上海社区人群高密度脂蛋白胆固醇水平

Mean high density lipoprotein level in Shanghai community

目的了解上海社区人群高密度脂蛋白胆固醇(HDL-C)水平、低高密度脂蛋白血症的患病情况及伴随的其他代谢异常情况。方法对两个社区5 628名≥20岁的社区人群(男2 430名,女3 198名)进行代谢综合征及相关疾病的流行病学调查,测定体重指数(BMI)、血压(BP)、空腹血糖(FBG)、糖负荷后2 h血糖、血脂谱和空腹胰岛素(FIN)。结果①平均HDL-C值为(1．318±0．004)mmol／L,女性为(1．352±0．005)mmol／L,显著高于男性的(1．273±0．006)mmol／L(P<0．01)。②据我国定义的低高密度脂蛋白血症标准,患病率为8．90％;据美国胆固醇教育计划(NCEP)成人治疗组第3次报告(ATPⅢ)定义的标准,为15．16％。16．79％的被调查者HDL-C值≥1．56 mmol／L。③HDL-C<0．91 mmol／L的人群,患糖尿病、糖调节受损、高血压、高三酰甘油血症和肥胖的比例分别为22．27％、12．27％、47．73％、60．45％和57．27％;HDL-C≥0．91且<1．04 mmol／L的人群,分别为12．29％、12．97％、45．05％、62．46％和52．56％;HDL-C≥1．56 mmol／L的人群,分别为10．34％、9．35％、36．26％、43．63％和31．30％。④以HDL-C为应变量,年龄、性别、BMI、腰臀比(WHR)、FBG、收缩压、舒张压、三酰甘油(TG)和稳态模式评估法的胰岛素抵抗指数(HOMA-IR)为自变量进行多元逐步回归分析,性别、年龄、HOMA-IR、BMI、TG、FBG和WHR是HDL-C的影响因素(P值均<0．01)。结论①HDL-C水平存在性别、种族差异。②随着HDL-C的下降,个体伴发高血糖、高血压、高三酰甘油血症和肥胖的比例逐步上升。③胰岛素抵抗、肥胖、高三酰甘油血症和高血糖是HDL-C的影响因素。

Objective To determine the mean high density lipoprotein cholesterol （HDL-C） level in Shanghai community and the associated metabolic disorder. Methods A total of 5 852 Shanghai Chinese（men 2 430, women 3 198） aged above 20 years were included for investigating metabolic syndrome with correlated epidemic diseases. Body mass index （BMI）, blood pressure, fasting plasma glucose, lipid profile and plasma insulin concentrations were measured in all subjects. Results ①The mean HDL-C level was （1. 318±0. 004） mmol/L in our two communnities. Women had a significantly higher mean HDL-C level than men [（ 1. 352±0. 005）mmol/L vs （1. 273 ±0. 006）mmol/L, P 〈 0.01 ]. ② According to CHINA criteria, 8. 90% of our community people had low HDL-C. According to ATPUI criteria, 15.16% of our community people had low HDL-C. ③The proportions of diabetes mellitus （DM）, impaired glucose regulation （ IGR）, hypertension （ HTN）, hypertriglycermia, obesity were 22. 27%, 12.27%, 47. 73%, 60.45% and 57. 27% respectively in the population whose HDL-C was less than 0. 91 mmol/L. The proportions of DM, IGR, HTN, hypertriglycermia and obesity were 12.29%, 12.97%, 45.05%, 62. 46% and 52. 56% respectively in the population whose HDL-C were between 0.91 mmol/L and 1.04 mmol/L. The proportions of DM, IGR, HTN, hypertriglycermia and obesity were 10. 34%, 9. 35%, 36.26%, 43.63% and 31. 30% respectively in the population whose HDL-C was equivalent to or higher than 1.56 mmol/L. ④The multiple stepwise regression analysis in which HDL-C as a dependable variable and age,sex, BMI, WHR, FBG, SP, DP, TG, HOMA-IR as independent variables showed that sex, HOMA-IR, BMI, age, TG, FBG and WHR were influencing factors of HDL-C. Conclusion ②The concentration of HDL-C is different in men and women and among difference races. ②By the decrease of HDL-C, the proportion of individuals with hyperglycemia, hypertension, hypertriglycemia and obesity ascends gradually. ③BMI, WHR, HOMA-IR, FBG and TG are the influencing factors of HDL-C. （Shanghai Med J, 2006, 29： 695-698）