某農(nóng)村人群脂質(zhì)代謝異常的發(fā)病率及其危險(xiǎn)因素的隊(duì)列研究
發(fā)布時(shí)間：2018-10-26 10:45
【摘要】：目的:調(diào)查某農(nóng)村人群脂質(zhì)代謝異常的發(fā)病率及其危險(xiǎn)因素,為干預(yù)計(jì)劃的制定提供科學(xué)依據(jù)。方法:本研究選擇河南省某縣的兩個(gè)鎮(zhèn)為研究現(xiàn)場(chǎng),以自然村為單位,采用整群抽樣的方法,于2007年7—8月和2008年7—8月對(duì)20194名18歲以上農(nóng)村居民進(jìn)行問卷調(diào)查、體格檢查、空腹血糖及脂質(zhì)譜檢測(cè)。2013年7—8月和2014年7—10月進(jìn)行與基線相同內(nèi)容的隨訪研究,共隨訪到17265名研究對(duì)象。最終納入研究對(duì)象7720名。應(yīng)用logistic回歸模型分析血脂異常的危險(xiǎn)因素,并將得到的OR值轉(zhuǎn)化為RR值。Δ表示隨訪時(shí)的值與相對(duì)應(yīng)的基線值之差。結(jié)果:1、該農(nóng)村地區(qū)18歲及以上居民6年內(nèi)血脂異常的累積發(fā)病率為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])。低高密度脂蛋白膽固醇(high density lipoprotein-cholesterol,HDL-C)、高甘油三酯(triglyceride,TG)、高總膽固醇(total cholesterol,TC)和高低密度脂蛋白膽固醇(low density lipoprotein-cholesterol,LDL-C)血癥的累積發(fā)病率分別為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、對(duì)研究對(duì)象基線的性別、年齡、受教育水平、婚姻狀況及人均月收入調(diào)整后,多因素logistic回歸分析顯示:(1)超重/肥胖(RR=1.12,95%CI:1.01~1.24)、腰圍(waist circumference,WC)異常(RR=1.17,95%CI:1.06~1.28)、腰身比(waist-height ratio,WHt R)異常(RR=1.17,95%CI:1.05~1.30)、舒張壓(diastolic blood pressure,DBP)異常(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)、體重增重(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)均增加血脂異常的發(fā)病風(fēng)險(xiǎn),低體重(RR=0.58,95%CI:0.42~0.77)、體重減輕(RR=0.81,95%CI:0.71~0.91)、WC減少(RR=0.86,95%CI:0.77~0.96)均降低其發(fā)病風(fēng)險(xiǎn);(2)飲酒(RR=2.14,95%CI:1.12~4.03)、超重/肥胖(RR=1.76,95%CI:1.06~2.88)和Δ體重≥5.00 kg(RR=2.00,95%CI:1.31~3.02)均增加高TC血癥的發(fā)病風(fēng)險(xiǎn);(3)飲酒(RR=1.33,95%CI:1.02~1.72)、WC異常(RR=1.29,95%CI:1.05~1.57)、WHt R異常(RR=1.73,95%CI:1.39~2.16)、FPG≥6.1 mmol/L(RR=1.30,95%CI:1.05~1.60)、體重增重(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血癥的發(fā)病風(fēng)險(xiǎn),WC減少(RR=0.71,95%CI:0.56~0.90)降低高TG血癥的發(fā)病風(fēng)險(xiǎn);(4)WC異常(RR=1.16,95%CI:1.03~1.30)、WHt R異常(RR=1.17,95%CI:1.03~1.33)、體重增重(≥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血癥的發(fā)病風(fēng)險(xiǎn),低體重(RR=0.46,95%CI:0.31~0.68)和體重減輕(RR=0.85,95%CI:0.74~0.99)降低低HDL-C血癥的發(fā)病風(fēng)險(xiǎn);(5)高LDL-C血癥的發(fā)病風(fēng)險(xiǎn)與各因素均無關(guān)。結(jié)論:1、該農(nóng)村人群6年內(nèi)血脂異常的累積發(fā)病率水平較高,以高TG和低HDL-C血癥為主要脂質(zhì)代謝異常類型。2、超重/肥胖、WC異常、WHt R異常、DBP異常、FPG≥6.1 mmol/L、體重增重、ΔWC≥6.20cm是血脂異常獨(dú)立的危險(xiǎn)因素,而低體重、體重減輕、WC減少是其獨(dú)立的保護(hù)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.
【學(xué)位授予單位】：深圳大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R589.2
本文編號(hào)：2295462
[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.
【學(xué)位授予單位】：深圳大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R589.2
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