北京市中老年人群高密度脂蛋白胆固醇变化轨迹与糖尿病发病的关联研究

Correlation between trajectories of high density lipoprotein cholesterol and the risk of diabetes in middle-aged and elderly population in Beijing

目的研究中老年人高密度脂蛋白胆固醇(HDL-C)随时间变化的轨迹与糖尿病发病的关系。方法基于8288名中老年人的健康体检队列,应用轨迹分析模型(GBTM)建立HDL-C随时间变化轨迹,进行轨迹分组,将3组轨迹分别标记为HDL-C低水平组(3979人,48.0%)、中水平组(3317人,40.0%)和高水平组(992人,12.0%)。应用logistic回归模型分析不同HDL-C轨迹变化组对糖尿病发生的影响。结果8288人纳入本研究,平均年龄为(48.3±14.1)岁,其中男性5408人(65.3%)。3组年龄、吸烟和饮酒情况等均相似(均为P>0.05)。HDL-C高水平组人群的高血压患病率、体质指数、三酰甘油、低密度脂蛋白胆固醇和尿酸水平等均显著低于其余两组,总胆固醇和HDL-C均显著高于其余两组(均为P<0.01)。随访期间新发糖尿病1286例。调整可能的混杂因素后,logistic回归结果显示,与HDL-C低水平组比较,HDL-C中水平组的糖尿病发病风险是其0.794倍(95%CI:0.684~0.921),而HDL-C高水平组是其0.653倍(95%CI:0.494~0.864)。结论HDL-C随时间变化的轨迹与糖尿病发病风险相关。

Objective To study the correlation between the trajectory of high density lipoprotein cholesterol(HDL-C)over time and the onset of diabetes in middle-aged and elderly people.Methods Based on the Beijing Health Management Cohort(BHMC),8288 middle-aged and elderly people were enrolled in this study.The group-based trajectory model(GBTM)was used to establish the trajectories of HDL-C changes over time.According to the trajectories,people were divided into the HDL-C low level group(n=3979,48.0%),HDL-C medium level group(n=3317,40.0%)and HDL-C high level group(n=992,12.0%).Logistic regression model was used to analyze the effects of different HDL-C trajectory change groups on the occurrence of diabetes.Results Among the 8288 people enrolled,the average age was(48.3±14.1)years,and 5408 were male(65.3%).The age,smoking and drinking conditions were similar among the three groups(all P>0.05).The prevalence of hypertension,body mass index,triacylglycerol,low density lipoprotein cholesterol,and uric acid levels were significantly lower in the HDL-C high level group than in the other two groups,and the levels of total cholesterol and HDL-C were significantly higher than in the other two groups(all P<0.01).During the follow-up period,there were 1286 cases of newly diagnosed diabetes.After adjusting for possible confounding factors,the logistic regression results showed that,compared with the HDL-C low level group,the risk of diabetes in the HDL-C medium level group was 0.794(95%CI:0.684-0.921),while the HDL-C high level group was 0.653(95%CI:0.494-0.864).Conclusions The trajectory of HDL-C changes over time is related to the risk of diabetes.