老年体检人群血脂异常的流行特征和相关危险因素聚集与心脑血管疾病关系的研究

发布时间：2018-04-20 09:19

  本文选题：血脂异常 + 心血管危险因素　； 参考：《中国人民解放军医学院》2017年硕士论文

【摘要】：目的:探讨老年体检人群2009-2013年血脂异常变化及血脂异常和相关心血管危险因素(CRF)聚集与主要心脑血管疾病(CVD)的关系。方法:收集2009年和2013年在部队医院例行体检的大样本老年离退休人群数据。第一部分纳入2009年31382例(男性占94.27%), 2013年30361例(男性占93.49%)研究对象,分析老年血脂异常的患病特点及5年间主要血脂组分异常的变化情况,并对去除药物影响后人群重复上述分析;第二部分利用2013年体检数据,纳入30361例(男性占93.49%)研究对象,分析血脂异常和CRF(高血压、糖尿病和肥胖)聚集状况,并利用logistic回归模型计算危险因素聚集与冠心病和缺血性脑卒中的患病关联。CVD定义为至少患冠心病或缺血性脑卒中的一种。结果:第一部分结果显示,老年血脂异常男性以低HDL和高TG为主,女性以高TG和高TC为主。不论年份,高TC、高TG和高LDL-C患病率女性大多高于男性(p0.05),低HDL-C患病率男性高于女性(p0.05)。男性、女性(2013年)低HDL-C患病率随年龄增长整体呈上升趋势(p0.05);总的血脂异常,男性高TC、高TG和高LDL-C(2013年)患病率整体呈下降趋势。年份间对比,男性高TC、高TG(60-79岁)和高LDL-C(70-79岁)患病率下降,2009年高于2013年;血脂异常患病率和男性低HDL-C(60-79岁)患病率增加,2009年低于2013年。第二部分结果显示,研究对象的血脂异常和CRF聚集现象明显,尤其在男性中。男性血脂异常人群同时具有≥2项危险因素的比例是无血脂异常人群的1.59倍。多因素logistic结果显示,冠心病患病风险随血脂异常聚集的危险因素项数增多而明显增加。男性血脂异常无伴随,伴1项和伴≥2项危险因素时患冠心病的OR值(95%CI)分别为 1.24(95%CI: 1.12-1.38)、1.78(95%CI: 1.62-1.95)和 2.35(95%CI:2.09-2.64),女性分别为 0.90(95%CI: 0.64-1.26)、1.42(95%CI: 1.02-1.96)和2.15(95%CI: 1.34-3.47)。男性人群缺血性脑卒中的结果与之类似,相应的OR值(95%CI)分别为 1.02(95%CI:0.82-1.26) 、 1.67(95%CI: 1.40-1.99)和1.81 (95%CI: 1.46-2.25),女性人群缺血性脑卒中风险尚不能定论。结论:老年人群血脂异常流行特征存在明显性别差异,5年间男性低HDL-C患病率明显上升,同时血脂异常与CRF聚集显著增加CVD的患病风险,应关注其独立和联合作用的风险防控。
[Abstract]:Objective: to investigate the relationship between hyperlipidemia and the accumulation of serum lipid abnormality and related cardiovascular risk factors (CRF) and CVD in elderly people with major cardiovascular and cerebrovascular diseases (CVD) from 2009 to 2013. Methods: the data of large sample of elderly retirees who underwent physical examination in military hospitals in 2009 and 2013 were collected. In the first part, 31382 cases (94.27% male) and 30361 cases (93.49% male) were included in the study in 2009 to analyze the characteristics of senile dyslipidemia and the changes of main lipid components in the past five years. In the second part, 30361 subjects (93.49 males) were included in the study based on the data of physical examination in 2013 to analyze dyslipidemia and CRF (hypertension, diabetes and obesity). Logistic regression model was used to calculate the association between risk factors aggregation and coronary heart disease and ischemic stroke. CVD was defined as at least one type of coronary heart disease or ischemic stroke. Results: the results of the first part showed that low HDL and high TG were the main causes of dyslipidemia in elderly men, and high TG and high TC in females. In both years, the prevalence of high TC, high TG and high LDL-C in females was higher than that in males, and the prevalence of low HDL-C in males was higher than that in females. The prevalence rate of low HDL-C in males and females (2013) increased with the increase of age (p 0.05), and the prevalence rate of high TC, high TG and high LDL-C (2013) decreased in males. Compared with other years, the prevalence of high TC- (high TG(60-79) and high LDL-C(70-79 (age) decreased in men, and the prevalence of dyslipidemia and low HDL-C(60-79 in men increased in 2009, which was lower than that in 2013. The results of the second part showed that abnormal blood lipids and CRF aggregation were observed, especially in men. The proportion of men with dyslipidemia and 鈮，

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