2017年南京社区老年人群高甘油三酯-腰围表型相关影响因素与心血管危险因素聚集关系分析
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摘要
目的探讨60岁以上老年人群高甘油三酯-腰围表型(hypertriglyceridemic-waist phenotype,HTWP)的流行病学特征、影响因素以及与心血管危险因素聚集的关系。方法回顾性分析2017年1～12月南京市南苑卫生服务中心进行健康体检的783例60岁以上老年人,将人群按HTWP判定标准分为非HTWP组(正常组、单纯高甘油三酯组和单纯中心性肥胖组)和HTWP组,分析该人群HTWP相关影响因素以及与心血管危险因素聚集的关系。结果 60岁以上老年人群HTWP表型的检出率为34. 7%(男性为22. 1%,女性为44. 6%),HTWP组心血管危险因素聚集检出率为68. 8%,正常组心血管危险因素聚集检出率为32. 7%。HTWP组体质量指数(BMI)、腰围、收缩压、舒张压、总胆固醇、甘油三酯水平高于非HTWP组,高密度脂蛋白胆固醇水平低于非HTWP组,差异均有统计学意义(P<0. 05)。多因素Logistic回归分析显示,男性、吸烟者、BMI值偏高、舒张压偏高以及高高密度脂蛋白胆固醇血症为HTWP的危险因素。进一步校正年龄、性别以及校正性别、年龄、BMI、吸烟、糖尿病家族史和高血压家族史后,HTWP组老年人心血管危险因素聚集风险分别为正常组老年人的5. 89倍(95%CI:3. 76～9. 24)以及3. 08倍(95%CI:1. 86～5. 09)。结论社区老年人群中HTWP与心血管危险因素聚集密切相关,可试作为一种发现心血管疾病高危病人的廉价方法在社区推广。
Objective To investigate the epidemiological characteristics,influencing factors of hypertriglyceridemic-waist phenotype(HTWP) in the elderly over 60 years old,and to investigate the relationship with the aggregation of cardiovascular risk factors. Methods A total of 783 elderly people aged over 60 years old who underwent a physical examination at the Nanyuan Health Service Center of Nanjing from January to December 2017 were included in the study. According to the HTWP criteria,they were divided into non-HTWP group(normal group,simple high triglyceride group and simple central obesity group) and HTWP group. The epidemiological characteristics,influencing factors of HTWP and the relationship with cardiovascular risk factors were analyzed. Results The detection rate of HTWP in the elderly was 34. 7%(22. 1% for males and 44. 6% for females). The detection rate of cardiovascular risk factors in the HTWP group was 68. 8% and the rate of normal group was 32. 7%. The levelf of BMI,waist circumference,systolic blood pressure,diastolic blood pressure,total cholesterol,and triglyceride were higher in the HTWP group than those in the non-HTWP group,while the high-density lipoprotein cholesterol level was lower than that in the non-HTWP group. Multivariate Logistic regression analysis showed that male,smoking,high levels of BMI,diastolic blood pressure,and high-density lipoprotein cholesterol were risk factors for HTWP. Further analysis of the influencing factors of cardiovascular risk factors showed that,the risk of cardiovascular risk factors aggregation in the HTWP group were 5. 89times(95% CI: 3. 76-9. 24) and 3. 08 times(95% CI: 1. 86-5. 09) of the normal group,respectively.Conclusions HTWP is closely related to cardiovascular risk factors in the community seniors. It can be promoted as a cheap method to identify patients at high risk of cardiovascular disease in the community.
Objective To investigate the epidemiological characteristics,influencing factors of hypertriglyceridemic-waist phenotype(HTWP) in the elderly over 60 years old,and to investigate the relationship with the aggregation of cardiovascular risk factors. Methods A total of 783 elderly people aged over 60 years old who underwent a physical examination at the Nanyuan Health Service Center of Nanjing from January to December 2017 were included in the study. According to the HTWP criteria,they were divided into non-HTWP group(normal group,simple high triglyceride group and simple central obesity group) and HTWP group. The epidemiological characteristics,influencing factors of HTWP and the relationship with cardiovascular risk factors were analyzed. Results The detection rate of HTWP in the elderly was 34. 7%(22. 1% for males and 44. 6% for females). The detection rate of cardiovascular risk factors in the HTWP group was 68. 8% and the rate of normal group was 32. 7%. The levelf of BMI,waist circumference,systolic blood pressure,diastolic blood pressure,total cholesterol,and triglyceride were higher in the HTWP group than those in the non-HTWP group,while the high-density lipoprotein cholesterol level was lower than that in the non-HTWP group. Multivariate Logistic regression analysis showed that male,smoking,high levels of BMI,diastolic blood pressure,and high-density lipoprotein cholesterol were risk factors for HTWP. Further analysis of the influencing factors of cardiovascular risk factors showed that,the risk of cardiovascular risk factors aggregation in the HTWP group were 5. 89times(95% CI: 3. 76-9. 24) and 3. 08 times(95% CI: 1. 86-5. 09) of the normal group,respectively.Conclusions HTWP is closely related to cardiovascular risk factors in the community seniors. It can be promoted as a cheap method to identify patients at high risk of cardiovascular disease in the community.
