北京市老年人血压、血糖、血脂水平与4年全死因死亡分析

Analysis of blood pressure,serum glucose and lipid level and 4-year mortality in elderly residents of Beijing

目的分析北京市一个有代表性的老年人群多项代谢指标和4年全死因的关系。方法于2000年对一个老年流行病学队列研究人群1 496例进行身高、体质量测量及血压和多项血液代谢指标的检查并进行随访,4年中累计死亡老人203例。分析生存1 293例与死亡203例的基线代谢指标与4年全因死亡的关系。结果 1 496例老年人中,平均年龄(71.3±6.4)岁,与生存的老人相比较,死亡组年龄偏大,基线收缩压偏高,体质量指数(BMI)和甘油三酯(TG)水平、总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)水平偏低,以上各项差异均有统计学意义(P<0.05)。死亡老人中高血压、糖尿病、低高密度脂蛋白胆固醇(HDL-C)、低BMI、吸烟的比例显著高于生存组(P<0.05)。回归分析以全死因为因变量,高血压(HR=1.40,95%CI=1.03～1.91)、糖尿病(HR=1.57,95%CI=1.09～2.26)、BMI≥25(HR=0.65,95%CI=0.46～0.91)、低HDL-C血症(HR=2.40,95%CI=1.41～4.09)能够进入回归方程。结论老年人中,多种代谢异常与全因死亡有关,低HDL-C血症对死亡有预测价值。

Objective To investigate the association between metabolic disorders and 4-year all cause mortality among elderly residents in Beijing. Methods An elderly cohort in Beijing including 1 496 cases, was performed in physical examination in 2000. Height, body mass and blood test were also collected. With 4 years＇ follow-up, 203 elderly were dead. The association of metabolic disorders and 4-year mortality was analyzed between the survival 1 293 cases and dead 203 cases. Results The mean age of 1 496 residents was （71.3 ± 6.4） years old. Compared with those of survival group, older age, high systolic blood pressure, low serum total cholesterol （TC）, low-density lipoprotein cholesterol（LDL-C） ,triglycerides（TG） and body mass index（BMI） in dead group were significant more （ P 〈0.05）. At the same time, hypertension, diabetes mellitus, low high-density lipoprotein cholesterol（HDL-C）, low BMI and smokers in dead group were significantly higher than in survival group （P 〈 0.05）. In Cox regression analysis, hypertension had significant value to predict all cause mortality （ HR = 1.40,95 % CI = 1.03-1.91）. Other risk factors to all cause mortality were diabetes mellitus （ HR = 1.57,95% CI ： 1.09-2.26）, BMI≥25 （ HR=0.65,95% CI = 0. 46-0. 91） , low HDL-C （ fir ： 2.40, 95% CI = 1.41-4.09）. Conclusion＇ Metabolic disorders were common in elderly. Low HDL-C may have the predictive value for all cause mortality among 4 years follow-up in this community elderly people.