既往有偿献血地区血脂水平与丙型肝炎病毒的关联研究

Study on association between lipid levels and HCV infection in remunerated blood donation

目的探讨既往有偿献血地区丙型肝炎病毒(hepatitis C virus,HCV)感染与血脂的相关性及血脂异常的影响因素。方法2015年3月至5月对江苏省某地区>50周岁人群进行横断面调查,通过问卷调查获取一般人口学资料及既往献血史等信息,并采集5 ml空腹静脉血进行相关指标的检测;分析比较不同HCV感染状况血脂水平,并进行单因素、多因素逐步Logistic回归分析模型探索血脂异常的影响因素。结果共纳入1537例研究对象,其中未感染者1234例(80.3%),自限清除者117例(7.6%),持续感染者186例(12.1%)。倾向得分匹配后3组血清甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)水平均存在统计学差异(均有P<0.05),且持续感染组血清TG和TC水平均低于其余两组。该地区血脂异常率为18.6%(286/1537),多因素Logistic回归分析模型结果显示性别(OR=1.41,95%CI:1.06~1.87,P=0.018)、较高的空腹血糖(OR=2.54,95%CI:1.75~3.68,P<0.001)以及HCV持续感染者(OR=0.22,95%CI:0.12~0.41,P<0.001)是血脂异常发生的独立影响因素。结论江苏省既往有偿献血地区,持续感染者血清TG和TC水平均低于未感染者或自限清除者;HCV感染、性别及空腹血糖水平是该地区血脂异常的独立影响因素。

Objective To explore the correlation between hepatitis C virus(HCV)infection and lipid,and determine the influencing factors of dyslipidemia in remunerated blood donation.Methods From March to May 2015,a cross-sectional study was conducted among people over 50 years old in Jiangsu Province.We obtained demographic data and related measurements through questionnaire surveys and blood test.We compared the lipid levels of different HCV infection groups.The influencing factors of dyslipidemia were explored by univariate and multivariate Logistic regression analysis.Results Of a total of 1537 participants were included,of which 1234(80.3%)were uninfected HCV,117(7.6%)were HCV spontaneous clearance,and 186(12.1%)were HCV persistent infection clients.Differences in serum TG and TC levels among the three groups after PSM were statistically significan(all P<0.05),and those were lower in the participants with persistent infection than the other groups.Dyslipidemia occurred in 286 participants and the prevalence was 18.6%.Multivariate Logistic regression analysis showed that sex(OR=1.41,95%CI:1.06-1.87,P=0.018),higher fasting plasma glucose(OR=2.54,95%CI:1.75-3.68,P<0.001)and HCV persistent infection(OR=0.22,95%CI:0.12-0.41,P<0.001)were independent influencing factors for dyslipidemia.Conclusions The serum levels of TG and TC are lower in patients with persistent infection than those uninfected or with spontaneous clearance in remunerated blood donation.HCV infection,sex and fasting plasma glucose are related with dyslipidemia.