引文
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[12]刘宇,娄冬华,沈冲,等.2012年江苏省句容市农村地区居民高三酰甘油腰围表型流行现状及危险因素[J].实用预防医学,2016,23(6):680-683.
[13]徐燕,武鸣,吕淑荣,等.江苏省慢性病及其危险因素监测报告[M].南京:南京师范大学出版社,2013:73-75.
[14]戴月,甑世祺,袁宝君.江苏居民营养与健康状况追踪研究[M].南京:南京大学出版社,2014:35-36.
[15] de Cunha OC,Carneiro RA,Eiekemberg M,et al. Hypertriglyceridemie waist phenotype:association with metabolic disorders and visceral fat in adults[J].Nutr Hosp,2014,30(1):25-31.
[16] Guilherme FR,Molena-Femandes CA,Hintze LJ,et al.Hypertriglyceridemic waist and metabolic abnormalities in Brazilian schoolchildren[J]. PLoS One, 2014, 9(11):e111724.
[17] Miyatake N,wada J,Kawasaki Y,et al. Relationship between metabolic syndrome and cigarette smoking in the Japanese population[J]. Intero Med, 2006, 45(18):1039-1043.
[2] Yang RF,Lin Z,Liu XY,et al. A clinical study of patients with coronary heart disease complicated with hypertriglyceridemic waist phenotype[J].Cell Biochem Biophys,2014,70(1):289-293.
[3]马春明,刘晓丽,高国芹,等.青少年高甘油三酯血症-腰围表型与心血管危险因素聚集相关[J].中华内分泌代谢杂志,2015,31(2):95-98.
[4]冯玲,赵伟,郑晓,等.高甘油三酯血症-腰围表型与早期型糖尿病肾病的相关性研究[J].中华内分泌代谢杂志,2013,29(5):374-376.
[5]张磊,董砚虎,徐美华,等.型糖尿病患者高甘油三酯血症-腰围表型与颈动脉粥样硬化相关[J].中华内分泌代谢杂志,2012,28(1):21-23.
[6]中国成人血脂异常防治指南制订联合委员会.中国成人血脂异常防治指南[J].中华健康管理学杂志,2017,11(1):7-28.
[7]中国肥胖问题工作组数据汇总分析协作组.我国成人体重指数和腰围对相关疾病危险因素异常的预测价值:适宜体重指数和腰围[J].中华流行病学杂志,2002,23(1):5-10.
[8]中国高血压防治指南修订委员会.中国高血压防治指南年[J].中华心血管病杂志,2011,39(7):579-616.
[9]高晓津,杨金刚,杨跃进,等.中国急性心肌梗死患者心血管危险因素分析[J].中国循环杂志,2015,30(3):206-210.
[10] Wang A,Li Z,Zhou Y,et al. Hypertriglyceridemic waist phenotype and risk of cardiovascular diseases in China:results from the Kailuan Study[J]. Int J Cardiol,2014,174(1):106-109.
[11]袁宁,黄晓波,刘雅,等.中老年人群高甘油三酯血症-腰围表型与心血管危险因素聚集关系探讨[J].中国循环杂志,2016,31(11):1079-1083.
[12]刘宇,娄冬华,沈冲,等.2012年江苏省句容市农村地区居民高三酰甘油腰围表型流行现状及危险因素[J].实用预防医学,2016,23(6):680-683.
[13]徐燕,武鸣,吕淑荣,等.江苏省慢性病及其危险因素监测报告[M].南京:南京师范大学出版社,2013:73-75.
[14]戴月,甑世祺,袁宝君.江苏居民营养与健康状况追踪研究[M].南京:南京大学出版社,2014:35-36.
[15] de Cunha OC,Carneiro RA,Eiekemberg M,et al. Hypertriglyceridemie waist phenotype:association with metabolic disorders and visceral fat in adults[J].Nutr Hosp,2014,30(1):25-31.
[16] Guilherme FR,Molena-Femandes CA,Hintze LJ,et al.Hypertriglyceridemic waist and metabolic abnormalities in Brazilian schoolchildren[J]. PLoS One, 2014, 9(11):e111724.
[17] Miyatake N,wada J,Kawasaki Y,et al. Relationship between metabolic syndrome and cigarette smoking in the Japanese population[J]. Intero Med, 2006, 45(18):1039-1043.