中年人群体育锻炼与血脂血糖水平的横断面研究
发布时间：2018-11-18 18:35
【摘要】：背景随着生活水平的提高及生活方式的改变,我国人群高血脂、糖尿病的患病率也持续升高。血脂异常、糖尿病是心血管疾病的独立危险因素。加强生活方式干预可改善机体的血脂水平,降低或推迟糖尿病的发生。大量随机对照试验证据显示,体力活动对血脂异常等具有良好的保护作用,增加体力活动可降低糖尿病人糖化血红蛋白(HbAlc)水平,有利于糖尿病病人的血糖控制。另外,国外也有人群研究报道增加体力活动可以改善血脂水平,降低糖尿病的发生风险。但是关于社区人群多样性体育锻炼与血脂、血糖水平之间的关联的研究还较少。此外,国内相关的人群研究也较为缺乏。本研究在我国南北方城乡中年人群中探讨体育锻炼能耗与血脂、血糖水平之间的关联。目的探讨体育锻炼与血脂水平的关联；探讨体育锻炼与血糖水平之间的关系。方法研究人群来自于中国心血管流行病学多中心协作研究对象中北京、广州城乡四组人群,共计3644名,年龄35-59岁,剔除了资料不完整或缺失的研究对象58名,排除调查时有脑卒中、冠心病及恶性肿瘤病史等的194人,共有3392名作为本次分析对象。采用调查问卷法收集一般人口统计学资料、疾病史、行为生活习惯及平时体育锻炼情况等数据,并进行体格检查及生化指标的检测。采用代谢当量值(MET)估计体育锻炼强度,并根据其锻炼时间计算平时每日体育锻炼能量能耗(Energy Expenditure of Exercise, EEexer)。采集空腹静脉血,采用统一的标准化方法测定总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)及血糖(Glu)水平,并利用所测血脂指标计算非高密度脂蛋白胆固醇(non HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平(Friedewald公式)。使用SAS 9.3进行统计分析,计量资料用均数±标准差表示,利用方差分析进行组间差异比较,计数资料用百分位数表示,采用卡方检验进行比较；利用协方差分析,采用三种模型评估体育锻炼能耗与TC、LDL-C、non HDL-C、HDL-C、TG及血糖水平之间的关联,模型1：控制年龄、城乡、文化程度；模型2：在模型1基础上控制吸烟、饮酒、BMI；模型3：在模型2基础上进一步控制体育锻炼以外的体力活动能耗(Energy Expenditure ofPhysical Activity outside of Exercise,EEPA);以P小于0.05为组间差异具有显著性。结果1. 研究人群的体育锻炼情况在总人群中,有体育锻炼的有1487人,占总人群的43.84%(1487/3392)；男性中有体育锻炼的有773人,占男性的46.74%(773/1654)；女性中有714人,占的41.08%(714/1738)。总人群、男、女性体育锻炼人群中,锻炼能耗中位数分别为2.56 MET·h·d1、2.52 MET·h·d-1、2.63 MET·h·d-1。2. 体育锻炼能耗与血脂水平之间的关联根据研究人群体育锻炼情况为三组,即无体育锻炼组、体育锻炼日均耗能(EEexer)中位数以下组(体育锻炼较少组)和中位数以上组(体育锻炼较多组)。利用协方差分析,评估体育锻炼能耗与血脂水平之间的关联。单因素分析：男性中,与无锻炼组相比,两个体育锻炼组血清non HDL-C水平较高(P0.05), HDL-C水平较低(P0.05)。血清TC、LogTG、LDL-C三组间均无显著差异(P0.05)。女性中,两锻炼组TC、LogTG、non HDL-C水平高于无锻炼组(P0.05), HDL-C、LDL-C三组间无显著差异(P0.05)多因素分析：女性总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(non HDL-C)、甘油三酯(LogTG)两锻炼组要低于无锻炼组,其中LDL-C及non HDL-C水平组间差异有统计学意义(P0.05)；与无锻炼组比,女性体育锻炼较多组LDL-C及non HDL-C水平降低约0.14mmol/L (P=0.0075)、 0.14mmol/L (P=0.0145);男性TC、LDL-C、non HDL-C、TG水平两锻炼组要低于无锻炼组,但差异无统计学意义。高密度脂蛋白胆固醇(HDL-C)在男/女性中,三组间差别均无统计学意义。3. 体育锻炼能耗与血糖水平之间的关联单因素分析显示,男、女性中两锻炼组血糖水平要低于无锻炼组,组间差异均有统计学意义(P0.05)多因素分析显示,男、女性中,与无锻炼组比,两锻炼组血糖水平显著较低,差异均有统计学意义(P0.05)。两两比较显示,体育锻炼较高组(EEexer2.63 MET·h·d-1)与无锻炼人群相比,男性血糖水平降低0.17mmol/L (P0.05),女性降低0.14mmol/L (P0.05)。结论一定量的业余时间体育锻炼有利于改善女性LDL-C、non HDL-C水平。体育锻炼可改善男、女性血糖水平,二者中血糖水平均随着锻炼能耗的升高而降低。
[Abstract]:With the improvement of living standard and the change of life style, the prevalence of hyperlipemia and diabetes in our population is also rising. Dyslipidemia, diabetes is an independent risk factor for cardiovascular disease. Strengthening lifestyle intervention can improve the blood lipid level of the body, reduce or delay the occurrence of diabetes. A large number of randomized controlled trials have shown that physical activity has a good protective effect on dyslipidemia and the like, and the increase of physical activity can reduce the level of glycosylated hemoglobin (HbAlc) in patients with diabetes, and is beneficial to the control of blood sugar in patients with diabetes. In addition, there are also a group of studies abroad to report that the increase of physical activity can improve the level of blood fat and reduce the risk of diabetes. However, the study of the association between the physical exercise of the community and the level of blood fat and blood sugar is less. In addition, there is a lack of research on the population in the country. The relationship between the energy consumption of physical exercise and the level of blood fat and blood sugar was discussed in the middle-aged and rural middle-aged people in the south of China. Objective To study the relationship between physical exercise and blood lipid level, and to explore the relationship between physical exercise and blood sugar level. Methods A total of 3,44 study subjects from Beijing and Guangzhou, aged 35 to 59, were selected from China's cardiovascular and epidemiological multi-center cooperation study, and 58 of the subjects were excluded from incomplete or missing data. There were 194 cases of coronary heart disease and the history of malignant tumor, with a total of 3392 as the subject of this analysis. The data of general population statistics, the history of the disease, the behavior of behavior and the physical exercise of the general population were collected by the questionnaire method, and the physical examination and the biochemical indexes were tested. The exercise intensity is estimated by the amount of metabolism (MET) and the energy energy of exercise of exercise is calculated on the basis of the exercise time. fasting venous blood was collected and total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and blood glucose (Glu) levels were determined by a unified standardized method, and the non-high-density lipoprotein cholesterol (non-HDL-C) and the low-density lipoprotein cholesterol (LDL-C) level (Friedewald formula) were calculated using the measured blood lipid index. The