,95%CI:1.01~1.24)、腰围(waist circumference,WC)异常(RR=1.17,95%CI:1.06~1.28)、腰身比(waist-height ratio,WHt R)异常(RR=1.17,95%CI:1.05~1.30)、舒张压(diastolic blood pressure,DBP)异常(RR=1.14,95%CI:1.01~1.28)、空腹血糖水平(fasting plasma glucose,FPG)≥6.1 mmol/L(RR=1.15,95%CI:1.03~1.27)、体重增重(2.50~5.00 kg:RR=1.11,95%CI:1.01~1.21;≥5.00 kg:RR=1.36,95%CI:1.25~1.46)、ΔWC≥6.20 cm(RR=1.17,95%CI:1.06~1.27)均增加血脂异常的发病风险,低体重(RR=0.58,95%CI:0.42~0.77)、体重减轻(RR=0.81,95%CI:0.71~0.91)、WC减少(RR=0.86,95%CI:0.77~0.96)均降低其发病风险;(2)饮酒(RR=2.14,95%CI:1.12~4.03)、超重/肥胖(RR=1.76,95%CI:1.06~2.88)和Δ体重≥5.00 kg(RR=2.00,95%CI:1.31~3.02)均增加高TC血症的发病风险;(3)饮酒(RR=1.33,95%CI:1.02~1.72)、WC异常(RR=1.29,95%CI:1.05~1.57)、WHt R异常(RR=1.73,95%CI:1.39~2.16)、FPG≥6.1 mmol/L(RR=1.30,95%CI:1.05~1.60)、体重增重(2.50~5.00 kg:RR=1.32,95%CI:1.07~1.59;≥5.00 kg:RR=2.01,95%CI:1.68~2.38)和ΔWC≥6.20 cm(RR=1.52,95%CI:1.24~1.85)均增加高TG血症的发病风险,WC减少(RR=0.71,95%CI:0.56~0.90)降低高TG血症的发病风险;(4)WC异常(RR=1.16,95%CI:1.03~1.30)、WHt R异常(RR=1.17,95%CI:1.03~1.33)、体重增重(≥5.00 kg:RR=1.29,95%CI:1.16~1.42)和ΔWC≥6.20 cm(RR=1.13,95%CI:1.01~1.26)均增加低HDL-C血症的发病风险,低体重(RR=0.46,95%CI:0.31~0.68)和体重减轻(RR=0.85,95%CI:0.74~0.99)降低低HDL-C血症的发病风险;(5)高LDL-C血症的发病风险与各因素均无关。结论:1、该农村人群6年内血脂异常的累积发病率水平较高,以高TG和低HDL-C血症为主要脂质代谢异常类型。2、超重/肥胖、WC异常、WHt R异常、DBP异常、FPG≥6.1 mmol/L、体重增重、ΔWC≥6.20cm是血脂异常独立的危险因素,而低体重、体重减轻、WC减少是其独立的保护因素。
[Abstract]:Objective: To investigate the incidence and risk factors of lipid metabolism abnormality in a rural population, and to provide scientific basis for the development of intervention plan. Methods: This study selects two towns of a county in Henan Province as the research field, takes the natural village as the unit, adopts the cluster sampling method, makes a questionnaire survey and physical examination on 20194 rural residents aged 18 and over in July and August 2007 and July 2008, 2008. Fasting blood glucose and lipid mass spectrometry were detected. Follow-up study of the same content from baseline was conducted in August 2013 and October 2014 for a total of 1,265 study subjects. A total of 7,720 subjects were included in the study. The risk factors of lipid abnormality were analyzed by logistic regression model and the OR value obtained was converted to RR value. The mean value indicates the difference between the value of the follow-up and the corresponding baseline value. Results: 1. The cumulative incidence of lipid abnormality was 36. 61% (95% CI: 35. 53-37. 69) in the rural areas under 18 years and above, among which men (39. 62%[95% CI: 37. 74-41. 53]) were higher than women (35. 07%[95% CI: 33. 76-36. 40]). The cumulative incidence of low-density lipoprotein cholesterol (HDL-C), high triglyceride (TG), high total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) was 28.71% (95% CI: 27. 