采用Logistic回归以及ROC曲线分析小儿血脂紊乱筛检指标

Analyze the indices of the screening test of hyperlipidemia by Logistic regression analysis and ROC study in children

目的探讨与小儿血脂紊乱发病有关的危险因素,找寻小儿血脂紊乱的筛检试验指标。方法调查分析北京市某中、小学在校学生(5-19岁)的血脂水平,应用日立7060型全自动生化分析仪检测其空腹血浆总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)及低密度脂蛋白(LDL-C)含量。测量其身高、体重、坐高、腰围、上臂围及血压,计算体重指数(BMI)及腰围身高比值(WHR)反映身体的肥胖程度,通过Logistic回归分析以及ROC曲线进一步分析这些指标与血脂水平的关系。结果在962例学生中,共检出血脂紊乱患者107例,患病率为11.12%;血脂紊乱组的坐高、上臂围、BMI、WHR及舒张压(DBP)、收缩压(SBP)等6项指标均明显高于血脂正常组;BMI、WHR、DBP和家族史4项是血脂紊乱发病的危险因素。结论可根据BMI、WHR、血压及阳性家族史筛查出小儿血脂紊乱的高危人群,进而进行空腹血浆血脂成分的检测。

Objective To examine serum lipid levels and to investigate the risk factors of dyslipidemia in children and to study the indices of screening test for dyslipidemia of children in Beijing. Methods Serum total cholesterol （T C）, triglyceride （TG）, high density lipoprotein-cholesterol （HDL-c） and low density lipoprotein-cholesterol （LDL-c） were detected by HITACHI 7060 automatic biochemical analyzer in Beijing students. Body height, weight, upper body height, waist circumference, upper arm circumference and blood pressure were measured. Body mass index （BMI） was calculated according to the measurement of body height and weight. Waist-to-height ratio （WHR） was also calculated. Then a l^gistic regression analysis and ROC study were conducted to examine the relationship between the above indices and dyslipidemia. Results Of 962 students, 107 were found dyslipidemia. The prevalence rate was 11.12%. The upper body height, upper arm circumference, BMI, WHR, systolic pressure and diastolic pressure in children with dyslipidemia were higher than those of normal subjects （ P 〈 0. 05 ）. BMI, WHR, diastolic pressure and positive familial history were risk factors of children with dyslipidemia. Conclusion High risk group of dyslipidemia in children can be screened by BMI, WHR, blood pressure and familial history.