statistical analysis was carried out using SAS 9.3. The mean square standard deviation of the data used for the measurement was expressed by means of variance analysis. The percentile expression of the count data was compared with the test of the card. Using the analysis of the covariance, three models were used to evaluate the energy consumption of physical exercise and TC, LDL-C, Association between non-HDL-C, HDL-C, TG and blood glucose levels, model 1: control age, urban and rural, cultural level; model 2: control smoking, drinking, BMI on the basis of model 1; model 3: The energy consumption of physical activity (EEPA) other than physical exercise was further controlled on the basis of model 2. Results 1. The physical exercise of the study population in the general population, there were 1487 people with physical exercise, 43. 84% of the total population (1487/ 3392), 773 of the male with physical exercise, 46. 74% of the male (773/ 1654), and 714 in the female, accounting for 41.08% (714/ 1738). The median energy consumption was 2.56 MET 路 h 路 d1, 2.52 MET 路 h 路 d-1, 2.63 MET 路 h 路 d-1. The association between the energy consumption of physical exercise and the level of blood fat was divided into three groups according to the study population, that is, there was no physical exercise group, and the average daily energy consumption of physical exercise (EEx) was the following group (lower group of physical exercise) and the above group (group of physical exercises). The correlation between the energy consumption of physical exercise and the level of blood fat was assessed by the analysis of covariance. Single factor analysis: Compared with the non-exercise group, the serum non-HDL-C level in the two exercise groups was higher (P0.05), and the level of HDL-C was lower (P0.05). There was no significant difference between the three groups of serum TC, LogTG and LDL-C (P0.05). In women, the levels of TC, LogTG and non-HDL-C in both exercise groups were higher than that in the non-exercise group (P0.05), and there was no significant difference between the three groups of HDL-C and LDL-C (P0.05): total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C). The levels of LDL-C and non-HDL-C decreased by about 0.14mmol/ L (P = 0. 0075), 0.14mmol/ L (P = 0.0145), male TC, LDL-C, non-HDL-C. The level of TG was lower than that of the non-exercise group, but the difference was not significant. The difference of high-density lipoprotein cholesterol (HDL-C) in male/ female was not statistically significant. The analysis of the correlation between the energy consumption and the blood sugar level showed that the blood sugar level of the two exercise groups in the male and female group was lower than that of the non-exercise group, and the difference between the group and the group was statistically significant (P0.05). The blood glucose level of the two exercise groups was significantly lower, and the difference was statistically significant (P0.05). Compared with the non-exercise group, the level of blood glucose decreased by 0.17mmol/ L (P0.05), and that of female was 0.14mmol/ L (P0.05). Conclusion Exercise can improve the level of LDL-C and non-HDL-C in female. Physical exercise can improve the blood sugar level of male and female, and the blood sugar level in both of them decrease with the increase of the energy consumption of exercise.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R587.1
本文编号：2340816
[Abstract]:With the improvement of living standard and the change of life style, the prevalence of hyperlipemia and diabetes in our population is also rising. Dyslipidemia, diabetes is an independent risk factor for cardiovascular disease. Strengthening lifestyle intervention can improve the blood lipid level of the body, reduce or delay the occurrence of diabetes. A large number of randomized controlled trials have shown that physical activity has a good protective effect on dyslipidemia and the like, and the increase of physical activity can reduce the level of glycosylated hemoglobin (HbAlc) in patients with diabetes, and is beneficial to the control of blood sugar in patients with diabetes. In addition, there are also a group of studies abroad to report that the increase of physical activity can improve the level of blood fat and reduce the risk of diabetes. However, the study of the association between the physical exercise of the community and the level of blood fat and blood sugar is less. In addition, there is a lack of research on the population in the country. The relationship between the energy consumption of physical exercise and the level of blood fat and blood sugar was discussed in the middle-aged and rural middle-aged people in the south of China. Objective To study the relationship between physical