我国中老年人血清低HDL-c血症与膳食关系研究

The relationship between serum low high-density lipoprotein cholesterol and diet among Chinese middle-aged and older adults

目的分析我国中老年人血清低高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-c)血症与膳食的关系。方法数据来源于2010-2012年中国居民营养与健康状况监测。对我国城乡150个监测点45岁及以上居民共28 092名进行基本情况问卷调查及连续3 d的24 h膳食调查,采用直接法测定调查对象空腹血清HDL-c水平,按《中国成人血脂异常防治指南(2016年修订版)》标准判断低HDL-c血症。结果我国中老年人低HDL-c血症患病率男性高于女性(x^2=202.144,P<0.001);低HDL-c血症患病率随年龄增加呈下降趋势(x^2=9.782,P=0.002);随收入增加(x^2=16.143,P<0.001)和文化程度提高(x^2=95.129,P<0.001)呈现上升趋势;大城市、中小城市、普通农村和贫困农村血清低HDL-c血症患病率分别为36.5%,32.4%,33.5%和34.0%,地区间差异有统计学意义(x^2=7.314,P=0.007)。城乡男性低HDL-c血症与HDL-c正常人群水果、蛋类和奶类摄入量差异均有统计学意义(均有P<0.05);城乡女性低HDL-c血症与HDL-c正常人群红肉类和禽肉类摄入量差异均有统计学意义(均有P<0.05)。调整其他因素后Logistic回归分析显示,低HDL-c血症与粮谷类、水果和红肉摄入有关,其OR(95%CI)值分别为1.06(1.03~1.09)、1.12(1.06~1.19)和0.91(0.89~0.93)。结论我国城乡中老年人血清低HDL-c血症患病率较高,低HDL-c血症与粮谷类、水果和红肉摄入量有关。

Objective To analyze the relationship between serum low high-density lipoprotein cholesterol（ HDL-c）and dietary intake among Chinese middle-aged and older adults. Methods Data were collected from Chinese Nutrition and Health Surveillance in 2010-2012. A total of 28 092 participants aged 45 y and older were collected in 150 surveillance sites of urban and rural in China. Questionnaire on general information and consecutive three days 24-hour dietary survey was conducted by qualified staff. Fasting serum HDL-c was tested by direct method and low HDL-c was evaluated by Guidelines on Prevention and Treatment of Blood Lipid Abnormality in Chinese Adults 2016 revised edition. Results The total prevalence of serum low HDL-c in male middle-aged and older adults was more than that in female（ χ^2= 202. 144,P〈0. 001）.The prevalence of low HDL-c decreased with age（χ^2= 9. 782,P = 0. 002） while increased with family average income（ χ^2= 16. 143,P〈0. 001） and educational levels（χ^2= 95. 129,P〈0. 001）. The difference among four regional types was significant（ χ^2= 7. 314,P = 0. 007）,which was 36. 5% in big city,32. 4% in small and medium-sized city,33. 5%in ordinary rural areas and 34. 0% in poverty rural areas respectively. Among male participants with low HDL-c and normal HDL-c,difference of dietary fruit intake,eggs intake and milk intake were statistically significant both in urban and rural areas（ all P〈0. 05）. When comparing the dietary intake difference between low HDL-c and normal HDL-c among female participants,difference of red meats intake and poultry intake were significant both in urban and rural areas（ all P〈0. 05）. Logistic regression by adjustment of confounding factors showed that cereals,fruits and red meats were associated with low HDL-c,their OR and 95% CI were 1. 06（ 1. 03-1. 09）,1. 12（ 1. 06-1. 19） and 0. 91（ 0. 89-0. 93）. Conclusions The low HDL-c prevalence was high among middle-aged and older adults both in urban and rural areas of China; low HDLc was related with cereals,fruits and red meats consumption.