居民血脂异常影响因素的列线图分析
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摘要
目的调查杭州市上城区居民血脂异常及影响因素,并建立列线图分析居民血脂异常风险。方法采用多阶段随机抽样方法,从上城区随机抽取5个街道,每个街道各抽取2个社区,每个社区抽取153户家庭,纳入家庭户中≥18岁居民进行问卷调查,体格检查和血糖、血脂检测;采用Logistic回归模型分析血脂异常的影响因素,并采用列线图分析血脂异常风险。结果有效调查3 061人,检出血脂异常536例,患病率为17.51%,标化患病率为13.74%。多因素Logistic回归分析结果显示,年龄≥45岁(OR45岁～=2.623, 95%CI:1.738～3.961; OR65岁～=3.941, 95%CI:2.632～5.900; OR75岁～=3.264, 95%CI:2.095～5.084)、超重/肥胖(OR=1.725, 95%CI:1.390～2.140)、糖尿病(OR=3.103,95%CI:2.369～4.063)、高血压(OR=2.789,95%CI:2.196～3.542)、有冠心病家族史(OR=2.215,95%CI:1.443～3.399)是血脂异常的危险因素;日常锻炼(OR=0.790,95%CI:0.630～0.991)是血脂异常的保护因素。建立的血脂异常风险列线图显示,年龄45～64岁为70分,65～74岁为100分,≥75岁为86分,患高血压为75分,患糖尿病为83分,有冠心病家族史为58分,日常不锻炼为17分,超重/肥胖为40分,总分0～373分,一致性指数C-index为0.790 (95%CI:0.779～0.801)。结论年龄≥45岁、超重或肥胖、患糖尿病、患高血压、有冠心病家族史和缺乏日常锻炼与血脂异常相关,根据上述影响因素建立的列线图对个体血脂异常风险有一定预测作用。
Objective To explore the related factors of dyslipidemia and establish a nomogram for predicting the risk of dyslipidemia among residents in Shangcheng District of Hangzhou. Methods By multi-stage random sampling method, five streets were randomly sampled from Shangcheng District;two communities were sampled from each street;153 families were sampled from each community. All residents aged 18 years and above were included for questionnaire survey, physical examination,glucose and lipid detection. Logistic regression model was applied to analyzing influencing factors for dyslipidemia,and a nomogram was built for risk assessment of individual dyslipidemia. Results Among 3 061 respondents, 536 with dyslipidemia were detected. The prevalence of dyslipidemia was 17.51%,the standardized prevalence of dyslipidemia was 13.74%according to age. The results of multivariate logistic regression analysis showed that age of 45 years and above(OR45～64 years=2.623,95%CI:1.738-3.961;OR65～74 years=3.941,95%CI:2.632-5.900;OR≥75 years=3.264,95%CI:2.095-5.084),overweight or obesity(OR=1.725,95%CI:1.390-2.140),diabetes(OR=3.103,95%CI:2.369-4.063),hypertension(OR=2.789,95%CI:2.196-3.542) and family history of coronary heart disease(OR=2.215,95%CI:1.443-3.399) were risk factors for dyslipidemia;daily exercise(OR=0.790,95%CI:0.630-0.991) was a protective factor for dyslipidemia. In the nomogram,age of 45-64 years,65-74 years,75 years and above,overweight or obesity,diabetes,hypertension,family history of coronary heart disease and no daily exercise were scored 70,100,86,40,83,75,58 and 17,respectively(totally 373),with a high C-index of 0.790(95%CI:0.779-0.801). Conclusion Age,overweight or obesity, diabetes,hypertension,family history of coronary heart disease and daily exercise were related to dyslipidemia. The nomogram based on these factors can help evaluate the risk of dyslipidemia individually.
