不同绝经状态下血脂异常的可控风险因素分析

Analysis of the controllable risk factors of dyslipidemia in women with different menopausal status

目的:研究不同绝经状态下中年女性血脂异常的可控风险因素,并提出预防策略。方法:纳入2018年1月至2019年1月于哈尔滨医科大学附属第一医院体检的1011名40~60岁女性为研究对象,采用问卷调查进行饮食评估,并进行体格测量和生化指标检测。根据绝经状态将研究对象分为绝经前期、围绝经期和绝经后期3组,比较不同绝经状态下中年女性生活方式、膳食摄入、慢性病及生化指标的差异;再根据血脂正常或异常分两组,采用Logistic回归分析以上差异指标中与不同绝经状态女性的血脂异常相关的可控风险因素。结果:不同绝经状态研究对象的经济状况、生活方式(饮酒、睡眠情况)、慢性病(血脂异常、高血压、冠心病、脑梗、下肢斑块)、膳食摄入(坚果摄入、吃饭速度)、生化指标(低密度脂蛋白、高密度脂蛋白、总胆固醇、肌酐和尿素氮水平)差异有统计学意义(P<0.05)。在绝经前和围绝经期,体质指数是血脂异常的危险因素(OR=1.237,95%CI:1.091-1.401,P<0.05;OR=1.218,95%CI:1.103-1.346,P<0.05)。在绝经后期,经济状况较好、偶尔饮酒、尿酸水平是血脂异常的危险因素(OR=3.785,95%CI:1.240-11.554,P<0.05;OR=4.372,95%CI:1.281-14.924,P<0.05;OR=1.003,95%CI:1.000-1.006,P<0.05);而蔬菜摄入量正常、睡眠时间>7 h、空腹血糖水平是血脂异常的保护因素(OR=0.310,95%CI:0.142-0.677,P<0.05;OR=0.457,95%CI:0.268-0.781,P<0.05;OR=0.894,95%CI:0.830-0.964,P<0.05)。结论:体质指数、生活行为方式和膳食摄入等可控风险因素对不同绝经状态下的中年女性的血脂有影响。

Objective:To investigate the controllable risk factors of dyslipidemia in middle-aged women under different menopausal status and to propose preventive strategies.Methods:A total of 1011 women aged 40-60 who were enrolled in the First Affiliated Hospital of Harbin Medical University from January 2018 to January 2019 were included.The diet was assessed using questionnaire.Physical measurement and biochemical detection were also performed.According to the status of menopause,women were divided into premenopausal,perimenopausal and postmenopausal groups.The differences of lifestyle,dietary intake,chronic diseases and metabolic indexes in middle-aged women with different menopausal status were compared.According to the level of blood lipid,the controllable risk factors associated with dyslipidemia in women with different menopausal status were analyzed by Logistic regression among the above different indicators.Results:There were significant differences in economic status,lifestyle(alcohol consumption,sleep status),chronic diseases(dyslipidemia,hypertension,coronary heart disease,cerebral infarction,lower limb plaques),dietary intake(nut intake,eating speed),the levels of biochemical indicators(low density lipoprotein,high density lipoprotein,total cholesterol,creatinine and urea nitrogen)(P<0.05).Body mass index was a risk factor for dyslipidemia in premenopause and perimenopause.(OR=1.237,95%CI:1.091-1.401,P<0.05;OR=1.218,95%CI:1.103-1.346,P<0.05).Better economic status,occasional alcohol consumption and uric acid levels were risk factors for dyslipidemia in postmenopausal women(OR=3.785,95%CI:1.240-11.554,P<0.05;OR=4.372,95%CI:1.281-14.924,P<0.05;OR=1.003,95%CI:1.000-1.006);while the protective factors for dyslipidemia were normal vegetable intakes,sleeping time longer than 7 hours,and fasting blood glucose levels(OR=0.310,95%CI:0.142-0.677,P<0.05;OR=0.457,95%CI:0.268-0.781,P<0.05;OR=0.894,95%CI:0.830-0.964,P<0.05).Conclusion:Controllable risk factors including body mass index,lifestyle and dietary intake may have an impact on the blood lipid levels in middle-aged women under different menopausal status.