武汉市健康体检人群高血压、空腹高血糖及血脂异常的拐点年龄分析

Analysis of the inflection age point in hypertension,fasting hyperglycemia and dyslipidemia of a population undergoing routine medical checkup in Wuhan

目的:分析武汉市健康体检人群高血压、空腹高血糖及血脂异常的拐点年龄,为后续高血压、糖尿病、血脂异常的早期诊断和控制提供理论依据。方法:以2013年12月31日到2016年8月12日期间武汉大学人民医院健康管理中心的健康体检人群为研究对象,提取体检人员的性别、年龄、血压、空腹血糖(FPG)、总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等临床资料。绘制年龄预测高血压、空腹高血糖及血脂异常发生的ROC曲线,并确定其发生率水平变动的拐点年龄,采用卡方检验验证拐点年龄前后高血压、空腹高血糖及血脂异常发生率的变化情况。结果:武汉市体检人群的男女性别比例为1.39∶1,年龄分布在11~109岁之间,21~65岁是体检的主要人群,占比达90.05%。高血压检出的拐点年龄男性为52.5岁,女性为50.5岁(AUC_(男)=0.722,AUC_(女)=0.850);空腹高血糖发生的拐点年龄男性为46.5岁,女性为50.5岁(AUC_(男)=0.718,AUC_(女)=0.795);血脂异常发生的年龄拐点具有明显的性别差异,男性人群年龄拐点预测价值差(AUC_(男)=0.488),女性血脂异常的拐点年龄为46.5岁(AUC_(女)=0.638)。>50岁男性人群高血压的发生风险是≤50岁的3.632倍(χ^(2)=3110.987,P<0.001),>50岁女性人群高血压的发生风险是≤50岁的11.021倍(χ^(2)=4187.053,P<0.001);>46岁男性人群空腹高血糖的发生风险是≤46岁的4.583倍(χ^(2)=2296.365,P<0.001),>46岁女性人群空腹高血糖的发生风险是≤46岁的7.502倍(χ^(2)=1420.847,P<0.001);>46岁男性人群血脂异常的发生风险为≤46岁的0.931倍(χ^(2)=15.424,P<0.001),>46岁女性人群血脂异常的发生风险是≤46岁的2.392倍(χ^(2)=857.713,P<0.001)。结论:高血压、空腹高血糖以及女性人群血脂异常的发生均具有明显的年龄拐点,年龄拐点后人群的疾病风险较拐点前均明显升高,建议对风险人群进行健康宣讲活动,提倡健康的生活方式,加强体育锻炼,从源头上降低高血压、糖尿病及血脂异常的发生,减少由此产生的心脑血管疾病。

Objective:Analyze the inflection age point in hypertension,fasting hyperglycemia and dyslipidemia of the routine physical examination population in Wuhan,and provide a theoretical basis for subsequent earlier diagnosis and control of hypertension,diabetes,and dyslipidemia.Methods:The clinical data were retrospectively analyzed of routine physical examination population in Renmin Hospital of Wuhan University from December 31,2013 to August 12,2016.The following information were collected and analyzed including the people’s gender,age,blood pressure,fasting blood glucose(FPG),total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)and so on.The ROC curve for predicting the occurrence of hypertension,fasting hyperglycemia and dyslipidemia,and determined the inflection point age of the changes in the incidence level.Chi-square test was used to verify the effect of inflection point age on the incidence of hypertension,fasting hyperglycemia and dyslipidemia.Results:Among the routine physical examination population in our hospital with male-female ratio of 1.39:1 and aging from 11 to 109 years,people aged 21-65 years was the main population with accounting for 90.05%.The inflection point age of hypertension was 52.5 years for males and 50.5 years for females(AUC_(male)=0.722,AUC_(female)=0.850).The inflection point age of fasting hyperglycemia was 46.5 years for males and 50.5 years for females(AUC male=0.718,AUC female=0.795).The inflection point age of fasting hyperglycemia was 46.5 years for males and 50.5 years for females(AUC male=0.718,AUC female=0.795).The inflection point age of dyslipidemia had obvious gender differences that the predictive value of inflection point age was poor in male(AUC male=0.488),and the inflection point age of dyslipidemia was 46.5 years for females(AUC female=0.638).Comparing with≤50 years individuals,the risk of hypertension was 3.632 times higher among men with>50 years of age(χ^(2)=3110.987,P<0.001),and 11.021 times higher among women with>50 years of age(χ^(2)=4187.053,P<0.001).Comparing with≤46 years individuals,the risk of fasting hyperglycemia were 4.583 times higher among men with>46 years of age(χ^(2)=2296.365,P<0.001)and 7.502 times higher among women with>46 years of age(χ^(2)=1420.847,P<0.001).Comparing with≤46 years individuals,the risk of dyslipidemia were 0.931 times lower among men with>46 years of age(χ^(2)=15.424,P<0.001)and 2.392 times higher among women with>46 years of age(χ^(2)=857.713,P<0.001).Conclusion:The incidence of hypertension,fasting hyperglycemia in all population and dyslipidemia in female population had obvious inflection age point.Health promotion activities should be carried out for the above people to reduce the occurrence of hypertension,diabetes and dyslipidemia from the source to reduce the resulting cardiovascular and cerebrovascular diseases.