Objective To explore the related factors of dyslipidemia and establish a nomogram for predicting the risk of dyslipidemia among residents in Shangcheng District of Hangzhou. Methods By multi-stage random sampling method, five streets were randomly sampled from Shangcheng District;two communities were sampled from each street;153 families were sampled from each community. All residents aged 18 years and above were included for questionnaire survey, physical examination,glucose and lipid detection. Logistic regression model was applied to analyzing influencing factors for dyslipidemia,and a nomogram was built for risk assessment of individual dyslipidemia. Results Among 3 061 respondents, 536 with dyslipidemia were detected. The prevalence of dyslipidemia was 17.51%,the standardized prevalence of dyslipidemia was 13.74%according to age. The results of multivariate logistic regression analysis showed that age of 45 years and above(OR45～64 years=2.623,95%CI:1.738-3.961;OR65～74 years=3.941,95%CI:2.632-5.900;OR≥75 years=3.264,95%CI:2.095-5.084),overweight or obesity(OR=1.725,95%CI:1.390-2.140),diabetes(OR=3.103,95%CI:2.369-4.063),hypertension(OR=2.789,95%CI:2.196-3.542) and family history of coronary heart disease(OR=2.215,95%CI:1.443-3.399) were risk factors for dyslipidemia;daily exercise(OR=0.790,95%CI:0.630-0.991) was a protective factor for dyslipidemia. In the nomogram,age of 45-64 years,65-74 years,75 years and above,overweight or obesity,diabetes,hypertension,family history of coronary heart disease and no daily exercise were scored 70,100,86,40,83,75,58 and 17,respectively(totally 373),with a high C-index of 0.790(95%CI:0.779-0.801). Conclusion Age,overweight or obesity, diabetes,hypertension,family history of coronary heart disease and daily exercise were related to dyslipidemia. The nomogram based on these factors can help evaluate the risk of dyslipidemia individually.
引文
[1]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2017》概要[J].中国循环杂志,2018,33(1):1-8.
[2]诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志, 2016, 31(10):937-953.
[3]任佩佩,许春双,陈亚慧.宁波市某街道55岁及以上居民血脂异常调查[J].预防医学,2017,29(2):170-172.
[4] BALACHANDRAN V P,GONEN M,SMITH J J,et al. Nomograms in oncology:more than meets the eye[J]. Lancet Oncology,2015,16(4):e173-e180.
[5]王晓霞,鲜彤章,贾晓凡,等. 2型糖尿病患者的心脑血管疾病影响因素的Nomogram分析[J].中国心血管杂志,2017,22(1):43-48.
[6] LIANG W,ZHANG L,JIANG G,et al. Development and validation of a nomogram for predicting survival in patients with resected non-small-cell lung cancer[J]. Journal of Clinical Oncology,2015,33(8):861-869.
[7]王文,张维忠,孙宁玲,等.中国血压测量指南[J].中华高血压杂志,2011,19(12):1101-1115,1100.
[8]中国疾病预防控制中心.中国慢性病及其危险因素监测报告2010[M].北京:军事医学科学出版社,2012:23.
[9]王斐,刘丽媛,王永久,等.体重指数与乳腺癌预后的相关性分析[J].中国现代普通外科进展,2016,19(9):673-678.
[10]胡文斌,张婷,史建国,等.男性吸烟与高血压病的剂量-反应关系[J].中华心血管病杂志,2014,42(9):773-777.
[11]于慧慧,李爱娇,王莎莎,等.“健康中国”战略下山东省老年人糖尿病患病现状及影响因素[J].中国老年学杂志,2018,38(1):199-201.
[12]付振涛,马吉祥,郭晓雷,等.山东省五莲县居民高血压、超重及肥胖状况调查[J].中国医学创新,2012,9(1):92-94.
[13]陈胜则,陈建平,郑沛.永嘉县居民健康相关生活方式因素现况调查[J].预防医学,2015,27(5):469-472.
[14]张新卫,叶真,周丹,等.浙江省成年居民血脂异常患病率及其分布特征的现况分析[J].疾病监测,2012,27(5):395-399.
[15]郁旷明,寇俊,叶俊杰,等.上城区居民主要慢性病患病情况调查[J].预防医学,2013,25(4):37-39.
[16]白云,耿坤,徐志鑫.北京市昌平区成人血脂异常流行及相关因素分析[J].中国卫生检验杂志,2018,28(9):1126-1129.
[17]游弋,李宁,吴明,等.辽宁省城区居民主要慢性病流行现况及影响因素分析[J].预防医学,2018,30(1):35-40,45.
[18] KANNEL W B. Fifty years of Framingham Study contributions to understanding hypertension[J]. J hum hypertens,2000,14(2):83-90.
[19]杨茂敏. 66例糖尿病患者血脂检测结果分析[J].检验医学与临床,2013,10(7):893-894.
[20]邵永强,樊丽辉,李江峰,等.温州市成人血脂异常流行特征分析[J].预防医学,2016,28(10):1000-1004.
[21]杨雪莹,王亭,王亚平.天津市成年居民血脂异常流行特征及影响因素分析[J].中国公共卫生,2016,32(3):286-290.
