老年心脑血管病患者生活方式与脂质代谢异常的关系

Relationship between lifestyle and dyslipidemia in elderly patients with cardiocerebral vascular disease

目的了解老年心脑血管病患者不同生活方式对脂质代谢的影响。方法采用横断面研究方法,连续纳入符合条件的观察对象433名,进行人体测量,调查吸烟、饮酒、喝茶、规律运动等情况,检测血清总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A 1（Apo A 1）、载脂蛋白B（Apo B）以及游离脂肪酸（FFA）水平。结果本组观察对象血脂异常发生率为68.1%。其中高TC为23.1%,低HDL-C为46.7%,高LDL-C为17.6%,高TG为29.6%。多因素Logistic回归分析显示,饮酒是高TC的危险因素（OR：2.75,95%CI：1.14~6.60）,也是防止HDL-C减低的保护因素（OR：0.46,95%CI：0.21~0.97）;经常喝茶是高TG的危险因素（OR：2.24,95%CI：1.30~3.84）,也是防止Apo B/Apo A 1比率增加的保护因素（OR：0.56,95%CI：0.33~0.96）;体力活动是防止FFA升高的保护因素（OR：0.61,95%CI：0.39~0.96）;吸烟是Apo B/Apo A 1比率增加的危险因素（OR：2.59,95%CI：1.39~4.85）。结论老年心脑血管病患者血脂异常发生率高,适度体力活动、限量饮酒、避免频繁喝茶、不吸烟可能有助于控制血脂水平。

Objective To investigate the relationship between lifestyles and lipid profiles in elderly patients with cardiocerebral vascular disease. Methods A cross-sectional survey was conducted on433 elderly patients with cardiocerebral vascular disease admitted in Tongji Hospital from June 2012 toJune 2013. Anthropometric characteristics and blood pressure were examined. The lifestyles of patients were surveyed in terms of smoking,alcohol drinking,tea consumption and regular physical activity.Fastingblood samples were collected,and serum total cholesterol（ TC）,triglyceride（ TG）,highdensity lipoprotein cholesterol（ HDL-C）,low-density lipoprotein cholesterol（ LDL-C）,apolipoprotein A 1（ ApoA 1）,apolipoprotein B（ ApoB） and free fatty acids（ FFA） were measured.Results The overall prevalence of dyslipidemia in this group of patients was 68. 1%. The prevalence of hypercholesterolemia,lowHDL-C,high LDL-C and hypertriglyceridemia were 23. 1%,46. 7%,17. 6% and 29. 6%, respectively. M ultivariate Logistic regression analysis showed that alcohol drinkingwas a risk for high TC（ OR： 2. 75,95% CI： 1. 14-6. 60）,while a protective factor for HDL-C（ OR： 0. 46,95% CI： 0. 21-0. 97）; tea consumption was a risk factor for high TG（ OR： 2. 24,95%CI： 1. 30-3. 84）,while a protective factor for ApoB / ApoA 1（ OR： 0. 56,95% CI： 0. 33-0. 96）;physical activity was a protective factor for FFA elevated（ OR： 0. 61,95% CI： 0. 39-0. 96）; smokingwas a risk factor for the high ratioof ApoB / ApoA 1（ OR： 2. 59,95% CI： 1. 39-4. 85）.Conclusion This study shows that the prevalence of dyslipidemia is high in elderly patients with cardiocerebral vascular disease. Moderate physical activity,limits of alcohol,avoiding frequent tea drinking and no smoking would ameliorate dyslipidemia.