70 ~ 29.74), 11.24% (95% CI: 10.54 ~ 11.96), 2.54% (95% CI: 2.20 ~ 2.91) and 2.14% (95% CI: 1.82 ~ 2.48), respectively. Multivariate logistic regression analysis showed: (1) overweight/ obesity (RR = 1. 12, 95% CI: 1. 01 ~ 1. 24), waist circumference (WC) abnormality (RR = 1. 17, 95% CI: 1. 06 ~ 1. 28), waist-body ratio (WHt R) abnormality (RR = 1.17, 95% CI: 1. 05 ~ 1. 30). Diastolic blood pressure (DBP) was abnormal (RR = 1. 14, 95% CI: 1. 01 ~ 1. 28), fasting plasma glucose level (FPG) was 6. 1 mmol/ L (RR = 1. 15, 95% CI: 1. 03 ~ 1. 27), body weight gain (2. 50 ~ 5. 00 kg: RR = 1. 11, 95% CI: 1. 36, 95% CI: 1. 25 ~ 1. 46). The incidence risk and low body weight (RR = 0.958, 95% CI: 0. 42 ~ 0. 77) were increased. Body weight loss (RR = 0. 81, 95% CI: 0. 71 ~ 0. 91), WC decreased (RR = 0.986, 95% CI: 0.077 ~ 0. 96) all decreased their risk of onset; (2) Alcohol consumption (RR = 2.14, 95% CI: 1. 12 ~ 4.03), overweight/ obesity (RR = 1.76, 95% CI: 1. 06 ~ 2.88) and WHt R abnormality (RR = 1.73, 95% CI: 1. 05 ~ 1.57), WHt R abnormality (RR = 1.73, 95% CI: 1.39 ~ 2.16), WHt R abnormality (RR = 1.73, 95% CI: 1. 05 ~ 1. 60), body weight gain (2.50 ~ 5.00kg: RR = 1.32, 95% CI: 1.07 ~ 1.59; The incidence risk of high TG was increased by 5. 00 kg: RR = 2. 01, 95% CI: 1.68 ~ 2.38) and WWC = 6.20 cm (RR = 1.52, 95% CI: 1.24 ~ 1.85). WC was decreased (RR = 0.971, 95% CI: 0. 56 ~ 0. 90), and WC was abnormal (RR = 1.16, 95% CI: 1. 03 ~ 1.33), WHt R abnormality (RR = 1.17, 95% CI: 1. 03 ~ 1.33), body weight gain (RR = 1.17, 95% CI: 1. 03 ~ 1.33), body weight gain (RR = 1.17, 95% CI: 1. 03 ~ 1.33), body weight gain weight gain (RR = 1. 17, 95% CI: 1. 03 ~ 1. 33), weight gain weight gain (RR = 1. 17, 95% CI: 1. 03 ~ 1. 33), weight gain weight gain (RR = 1. 17, 95% CI: 1. 03 ~ 1. 33), weight gain weight gain (RR = 1. 17, 95% CI: 1. 03 ~ 1. 33), weight gain weight gain (RR = 1. 13, 95% CI: 1. 01 ~ 1. 26) all increased the risk of low HDL-C, Low body weight (RR = 0.946, 95% CI: 0. 31 ~ 0. 68) and weight loss (RR = 0. 85, 95% CI: 0. 74 ~ 0. 99) decreased the risk of low HDL-C disease; (5) The risk of high LDL-C was not related to all factors. Conclusion: 1. The cumulative incidence of lipid abnormality in the rural population is higher in 6 years, and the hyperTG and low HDL-C are the main lipid metabolism abnormal types. The overweight/ obesity, WC abnormality, WHt R abnormality, DBP abnormality, FPG, 61.1 mmol/ L, body weight gain, The low body weight, weight loss and WC were independent protective factors.
【学位授予单位】：深圳大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R589.2

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