北京部分社区健康中老年人非空腹血清甘油三酯参考区间的初步建立

Preliminary establishment of reference interval for non-fasting serum triglycerides among healthy middle-aged and elderly people in some communities Beijing

目的:初步建立适合北京部分社区健康中老年人非空腹状态餐后4 h血清甘油三酯(TG)的参考区间,为餐后血脂代谢异常的判断提供诊断依据。方法:选取2018年1月至10月在中国中医科学院广安门医院健康体检中老年人369名,受试者禁食12 h后于次日清晨采集空腹静脉血液标本,随后进食符合本地膳食习惯的标准早餐,并于进食后4 h再次采集静脉血液标本。使用AU5822全自动生化分析仪及配套试剂检测餐后4 h的血清TG水平。不同年龄和性别组之间餐后TG的比较采用两个独立样本的非参数检验,餐后与空腹TG之间的对比采用两个配对样本的非参数检验。依照CLSI EP28-A3c文件的相关要求采用非参数方法计算95%置信区间,以P2.5,P97.5表示参考区间。结果:健康体检的中老年人45~59岁和≥60岁两组餐后4 h TG中位数分别为1.65(1.25,2.13)mmol/L和1.58(1.25,2.00)mmol/L,两组间差异无统计学意义(Z=-1.040,P>0.05);餐后4 h TG水平在45~59岁组的男性1.69(1.22,2.31)mmol/L和女性1.63(1.26,2.12)mmol/L间无统计学差异(Z=-0.179,P>0.05),在≥60岁组的男性1.64(1.22,2.06)mmol/L和女性1.53(1.28,1.99)mmol/L间亦差异无统计学意义(Z=-0.256,P>0.05);与空腹TG中位数1.05(0.87,1.29)mmol/L对比,餐后4 h血清TG中位数1.61(1.25,2.09)mmol/L明显升高(Z=-16.449,P<0.01),餐后-餐前差值中位数为0.52(0.30,0.85)mmol/L;餐后4 h血清TG的参考值区间为0.82~3.02 mmol/L。结论:本研究初步建立了北京部分社区健康中老年人群餐后4 h血清甘油三酯的参考值区间。

Objective To establish the reference interval of serum triglyceride(TG)for 4 hours after meal in healthy middle and old people of Beijing community,and to provide the diagnostic basis for the judgment of dyslipidemia after meal.Methods Selected 369 elderly people from January to October 2018 in the health examination of Guang′anmen Hospital of the Chinese Academy of Traditional Chinese Medicine.The subjects collected fasting venous blood samples in the morning the next day after fasting for 12 hours,then ate a standard breakfast that conformed to the local dietary habits,and collected venous blood samples again 4 hours after eating.Serum TG levels were measured 4 h after meal using AU5822 fully automatic biochemical analyzer and matching reagents.The comparison of postprandial TG between different age and sex groups was statistically significant using the nonparametric test of two independent samples,and the comparison between postprandial and fasting TG using the nonparametric test of two paired samples with P<0.05 as the difference.The 95%confidence interval was calculated using a nonparametric method according to the relevant requirements of the CLSI EP28-A3c file,and the reference interval was expressed as P2.5,P97.5.Results The median 4-hour post-prandial TG of the middle-aged and elderly aged 45-59 years and those aged≥60 years at health checkups were 1.65(1.25,2.13)mmol/L and 1.58(1.25,2.00)mmol/L,there was no significant difference between the two groups(Z=-1.040,P>0.05).There was no statistical difference between males 1.69(1.22,2.31)mmol/L and females 1.63(1.26,2.12)mmol/L at 4 hours postprandial TG levels in the 45-59 year-old group(Z=-0.179,P>0.05),there was also no statistical difference between 1.64(1.22,2.06)mmol/L for men and 1.53(1.28,1.99)mmol/L for women aged 60 years or older(Z=-0.256,P>0.05).Compared with the median fasting TG of 1.05(0.87,1.29)mmol/L,the median serum TG of 1.61(1.25,2.09)mmol/L at 4 hours after meal was significantly increased(Z=-16.449,P<0.01).The difference between postprandial and fasting was 0.52(0.30,0.85)mmol/L.The reference range of serum TG at 4 hours after meal was 0.82 to 3.02 mmol/L.Conclusion In this study,the reference range of serum triglycerides for 4 hours after meal was established in some healthy elderly population groups in Beijing.