中国35～64岁人群血清甘油三酯与心血管病发病危险的关系

Serum triglyceride is an independent risk factor for acute coronary heart disease events in 35 -64 years old Chinese-Chinese Multi-provincial Cohort Study

目的探讨我国35～64岁人群血清甘油三酯（TG）与心血管病发病危险的关系。方法采用前瞻性队列研究的方法，利用中国多省市心血管病危险因素队列研究30378人的资料，通过对基线血清TG不同水平人群12年间（1992--2004年）急性冠心病事件、缺血性脑卒中事件和出血性脑卒中事件发病风险进行比较，研究TG对各类心血管病发病风险的影响。结果（1）TG与急性冠心病事件的发病危险有明确的关系。急性冠心病事件的人年发病率在TG水平较低时（TG≥1．15mmol／L）开始增加，TG水平上四分之一分位组（TG≥1．60mmoL／L）人群的急性冠心病事件人年发病率是TG水平下四分之一分位组（TG〈0．81mmol／L）的2．7倍（168．4／10万，62．6／10万）。（2）应用COX回归分析调整了多种其他危险因素后，TG水平对12年间急性冠心病的发病风险有独立的预测作用。分析未发现TG与缺血性脑卒中和出血性脑卒中的发病危险存在关联。结论在35～64岁中国人群中，TG是急性冠心病事件发病的独立危险因素。急性冠心病事件的发病危险从TG≥1．15mmol／L即开始升高。

Objective To evaluate the association between serum triglyceride （TG） and the cardiovascular diseases （CVD） risk in Chinese population. Methods A total of 30, 378 men and women aged 35-64 years old were recruited in the Chinese-Chinese Multi-provincial Cohort Study （CMCS） . The serum TG and other CVD risk factors were measured. All subjects were followed up annually or biannually for acute CVD events from 1992 to 2004. A Cox regression model was established to identify the association between TG and risk of CVD events. Results The accumulative incidence rate of acute coronary heart disease （CHD） events increased from 62.6/100 000 in the low TG groups to 168.4/100 000 in the high TG group divided by the quartile. TG was identified as an independent risk factor for CHD after adjustment for the confounding risk factors by a Cox regression model. Compared subjects with TG 〈 0. 81 mmol/L, CHD risk increased 81% and 59% in subjects with TG 1.15-1.59 mmoL/L and TG≥1. 60 mmol/L, respectively （ all P 〈 0. 05 ）. There was no significant association between TG level and the risks of hemorrhagic and ischemic stroke events （ P 〉 0. 05 ）. Conclusion Serum TG is an independent risk factor for acute CHD events in Chinese population aged 35-64.