河南省农村地区居民血脂异常患病率及其危险因素调查

Prevalence and risk factors of dyslipidemia in a rural population of Henan Province, China

目的调查河南省某农村地区居民血脂异常的分布特征及其危险因素。方法采用整群抽样方法，选择河南省某县的两个乡（镇）为研究现场，以自然村为单位，于2007年7—8月和2008年7—8月对20 194名18岁以上农村居民进行问卷调查、体格检查、FPG及脂质谱检测。于2013年7—8月和2014年7—10月进行了随访，共随访到16 155名研究对象。排除无法依据血脂异常的判定标准确诊是否患有血脂异常者2286名，最终13 869名研究对象被纳入本研究。分析该人群血脂异常的分布状况，应用2010年全国第六次人口普查资料对患病率进行年龄标化。调整性别、年龄、受教育水平、婚姻状况和人均月收入后，采用多因素非条件logistic回归模型分析血脂异常的影响因素。结果 河南省该农村地区22岁以上居民血脂异常患病率为53.72%（7 450/13 869），标化患病率为50.50%，其中男性患病率为59.32%（3 069/5 174），标化患病率为59.27%，女性患病率为50.39%（4 381/8 695），标化患病率为45.53%。高TC血症、高TG血症、低HDL-C血症和高LDL-C血症患病率分别为4.34%（602/13 868）、20.42%（2 826/13 837）、42.75%（5 927/13 865）和3.14%（420/13 375），其标化患病率分别为2.44%、18.84%、41.42％和1.86%。调整性别、年龄、受教育水平、婚姻状况和人均月收入后，多因素非条件logistic回归模型分析显示，饮酒（OR=1.27, 95%CI： 1.05-1.53）、高脂血症家族史（OR= 1.29, 95%CI：1.17-1.43）、超重（OR=1.40, 95%CI： 1.22-1.61）、肥胖（OR=1.65, 95%CI： 1.39-1.96）、腰围异常（OR=1.22, 95%CI： 1.04-1.43）和腰身比异常（OR=1.21, 95%CI： 1.01-1.45）是血脂异常的危险因素，高度体力活动（OR=0.85, 95%CI： 0.77-0.95）和低体重（OR=0.52, 95%CI： 0.36-0.75）是其保护因素。结论 河南农村地区居民血脂异常患病率较高，饮酒、高脂血症家族史、超重、肥胖、腰围异常和腰身比异常是血脂异常的独立危险因素。

Objective The purpose of this study was to investigate the prevalence and risk factors of dyslipidemia in a rural population of Henan Province, China.Methods A total of 20 194 participants aged ≥18 years were selected randomly by cluster sampling from two townships（towns）in Henan Province from July to August 2007 and July to August 2008. Investigations included questionnaires, anthropometric measurements, fasting plasma glucose, and lipid profile examination at baseline. A total of 16 155 participants were followed up from July to August 2013 and July to October 2014. Overall, 13 869 participants were included in the study, after excluding 2 286 participants with incomplete dyslipidemia follow-up data. Distributions of the characteristics of dyslipidemia were determined, and prevalence was standardized by age according to data of the 2010 Sixth National Population Census. Risk factors for dyslipidemia were analyzed using a logistic regression model after adjusting for sex, age, education level, marital status, and income status.Results The prevalence of dyslipidemia was 53.72%（7 450/13 869）for residents aged ≥22 years living in rural areas of Henan Province（59.32%（3 069/5 174）for men and 50.39%（4 381/8 695）for women）. The adjusted prevalence of dyslipidemia was 50.50%（59.27% for men and 45.53% for women）. The prevalence of hypercholesterolemia, hypertriglyceridemia, low HDL-C, and high LDL-C was 4.34%（602/13 868）, 20.42%（2 826/13 837）, 42.75%（5 927/13 865）, and 3.14%（420/13 375）, respectively, and the adjusted prevalence was 2.44%, 18.84%, 41.42%, and 1.86%, respectively. Logistic regression analyses showed that alcohol consumption（OR=1.27, 95% CI： 1.05-1.53）, family history of hyperlipidemia（OR=1.29, 95% CI： 1.17-1.43）, overweight（OR=1.40, 95% CI： 1.22-1.61）, obesity（OR= 1.65, 95% CI： 1.39- 1.96）, abnormal waist circumference（OR=1.22, 95% CI： 1.04- 1.43）, and abnormal waist-height ratio（OR=1.21, 95% CI： 1.01-1.45）were significant independent risk factors, and high levels of physical activity（OR=0.85, 95% CI： 0.77- 0.95）and underweight（OR=0.52, 95% CI： 0.36- 0.75）were protective factors for dyslipidemia after adjusting for sex, age, education level, marital status, and income status.Conclusion The prevalence of dyslipidemia was very high for this rural population. Alcohol consumption, family history of hyperlipidemia, overweight, obesity, abnormal waist circumference, and abnormal waist-height ratio were significant independent risk factors for dyslipidemia.