北京市35岁以下成年人亚临床动脉粥样硬化情况及影响因素研究

Prevalence and Associated Factors of Subclinical Atherosclerosis in Adults under 35 Years Old in Beijing

目的探讨35岁以下成年人亚临床动脉粥样硬化情况及其影响因素。方法选取2007—2012年在北京某三级甲等医院进行健康体检的1 317例35岁以下成年人为研究对象,收集体检者一般资料、臂-踝脉搏波传导速度(baPWV)、踝肱指数(ABI)及实验室检查等资料。比较不同性别体检者上述资料的差异,比较不同性别、不同年龄组体检者baPWV和ABI,采用多元线性回归分析baPWV的影响因素。结果男性的年龄、身高、体质量、体质指数(BMI)、腰围、收缩压、舒张压,饮酒、患高血压者所占比例,空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)水平均高于女性,高密度脂蛋白胆固醇(HDL-C)水平低于女性,差异具有统计学意义(P<0.001);两组吸烟、患糖尿病者所占比例比较,差异无统计学意义(P>0.05)。无论在男性或女性组中,baPWV均随着年龄增大而增高,差异有统计学意义(P<0.001)。不同年龄段男性baPWV、ABI均高于女性,差异有统计学意义(P<0.05)。35岁以下成年人baPWV>900 cm/s的比例为93.92%(1 237/1 317),女性随年龄的增高,baPWV>900 cm/s者所占比例具有增高趋势(P<0.05)。35岁以下成年人baPWV>1 400 cm/s的比例为4.71%(62/1 317),男性随年龄的增高,PWV>1 400 cm/s的比例具有增高趋势(P<0.05)。26~30、31~35岁组男性中baPWV>1 400 cm/s的比例高于同年龄段女性(P<0.001)。多元线性回归分析结果显示,年龄、性别、收缩压、舒张压、FBG、TG、HDL-C为baPWV的影响因素(P<0.05)。结论 35岁以下成年人亚临床动脉粥样硬化主要表现为baPWV异常,异常比例为4.71%,影响因素主要为血压水平。

Objective To investigate the prevalence and associated factors of subclinical atherosclerosis in adults under 35 years old in Beijing.Methods A total of 1 317 adult physical examinees under 35 years old were recruited from a grade A tertiary hospital in Beijing between 2007 and 2012.Data on demographic characteristics and laboratory findings and so on were collected and compared by sex.Brachial-ankle pulse wave velocity(baPWV)and ankle brachial index(ABI)were also obtained and compared by sex and age group.Multiple linear regression analysis was performed to explore the associated factors of baPWV.Results Of the participants,males were older and higher on average,and they had greater average weight,larger average waist circumference,higher average BMI,systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),and uric acid(UA)levels,higher prevalences of alcohol consumption and hypertension,but lower average high-density lipoprotein cholesterol(HDL-C)levels compared with females(P<0.001).The prevalences of smoking and diabetes were similar in males and females(P>0.05).baPWV increased significantly with age either in males or females(P<0.001).Males showed much higher average baPWV and ABI than females in each age group(P<0.05).The overall prevalence rate of baPWV>900 cm/s was 93.92%(1 237/1 317).The prevalence rate of baPWV>900 cm/s increased significantly with age in females(P<0.05).The overall prevalence of baPWV>1 400 cm/s was 4.71%(62/1 317).The prevalence of baPWV>1 400 cm/s increased obviously with age in males(P<0.05).The prevalences of baPWV>1 400 cm/s were higher in males than in females in age groups of 26-30,and 31-35(P<0.001).Multiple linear regression analysis demonstrated that age,sex,SBP,DBP,FBG,TG and HDL-C were factors associated with baPWV(P<0.05).Conclusion The subclinical atherosclerosis in adults under 35 years old in Beijing was mainly manifested by baPWV abnormality,with a prevalence of 4.71%,which was mainly influenced by blood pressure.