中国飞行员血脂异常现状的Meta分析

Prevalence of Dyslipidemia among Pilots in China:a Meta-analysis

目的通过Meta分析了解中国飞行员血脂异常患病情况。方法系统检索2016-05月份以前的中国知网期刊全文数据总库（China national knowledge infrastructure,CNKI）、万方数据库以及PubMed数据库中有关中国飞行员血脂异常调查的横断面研究。利用随机效应模型合并所纳入文献中血脂异常患病率,并对不同工作领域（军用航空或民用航空）和时期执行亚组分析,采用敏感性分析评价单一研究对结果的影响。结果共纳入27篇文献,总样本量为45 621人,中国飞行员合并血脂异常总患病率为37.6%（95%CI：30.9%-44.3%）。高血清总胆固醇（total cholesterol,TC）、高三酰甘油（triacylglycerol,TG）、低高密度脂蛋白胆固醇（high density lipoprotein cholesterol,HDL-C）、高低密度脂蛋白胆固醇（low density lipoprotein cholesterol,LDL-C）等血脂异常患病率分别为17.2%（95%CI：12.3%-22.1%）、25.7%（95%CI：22.5%-28.9%）、22.6%（95%CI：18.9%-26.4%）、14.4%（95%CI：9.4%-19.3%）。民用航空飞行员高TC、高TG、低HDL-C、高LDL-C、血脂异常总患病率均高于军用航空飞行员,但仅高TG患病率两者比较差异有统计学意义（P=0.013）。2010/2015年与2003/2009年相比,高TC、高TG、低HDL-C和高LDL-C的患病率均呈上升趋势,但只有低HDL-C两者比较差异有统计学意义（P=0.013）。结论中国飞行员血脂异常患病率较高,应及早对发现的异常情况实施干预。

Objective To quantify the prevalence of dyslipidemia among pilots in China.Methods Data about prevalence of dyslipidemia among pilots in China before May 2016 in the China National Knowledge Infrastructure（CNKI）,Wanfang Databases and PubMed were comprehensively searched.The literatures about prevalence rate of dyslipidemia were combined by random effect model.Subgroup analysis was undertaken on working areas and secular trends issues.Sensitivity analysis was performed to evaluate the impact of each single study on the main results.Results A total of 27 papers were included in this Meta-analysis,with the whole sample size as 45 621 people.The overall pooled prevalence rate of dyslipidemia was estimated at 37.6%（95%CI：30.9%-44.3%）.Prevalence rates of high total cholesterol（TC）,triacylglycerol（TG）,low high density lipoprotein cholesterol（HDL-C）and low density lipoprotein cholesterol（LDL-C）were 17.2%（95%CI：12.3% -22.1%）,25.7%（95%CI：22.5% -28.9%）,22.6%（95%CI：18.9% -26.4%）and14.4%（95%CI：9.4%-19.3%）,respectively.Civil pilots had higher prevalence of high TG than their military counterparts（P=0.013）,while there were no significant differences for subgroups of working areas regarding the prevalence rates of high TC,LDL-C and low HDL-C.The prevalence of low HDL-C was higher in 2010-2015 than that in2003-2009（P=0.013）,while the prevalence of high TG,TC and LDL-C was not significantly different between two time periods.Conclusion The prevalence rate of dyslipidemia is relatively high and shows an increasing trend among pilots in China.Intervention must be immediately handled once exceptional cases is found.