exercise and blood lipid level, and to explore the relationship between physical exercise and blood sugar level. Methods A total of 3,44 study subjects from Beijing and Guangzhou, aged 35 to 59, were selected from China's cardiovascular and epidemiological multi-center cooperation study, and 58 of the subjects were excluded from incomplete or missing data. There were 194 cases of coronary heart disease and the history of malignant tumor, with a total of 3392 as the subject of this analysis. The data of general population statistics, the history of the disease, the behavior of behavior and the physical exercise of the general population were collected by the questionnaire method, and the physical examination and the biochemical indexes were tested. The exercise intensity is estimated by the amount of metabolism (MET) and the energy energy of exercise of exercise is calculated on the basis of the exercise time. fasting venous blood was collected and total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and blood glucose (Glu) levels were determined by a unified standardized method, and the non-high-density lipoprotein cholesterol (non-HDL-C) and the low-density lipoprotein cholesterol (LDL-C) level (Friedewald formula) were calculated using the measured blood lipid index. The statistical analysis was carried out using SAS 9.3. The mean square standard deviation of the data used for the measurement was expressed by means of variance analysis. The percentile expression of the count data was compared with the test of the card. Using the analysis of the covariance, three models were used to evaluate the energy consumption of physical exercise and TC, LDL-C, Association between non-HDL-C, HDL-C, TG and blood glucose levels, model 1: control age, urban and rural, cultural level; model 2: control smoking, drinking, BMI on the basis of model 1; model 3: The energy consumption of physical activity (EEPA) other than physical exercise was further controlled on the basis of model 2. Results 1. The physical exercise of the study population in the general population, there were 1487 people with physical exercise, 43. 84% of the total population (1487/ 3392), 773 of the male with physical exercise, 46. 74% of the male (773/ 1654), and 714 in the female, accounting for 41.08% (714/ 1738). The median energy consumption was 2.56 MET 路 h 路 d1, 2.52 MET 路 h 路 d-1, 2.63 MET 路 h 路 d-1. The association between the energy consumption of physical exercise and the level of blood fat was divided into three groups according to the study population, that is, there was no physical exercise group, and the average daily energy consumption of physical exercise (EEx) was the following group (lower group of physical exercise) and the above group (group of physical exercises). The correlation between the energy consumption of physical exercise and the level of blood fat was assessed by the analysis of covariance. Single factor analysis: Compared with the non-exercise group, the serum non-HDL-C level in the two exercise groups was higher (P0.05), and the level of HDL-C was lower (P0.05). There was no significant difference between the three groups of serum TC, LogTG and LDL-C (P0.05). In women, the levels of TC, LogTG and non-HDL-C in both exercise groups were higher than that in the non-exercise group (P0.05), and there was no significant difference between the three groups of HDL-C and LDL-C (P0.05): total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C). The levels of LDL-C and non-HDL-C decreased by about 0.14mmol/ L (P = 0. 0075), 0.14mmol/ L (P = 0.0145), male TC, LDL-C, non-HDL-C. The level of TG was lower than that of the non-exercise group, but the difference was not significant. The difference of high-density lipoprotein cholesterol (HDL-C) in male/ female was not statistically significant. The analysis of the correlation between the energy consumption and the blood sugar level showed that the blood sugar level of the two exercise groups in the male and female group was lower than that of the non-exercise group, and the difference between the group and the group was statistically significant (P0.05). The blood glucose level of the two exercise groups was significantly lower, and the difference was statistically significant (P0.05). Compared with the non-exercise group, the level of blood glucose decreased by 0.17mmol/ L (P0.05), and that of female was 0.14mmol/ L (P0.05). Conclusion Exercise can improve the level of LDL-C and non-HDL-C in female. Physical exercise can improve the blood sugar level of male and female, and the blood sugar level in both of them decrease with the increase of the energy consumption of exercise.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R587.1
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