用纵向队列法分析昆明地区体检人群同型半胱氨酸对血压、血糖及血脂的影响

A Longitudinal Cohort Study on the Effects of Homocysteine on Blood Pressure,Blood Glucose and Blood Lipid in Physical Examination Population in Kunming

目的通过纵向队列研究分析同型半胱氨酸(homocysteine,Hcy)对血压、血糖及血脂变化的影响,为相关慢性疾病的防治提供依据。方法选取在2017年基线调查之后2 a期间每年体检调查中具有完整资料的体检人员987人作为研究对象,构建纵向研究队列,收集其基本信息、Hcy、空腹血糖、空腹血脂以及血压测量结果。根据末次随访Hcy与基线Hcy变化情况,将其分为3组,分别为无变化组(正常-正常;异常-异常),正常-异常组,异常-正常组。采用广义线性回归模型分析Hcy不同变化情况与血压、血糖以及血脂变化的关系。结果研究对象在基线调查时年龄(43.63±11.4)岁,范围为23~85岁。3 a间同型半胱氨酸(Hcy)无变化(正常-正常;异常-异常),正常-异常,异常-正常的观察人数分别占50.25%(496例)、14.39%(142例)、35.36%(349例)。以Hcy变化情况为因变量进行分析,单因素分析结果显示,与无变化组相比,异常-正常组收缩压显著降低(P <0.05),其他指标差异无统计学意义(P> 0.05);基于广义线性回归对Hcy变化情况与血压、血糖及脂肪指标变化情况展开分析,调整年龄、性别、基线BMI、饮酒、吸烟变量,拟合结果显示异常-正常组收缩压较无变化组下降2.132,总胆固醇下降0.203,血糖下降0.182个单位,差异有统计学意义(P <0.05),舒张压、甘油三酯、高密度脂蛋白及低密度脂蛋白变化,差异无统计学意义(P> 0.05)。结论 Hcy变化与收缩压、总胆固醇以及血糖相关,Hcy降低有利于改善血糖、血压及血脂水平。

Objective To analyze the effects of homocysteine(Hcy)on blood pressure,blood glucose and blood lipid in a longitudinal cohort study,so as to provide basis knowledge for the prevention and treatment of related chronic diseases.Methods 987 physical examination personnel with complete data in the annual physical examination survey during the two-year period after the 2017 baseline survey were selected as study subjects to construct a longitudinal study cohort.We collected demographic characteristics,homocysteine,blood pressure,blood glucose and blood lipid,and based on the homocysteine change,divided them into three groups:the nonchange group(normal-normal;abnormal-abnormal),normal-abnormal group,abnormal-normal group.Gene-ralized linear regression model was used to analyze the relationship between homocysteine change and the changes in blood pressure,blood glucose and blood lipid.Results The average age of participants in baseline survey was(43.63±11.4)years with a range of 23 to 85 years.During the three-year period,there were 50.25%(496),14.39%(142),35.36%(349)people with non-change group(normal-normal;Abnormal-abnormal),normalabnormal group,abnormal-normal group,The Hcy change was taken as the dependent variable for analysis.Univariate analysis showed that,compared with the non-changed group,systolic blood pressure in the abnormally normal group was significantly reduced(P<0.05),and there were no statistical differences in other indicators.Based on generalized linear model,after adjustment for age,gender,baseline BMI,drinking,smoking,results show that when compared with the non-change group,the systolic blood pressure,total cholesterol,blood sugar of anomaly-normal group were significantly decrease(P<0.05),and the drop-out value were 2.132,0.203,0.182 respectively.There was no significant difference in the change of diastolic blood pressure,triglyceride,Highdensity lipoprotein and low-density lipoprotein.Conclusion The change of Hcy is related to the change of systolic blood pressure,total cholesterol and blood glucose,and the decrease of Hcy is conductive to the improvement of blood glucose,blood pressure and lipid levels.