四川绵阳科学城地区中、小学生非高密度脂蛋白胆固醇水平分析

Analysis of non-high-density-lipoprotein-cholesterol in primary and middle school students of Science City Area,Mianyang,Sichuan Province

目的探讨四川绵阳科学城地区中、小学生非高密度脂蛋白胆固醇(non-HDL-C)水平及高non-HDL-C血症患病率情况。方法采用整群抽样方法,选择2015年9月至11月,四川绵阳科学城地区3所小学和1所中学共计3 241名中、小学生为研究对象。根据中国0~18岁儿童、青少年人体质量指数(BMI)生长曲线,将其分为肥胖组(n=326)、超重组(n=508)与对照组(n=2 407)。对3组受试者的年龄、身高、体重、血脂水平等指标进行横断面调查。采集受试者空腹肘静脉血3mL,对其血脂水平进行检测。统计学比较3组受试者的non-HDL-C水平、高non-HDL-C血症患病率。本研究调查前,均与受试者监护人签署知情同意书。3组中、小学生的年龄、性别构成比等基本临床资料比较,差异均无统计学意义(P>0.05)。结果1本研究调查数据有效率为99.3%(3 241/3 263)。2本研究3 241名中、小学生中,non-HDL-C水平为(2.46±0.63)mmol/L,高non-HDL-C血症界值为3.58mmol/L。女性中、小学生non-HDL-C水平为(2.51±0.61)mmol/L,高于男性中、小学生的(2.44±0.66)mmol/L,二者比较,差异有统计学意义(t=3.14,P<0.001)。33组中、小学生non-HDL-C水平比较,差异有统计学意义(F=85.04,P<0.001)。肥胖组中、小学生non-HDL-C水平明显高于超重组和对照组,超重组高于对照组,差异均有统计学意义(P<0.001)。4本研究3 241名中、小学生中,高non-HDL-C血症患病率为3.6%(116/3 241)。男性中、小学生高non-HDL-C血症患病率为3.3%(54/1 617),女性为3.8%(62/1 624),二者比较,差异无统计学意义(χ~2=0.54,P=0.462)。肥胖组高non-HDL-C血症患病率为9.5%(31/326),明显高于超重组的3.7%(19/508)和对照组的2.7%(66/2 407),差异均有统计学意义(χ~2=11.73,P<0.001;χ~2=38.41,P<0.001)。超重组和对照组高non-HDL-C血症患病率比较,差异无统计学意义(χ~2=1.48,P=0.224)。结论四川绵阳科学城地区肥胖与超重中、小学生non-HDL-C水平形势不容乐观,应采取适当干预措施,预防高non-HDL-C血症的发生。

Objective To explore the level of non-high-density-lipoprotein-cholesterol （non-HDL-C） and prevalence of non-HDL-C hyperlipidemia in primary and middle school students of Science City Area, Mianyang, Sichuan Province. Methods From September to November 2015, a total of 3 241 cases of primary and middle school students of Science City Area, Mianyang, Sichuan Province were selected as research objects by cluster sampling method. According to the body mass index （BMI） growth curve of 0-18 years old children and adolescents in China, they were divided intoobese group （n=326）, overweight group （n=508） and control group （n=2 407）. The age, body height, body weight and lipid level of the students were collected by cross-sectional study method. A total of 3 mL elbow vein blood was collected and the lipid level was detected. The level of non-HDL-C and prevalence of non-HDL-C hyperlipidemia among 3 groups were compared by statistical methods. Before surveying, the informed consents were obtained from guardians of all the students. There were no statistical differences among 3 groups in the age, gender ratio and so on （P 〉 0. 05）. Results ①The effective rate of data collection was 99.3% （3 241/3 263）. ②Among the 3 241 cases of primary and middle school students, the level of non-HDL-C was （2. 46 ± 0. 63） mmol/L, the cutoff value of non-HDL-C hyperlipidemia was 3. 58 mmol/L. The level of non-HDL-C in female students was （2.51±0.61） mmol/L, which was higher than （2.51±0.61） mmol/L in male students, and the difference was statistically significant （t = 3. 14, P 〈 0. 001）. ③ There was statistical difference among 3 groups in the level of non-HDL-C （F=85. 04, P〈0. 001）. And the levels of non-HDL-C in obese group and overweight group were higher than that in control group, and the level of non-HDL-C in overweight group was also higher than that in control group, all the differences were statistically significant （P〈0. 001）. ④Among the 3 241 cases of primary and middle school students, the prevalence of non-HDL-C hyperlipidemia was 3. 6% （116/3 241）. There was no statistical difference in the prevalence of non-HDL-C hyperlipidemia between male and female students which was 3.3% （53/1 617） and 3.8% （62/1 624）, respectively （χ2=0.54, P=0. 462）. The prevalence of non-HDL-C hyperlipidemia in obese group was 9. 5% （31/326）, which was higher than 3. 7% （19/508） in overweight group and 2.7% （66/2 407） in control group, and both the differences were statistically significant （χ2=11.73, P〈0. 001; χ2= 38.41, P〈0. 001）. But there was no statistical difference in the prevalence of non-HDL-C hyperlipidemia between overweight group and control group （χ2 = 1.48, P=0. 224）. Conclusions The level of non-HDL-C in primary and middle school students of Science City Area, Mianyang, Sichuan Province is unoptimistic, and appropriate interventions should be taken to prevent the occurrence of non-HDL-C hyperlipidemia.