2017年南京社区老年人群高甘油三酯-腰围表型相关影响因素与心血管危险因素聚集关系分析

Correlation between cardiovascular risk factors and relevant influencing factors of hypertriglyceridemic-waistline phenotypes in elderly population in Nanjing community in 2017

目的探讨60岁以上老年人群高甘油三酯-腰围表型(hypertriglyceridemic-waist phenotype,HTWP)的流行病学特征、影响因素以及与心血管危险因素聚集的关系。方法回顾性分析2017年1～12月南京市南苑卫生服务中心进行健康体检的783例60岁以上老年人,将人群按HTWP判定标准分为非HTWP组(正常组、单纯高甘油三酯组和单纯中心性肥胖组)和HTWP组,分析该人群HTWP相关影响因素以及与心血管危险因素聚集的关系。结果 60岁以上老年人群HTWP表型的检出率为34. 7%(男性为22. 1%,女性为44. 6%),HTWP组心血管危险因素聚集检出率为68. 8%,正常组心血管危险因素聚集检出率为32. 7%。HTWP组体质量指数(BMI)、腰围、收缩压、舒张压、总胆固醇、甘油三酯水平高于非HTWP组,高密度脂蛋白胆固醇水平低于非HTWP组,差异均有统计学意义(P<0. 05)。多因素Logistic回归分析显示,男性、吸烟者、BMI值偏高、舒张压偏高以及高高密度脂蛋白胆固醇血症为HTWP的危险因素。进一步校正年龄、性别以及校正性别、年龄、BMI、吸烟、糖尿病家族史和高血压家族史后,HTWP组老年人心血管危险因素聚集风险分别为正常组老年人的5. 89倍(95%CI:3. 76～9. 24)以及3. 08倍(95%CI:1. 86～5. 09)。结论社区老年人群中HTWP与心血管危险因素聚集密切相关,可试作为一种发现心血管疾病高危病人的廉价方法在社区推广。

Objective To investigate the epidemiological characteristics,influencing factors of hypertriglyceridemic-waist phenotype(HTWP) in the elderly over 60 years old,and to investigate the relationship with the aggregation of cardiovascular risk factors. Methods A total of 783 elderly people aged over 60 years old who underwent a physical examination at the Nanyuan Health Service Center of Nanjing from January to December 2017 were included in the study. According to the HTWP criteria,they were divided into non-HTWP group(normal group,simple high triglyceride group and simple central obesity group) and HTWP group. The epidemiological characteristics,influencing factors of HTWP and the relationship with cardiovascular risk factors were analyzed. Results The detection rate of HTWP in the elderly was 34. 7%(22. 1% for males and 44. 6% for females). The detection rate of cardiovascular risk factors in the HTWP group was 68. 8% and the rate of normal group was 32. 7%. The levelf of BMI,waist circumference,systolic blood pressure,diastolic blood pressure,total cholesterol,and triglyceride were higher in the HTWP group than those in the non-HTWP group,while the high-density lipoprotein cholesterol level was lower than that in the non-HTWP group. Multivariate Logistic regression analysis showed that male,smoking,high levels of BMI,diastolic blood pressure,and high-density lipoprotein cholesterol were risk factors for HTWP. Further analysis of the influencing factors of cardiovascular risk factors showed that,the risk of cardiovascular risk factors aggregation in the HTWP group were 5. 89times(95% CI: 3. 76-9. 24) and 3. 08 times(95% CI: 1. 86-5. 09) of the normal group,respectively.Conclusions HTWP is closely related to cardiovascular risk factors in the community seniors. It can be promoted as a cheap method to identify patients at high risk of cardiovascular disease in the community.