[22]刘竟芳,陈哲,杨非柯,等.长沙市老年人血脂异常分布及其影响因素[J].中南大学学报(医学版),2014,39(8):797-801.
[23]吴盛喜,罗何三,张晓平,等.胸中段食管癌放化疗后远期生存Nomogram预测模型建立[J].中华肿瘤防治杂志,2018,25(6):417-421,427.
[24] GANLY I,AMIT M,KOU L,et al. Nomograms for predicting survival and recurrence in patients with adenoid cystic carcinoma:an international collaborative study[J]. European Journal of Cancer,2015,51(18):2768-2776.
[2]诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志, 2016, 31(10):937-953.
[3]任佩佩,许春双,陈亚慧.宁波市某街道55岁及以上居民血脂异常调查[J].预防医学,2017,29(2):170-172.
[4] BALACHANDRAN V P,GONEN M,SMITH J J,et al. Nomograms in oncology:more than meets the eye[J]. Lancet Oncology,2015,16(4):e173-e180.
[5]王晓霞,鲜彤章,贾晓凡,等. 2型糖尿病患者的心脑血管疾病影响因素的Nomogram分析[J].中国心血管杂志,2017,22(1):43-48.
[6] LIANG W,ZHANG L,JIANG G,et al. Development and validation of a nomogram for predicting survival in patients with resected non-small-cell lung cancer[J]. Journal of Clinical Oncology,2015,33(8):861-869.
[7]王文,张维忠,孙宁玲,等.中国血压测量指南[J].中华高血压杂志,2011,19(12):1101-1115,1100.
[8]中国疾病预防控制中心.中国慢性病及其危险因素监测报告2010[M].北京:军事医学科学出版社,2012:23.
[9]王斐,刘丽媛,王永久,等.体重指数与乳腺癌预后的相关性分析[J].中国现代普通外科进展,2016,19(9):673-678.
[10]胡文斌,张婷,史建国,等.男性吸烟与高血压病的剂量-反应关系[J].中华心血管病杂志,2014,42(9):773-777.
[11]于慧慧,李爱娇,王莎莎,等.“健康中国”战略下山东省老年人糖尿病患病现状及影响因素[J].中国老年学杂志,2018,38(1):199-201.
[12]付振涛,马吉祥,郭晓雷,等.山东省五莲县居民高血压、超重及肥胖状况调查[J].中国医学创新,2012,9(1):92-94.
[13]陈胜则,陈建平,郑沛.永嘉县居民健康相关生活方式因素现况调查[J].预防医学,2015,27(5):469-472.
[14]张新卫,叶真,周丹,等.浙江省成年居民血脂异常患病率及其分布特征的现况分析[J].疾病监测,2012,27(5):395-399.
[15]郁旷明,寇俊,叶俊杰,等.上城区居民主要慢性病患病情况调查[J].预防医学,2013,25(4):37-39.
[16]白云,耿坤,徐志鑫.北京市昌平区成人血脂异常流行及相关因素分析[J].中国卫生检验杂志,2018,28(9):1126-1129.
[17]游弋,李宁,吴明,等.辽宁省城区居民主要慢性病流行现况及影响因素分析[J].预防医学,2018,30(1):35-40,45.
[18] KANNEL W B. Fifty years of Framingham Study contributions to understanding hypertension[J]. J hum hypertens,2000,14(2):83-90.
[19]杨茂敏. 66例糖尿病患者血脂检测结果分析[J].检验医学与临床,2013,10(7):893-894.
[20]邵永强,樊丽辉,李江峰,等.温州市成人血脂异常流行特征分析[J].预防医学,2016,28(10):1000-1004.
[21]杨雪莹,王亭,王亚平.天津市成年居民血脂异常流行特征及影响因素分析[J].中国公共卫生,2016,32(3):286-290.
[22]刘竟芳,陈哲,杨非柯,等.长沙市老年人血脂异常分布及其影响因素[J].中南大学学报(医学版),2014,39(8):797-801.
[23]吴盛喜,罗何三,张晓平,等.胸中段食管癌放化疗后远期生存Nomogram预测模型建立[J].中华肿瘤防治杂志,2018,25(6):417-421,427.
[24] GANLY I,AMIT M,KOU L,et al. Nomograms for predicting survival and recurrence in patients with adenoid cystic carcinoma:an international collaborative study[J]. European Journal of Cancer,2015,51(18):2768-2776.
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