社区老年居民高脂血症发病风险列线图模型建立

Establishment of a nomogram prediction model for the risk of hyperlipidemia in elderly residents in the community

目的调查河南省洛阳市涧西区社区老年居民高脂血症患病情况及发病危险因素,建立高脂血症发病风险列线图模型。方法结合问卷调查、体格检查及实验室检查,抽样调查本地区老年常住人口相关数据。结果本次调查共发放问卷1 038份,回收有效问卷920份,有效率为88.63%,其中诊断为高脂血症350例,患病率为38.04%。Logistic回归分析结果显示,患高血压、糖尿病、有冠状动脉粥样硬化性心脏病家族史、缺乏锻炼习惯、年龄≥65岁及体型超重/肥胖为社区老年居民高脂血症发病的影响因素。列线图模型显示,居民患高血压得76分,患糖尿病得84分,有冠状动脉粥样硬化性心脏病家族史得59分,无锻炼习惯为18分,年龄根据年龄段不同得分不同,最高为86分(70~74岁),超重/肥胖得41分,总分为0~364分,一致性指数为0.81(95%置信区间:0.71~0.85)。Hosmer-Lemeshow检验结果显示,χ2=8.14,P=0.64。结论患高血压、糖尿病、有冠状动脉粥样硬化性心脏病家族史、缺乏日常锻炼、年龄≥65岁及超重/肥胖与社区老年居民高脂血症发病密切相关,列线图模型具有良好的一致性及区分度,具有一定的推广意义。

Objective To investigate the prevalence and risk factors of hyperlipidemia among the elderly residents in Jianxi District,Luoyang,Henan Province,and establish a model of the risk of hyperlipidemia.Methods Combined with questionnaire,physical examination and laboratory examination,the data of the elderly permanent residents in the area were sampled.Results A total of 1 038 questionnaires were issued in this survey,920 effective questionnaires were recovered,the effective rate was 88.63%.Among them,350 cases were diagnosed with hyperlipidemia,and the prevalence rate was 38.04%.The results of Logistic regression analysis showed that hypertension,diabetes,family history of coronary heart disease,lack of exercise habit,age≥65 years and overweight/obesity were the influencing factors of hyperlipidemia in community residents.The monogram model showed that the residents with hypertension were scored 76 points,diabetes mellitus 84 points,family history of coronary heart disease 59 points,no exercise habit 18 points.The score varied according to age,the highest score was 86(70-74 years old),overweight/obese 41 points,the total score was 0-364 points,the consistency index was 0.81(95% confidence interval:0.71-0.85).The results of the Hosmer-Lemeshow test showed that χ2=8.14,P=0.64.Conclusion Hypertension,diabetes,family history of coronary heart disease,lack of daily exercise,age≥65 years and overweight/obesity were closely related to the incidence of hyperlipidemia in the elderly community.The nomogram model had a good consistency and discrimination,had certain significance of popularization.