2016年六安市社区老年人高脂血症及其亚型与血铅的关联

Associations of hyperlipidemia and its subtypes with blood lead levels in Lu’an City community older adults in 2016

目的探讨六安市社区老年人高脂血症及其亚型与血铅的关联性。方法2016年6—9月,随机抽取安徽省六安市1个市区居委会和1个农村乡镇,招募60岁以上老年人自愿者,对其进行问卷调查(性别、年龄、地区、文化程度、职业、婚姻状况、生活方式、慢性病史等)、体格检查(身高、体重和血压)及实验室检测(血糖、血脂和血铅)。纳入1008名老年人参与研究,年龄(71.9±6.5)岁,男性459人(45.5%),农村地区557人(55.3%)。使用电感耦合等离子体质谱仪对全血铅浓度进行测量,采用四分位距对血铅浓度进行分组。采用Logistic回归模型分析老年人高脂血症与血铅的关联,并采用限制性立方样条分析两者的剂量-反应关系。结果1008名老年人中高脂血症患病率为52.1%(525人);血铅检出率为100%,浓度为7.89~278.33μg/L,几何均数为28.08μg/L。单因素分析发现,与血铅最低四分位数组相比,最高四分位数组老年人高脂血症及其两种亚型(高血清总胆固醇血症和混合型高脂血症)的比值比分别为1.42(95%CI 1.00~2.02)、1.83(95%CI 1.25~2.68)和1.49(95%CI 0.83~2.67)。在调整性别、年龄、地区、文化程度、职业、婚姻状况、吸烟状况、饮酒状况、锻炼状况、饮食情况、高血压、糖尿病和体质指数后,最高四分位数组血铅与高脂血症(OR=1.55,95%CI 1.02~2.36)和混合型高脂血症(OR=2.87,95%CI 1.44~5.70)的关联有统计学意义。限制性立方样条曲线显示血铅水平与老年人高脂血症、混合型高脂血症存在近似线性的剂量-反应关系。结论血铅水平与老年人高脂血症(尤其混合型高脂血症)呈线性关联。

OBJECTIVE To explore associations of hyperlipidemia and its subtypes with blood lead levels in community older adults.METHODS From June to September,2016,a rural and an urban community in Lu’an City,Anhui Province were randomly selected.Older adults aged 60 years old or over in two communities were recruited to participate,receiving a questionnaire interview(including gender,age,region,education,occupation,marital status,lifestyle,and chronic medical history,etc.),physical examinations(height,weight,and blood pressure)and laboratory tests(blood glucose,blood lipid,and blood lead levels).A total of 1080 older adults volunteered to participate,of which 1008 had completedata.Inductively coupled plasma mass spectrometry was used to measure concentrations of blood lead.The interquartile range was used to divide the distribution of lead in blood.Logistic regression model was used to examine associations of hyperlipidemia and its subtypes with blood lead levels.Restrictive cubic splineswere used to further determine potential dose-response relationships.RESULTS Of 1008 older adults,the mean age was(71.9±6.5)years old,459(45.5%)were male,and 557(55.3%)were from the rural community.The prevalence of hyperlipidemia was 51.2%(n=516).The detection rate and geometric mean of blood lead were 100%and 28.08μg/L(ranged from 7.89 to 278.33μg/L),respectively.Univariate analysis showed that older adults in the highest quartile group of blood lead(≥75%)had higher odds of hyperlipidemia(OR=1.42,95%CI 1.00-2.02)and two subtypes(high total serum cholesterol(OR=1.83,95%CI 1.25-2.68)and mixed hyperlipidemia(OR=1.49,95%CI 0.83-2.67))compared to counterparties in the lowest quartile group(≤25%).After adjustment for gender,age,region,education,occupation,marital status,smoking,drinking,exercise conditions,diet,high blood pressure,diabetes,and body mass index,the ORs for hyperlipidemia and mixed hyperlipidemia in the highest quartile group of blood lead were 1.55(95%CI 1.02-2.36)and 2.87(95%CI 1.44-5.70).The restricted cubic spline curves showed approximate linear relationships between blood lead levels and ORs of hyperlipidemia and mixed hyperlipidemia.CONCLUSION Linear associations of blood lead levels with hyperlipidemia and mixed hyperlipidemia were found in community older adults.