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目的了解张家港市211 715名50岁以上中老年人血脂异常的检出率及分布情况,探讨血脂异常与年龄、性别、体重指数、尿酸、血压、空腹血糖之间的相关性。方法从张家港市居民电子健康档案系统中导出2016年老年人健康体检数据库,对其中具有完整总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)检测数据的211 715名中老年人体检资料进行整理,根据不同变量需求确定样本量,分析血脂异常的检出率及分布情况;应用多因素Logistic回归分析血脂异常与年龄、性别、体重指数(BMI)、尿酸、血压、空腹血糖之间的相关性。结果 (1)211 715名中老年人血脂异常总体检出率为33.55%,男性检出率为31.14%,女性检出率为34.95%。以总体检人群作为标准人口,对年龄进行标化,男女血脂异常标化检出率分别为32.11%、35.34%,女性检出率高于男性。血脂异常检出率随年龄增长而呈现“先升后降”趋势(P<0.001)。(2)临床分型方面,高TC、高TG、混合型、低HDL-C的检出率分别为8.87%、16.11%、2.93%、10.61%,不同临床分型中女性检出率均高于男性(P<0.001)。(3)BMI过低及正常人群中,女性血脂异常检出率均高于男性(P<0.001);BMI超重人群男女检出率无差别;BMI肥胖人群中,男性检出率高于女性(P<0.001);血脂异常的检出率随着BMI的增加而呈现升高趋势(P<0.001)。(4)年龄、男性、高尿酸(HUA)、超重及肥胖、血压偏高、高空腹血糖(FBG)对血脂异常的风险度OR值(95%CI)分别为0.989(0.988~0.990)、0.811(0.795~0.828)、1.665(1.628~1.704)、1.549(1.517~1.581)、1.269(1.238~1.300)、1.438(1.406~1.471)。结论张家港市50岁以上中老年人血脂异常普遍流行,尤以高TG和女性群体为主;HUA、超重及肥胖、血压偏高、高FBG是50岁以上中老年人血脂异常的独立危险因素,而高龄、男性是其保护因素。
Objective To investigate the prevalence and distribution of dyslipidemia in 211 715 middle-aged and elderly people over 50 years old in Zhangjiagang City and to explore the correlation between dyslipidemia and age, sex, body mass index, uric acid, blood pressure and fasting blood glucose. Methods The database of health examination of the elderly in 2016 was derived from the electronic health record system of residents in Zhangjiagang City. The data of complete TC, TG, LDL-C, HDL (HDL-C) test data were collected from 211 715 middle-aged and old people. The sample size was determined according to the demand of different variables, and the detection rate and distribution of dyslipidemia were analyzed. Multivariate Logistic regression was used to analyze the relationship between dyslipidemia and age and gender , Body mass index (BMI), uric acid, blood pressure, fasting blood glucose. Results (1) The overall detection rate of blood lipids in middle-aged and elderly people was 211.5%, the detection rate of males was 31.14% and the detection rate of females was 34.95%. With the total population as the standard population, the standardization of age, the male and female dyslipidemia standardization detection rates were 32.11%, 35.34%, the detection rate of women than men. The detection rate of dyslipidemia showed a trend of “rising first and then decreasing” with age (P <0.001). (2) In terms of clinical classification, the detection rates of high TC, high TG, mixed type and low HDL-C were 8.87%, 16.11%, 2.93% and 10.61% respectively. The detection rate of women in different clinical types was high In males (P <0.001). (3) The prevalence of dyslipidemia in women with low BMI and normal population was higher than that of men (P <0.001). The detection rate of male and female in BMI overweight group was no difference. The prevalence of male in BMI group was higher than that in female P <0.001). The detection rate of dyslipidemia increased with the increase of BMI (P <0.001). (4) The odds ratio (95% CI) of the risk of dyslipidemia among age, male, hyperuricemia (HUA), overweight and obesity, high blood pressure and high fasting blood glucose (FBG) were 0.989 (0.988-0.990) (0.795-0.828), 1.665 (1.628-1.704), 1.549 (1.517-1.581), 1.269 (1.238-1.300), 1.438 (1.406-1.471). Conclusion The prevalence of dyslipidemia in middle-aged and elderly people over 50 years old in Zhangjiagang city is widespread, especially in high TG and female population. HUA, overweight and obesity, high blood pressure and high FBG are independent risk factors of dyslipidemia in middle- And older, men are their protective factors.