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目的调查山东省济南市某三甲医院健康查体人群代谢综合征(MS)的发生风险与血清胆红素的相关性。方法 2012年1月至2012年9月对在山东大学附属省立医院健康查体中心健康查体的人群进行问卷调查、体格检查和实验室检查。运用Pearson相关及多元Logistic回归分析血清胆红素与MS及其各组分之间的相关性。结果资料完整的4 896人中,MS的总发生率为10.7%,男性高于女性(13.1%vs 7.2%,χ2=44.486,P<0.001)。MS组直接胆红素(DBIL)浓度低于非代谢综合征(NMS)组[男性(2.55±0.78)μmol/L vs(2.79±0.92)μmol/L,P<0.01;女性(2.09±0.84)μmol/L vs(2.29±0.85)μmol/L,P<0.01)],两组总胆红素和间接胆红素差异无统计学意义(P>0.05)。偏相关分析表明,DBIL与体质量指数、空腹血糖、甘油三酯、总胆固醇、低密度脂蛋白呈负相关(P<0.05),与高密度脂蛋白呈正相关(P<0.001)。多元Logistic回归显示,调整年龄、饮酒、尿酸、AST、ALT、GGT后,女性DBIL与MS的相关性变弱,男性DBIL与MS发生风险呈负相关。与DBIL水平最高四分位数Q4组相比,男性Q1~Q3组MS的发生风险OR(95%CI)分别为1.7(1.2~2.4)、1.7(1.2~2.3)、1.3(1.0~1.8),女性分别为1.3(0.6~2.8)、1.3(0.6~2.9)、1.3(0.6~3.0)。结论男性健康查体人群MS的发生风险与血清DBIL呈负相关。
Objective To investigate the correlation between the risk of metabolic syndrome (MS) and serum bilirubin in healthy people in a top three hospital in Jinan City, Shandong Province. Methods From January 2012 to September 2012, questionnaires, physical examinations and laboratory tests were performed on the health check-ups in the Health Examination Center of Shandong Provincial Hospital Affiliated to Shandong University. Pearson correlation and multivariate logistic regression analysis were used to analyze the correlation between serum bilirubin and MS and its components. Results Among the 4 896 persons with complete data, the overall incidence of MS was 10.7%, higher in males than in females (13.1% vs 7.2%, χ2 = 44.486, P <0.001). The level of direct bilirubin (DBIL) in MS group was significantly lower than that in non-metabolic syndrome group (2.55 ± 0.78 μmol / L vs 2.79 ± 0.92 μmol / L vs 2.09 ± 0.84 μmol / L, (2.29 ± 0.85) μmol / L, P <0.01). There was no significant difference between the two groups in total bilirubin and indirect bilirubin (P> 0.05). Partial correlation analysis showed that DBIL was negatively correlated with body mass index, fasting blood glucose, triglycerides, total cholesterol and low density lipoprotein (P <0.05), and positively correlated with high density lipoprotein (P <0.001). Multivariate Logistic regression showed that the correlation between DBIL and MS in females was weakened after adjustment for age, drinking, uric acid, AST, ALT and GGT. The risk of DBIL in men was negatively correlated with the risk of MS. The odds ratio (95% CI) of MS in men with Q1 to Q3 was 1.7 (1.2-2.4), 1.7 (1.2-2.3) and 1.3 (1.0-1.8), respectively, compared with the highest tertile of DBIL in Q4 group , 1.3 (0.6 ~ 2.8), 1.3 (0.6 ~ 2.9) and 1.3 (0.6 ~ 3.0) respectively in women. Conclusions The risk of MS in male health check-up population is negatively correlated with serum DBIL.