乌鲁木齐市健康检查人群脂质蓄积指数与脑血流动力学相关性分析

Correlation analysis of lipid accumulation index and cerebral hemodynamics in physical examination population in Urumqi

目的探讨健康检查人群中脂质蓄积指数(LAP)与脑血流动力学积分值(CVHI)的关系。方法选取2019年6—12月在新疆医科大学第一附属医院完成CVHI检测的3264例健康检查人群为研究对象。首先通过现场问卷调查获取调查对象基本情况及疾病史;测量身高、体重、腰围,同时完成相关实验室检查及脑血流动力学监测,并计算体质指数、脂质蓄积指数。以脑血流动力学指标≥75为脑血管功能正常组,<75为异常组。根据LAP的四分位数将健康检查人群分为Q1、Q2、Q3及Q4组。分别计算和比较不同组别脂质蓄积指数水平与脑血流动力学的相关性。结果纳入研究对象共3264例,平均年龄为(45.92±10.76)岁。脑血管功能正常组2896(88.73%)人,异常组368(11.27%)人。年龄、吸烟、饮酒、高血压病史、高脂血症病史、运动缺乏、脑卒中家族病史、体质指数、高血糖、总胆固醇、脂质蓄积指数在脑血管功能正常组和异常组间比较,差异均有统计学意义(均P<0.05)。在左右两侧CVHI指标中,平均流速、最大流速、最小流速随着LAP水平的上升呈下降趋势;外周阻力、脉搏波速、特性阻抗、动态阻力、临界压水平、舒张压与临界压的差值随LAP水平的上升呈上升趋势。4组人群CVHI正常率(>75)分别为97.4%,89.7%,87.0%、80.8%,依次呈下降趋势。非条件logistic回归分析结果显示,吸烟、饮酒、高脂血症病史、脑卒中家族病史、运动缺乏、体质指数、脂质蓄积指数是CVHI异常的危险因素,其OR值依次为1.558、1.617、0.267、0.397、1.604、2.627倍;在体质指数分组中,超重组和肥胖组CVHI异常的可能性是正常组的2.515和9.199倍;在LAP分组中Q2、Q3、Q4组CVHI异常的可能性是Q1组的1.596、2.073、9.030倍。因此脂质蓄积指数越高,脑血流异常的风险越高。结论LAP与CVHI存在相关性,LAP越高CVHI异常的风险性越高,应引起高度重视。

Objective To investigate the relationship between lipid accumulation index(LAP)and cerebral hemodynamic score(CVHI)in people undergoing physical examination.Methods Totally 3264 physical examination people who underwent CVHI test in the First Affiliated Hospital of Xinjiang Medical University from June to December 2019 were selected as the study subjects.Firstly,the subjects’basic information and disease history were obtained through field questionnaire survey.Height,weight and waist circumference were measured.Meanwhile,relevant laboratory tests and cerebral hemodynamic monitoring were completed,and body mass index and lipid accumulation index were calculated.People with cerebral hemodynamic index≥75 were enrolled into the normal group and those<75 were enrolled into the abnormal group.According to the quartile of LAP,the physical examination population was divided into Q1,Q2,Q3 and Q4 groups.The correlation between lipid accumulation index and cerebral hemodynamics in different groups was calculated and compared.Results A total of 3264 subjects were included in the study,with the average age of(45.92±10.76)years old.There were 2896 patients in the normal group(88.73%)and 368 patients in the abnormal group(11.27%).There were statistically significant differences in age,smoking,drinking,history of hypertension,history of hyperlipidemia,lack of exercise,family history of stroke,body mass index,hyperglycemia,total cholesterol and lipid accumulation index between the normal group and the abnormal group(all P<0.05).In the indicators of CVHI on the left and right sides,the levels of the average flow velocity,the maximum flow velocity and the minimum flow velocity decreased with the increase of LAP level,while the levels of the peripheral resistance,the pulse velocity,the characteristic impedance,the dynamic resistance,the critical pressure level,the diastolic pressure and critical pressure difference increased with the increase of LAP level.The normal rate of CVHI(>75)in the four groups was 97.4%,89.7%,87.0%and 80.8%,respectively,showing a downward trend in turn.The results of unconditional logistic regression analysis showed that smoking,drinking,history of hyperlipidemia,family history of stroke,lack of exercise,body mass index,and lipid accumulation index were risk factors for abnormal CVHI,which the OR values were 1.558,1.617,0.267,0.397,1.604 and 2.627 times,respectively.In the body mass index groups,the probability of abnormal CVHI in the overweight and obesity group was 2.515 and 9.199 times higher than that in the normal group.In the LAP groups,the probability of abnormal CVHI in Q2,Q3 and Q4 was 1.596,2.073 and 9.030 times higher than that in Q1 group.Therefore,the higher the lipid accumulation index,the higher the risk of abnormal cerebral blood flow.Conclusion There is a correlation between LAP and CVHI,and the higher the LAP,the higher the risk of abnormal CVHI,which deserves more attention.