某军队医院军人医务人员脂代谢特点及血脂异常情况5年随访对比分析

Comparative analysis of 5⁃year follow⁃up:lipid metabolism characteristics and dyslipidemia of the military medical personnel in a military hospital

目的跟踪随访某军队医院同批次军人医务人员2016年、2021年相隔5年的脂代谢特点及血脂异常情况变化趋势,分析代谢性疾病健康教育和管理效果,为开展下一步相关工作提供参考依据。方法对2016年参加体检的某军队医院246名军人医务人员进行5年跟踪随访,重点关注有代谢相关性指标异常的人员,通过健康教育、资料推送、电话随访、复查提醒等方式进行健康管理。提取2016年、2021年该人群体重指数(BMI)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FDG)、血脂、血尿酸(UA)等代谢指标进行对比研究,并分析血脂异常情况及相关影响因素。结果与2016年相比较,2021年该人群BMI、FDG水平明显降低,总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)及UA水平明显升高,差异均有统计学意义(P<0.01),而SBP、DBP、三酰甘油(TG)及低密度脂蛋白胆固醇(LDL-C)水平比较差异无统计学意义(P>0.05);该群体2年脂代谢指标及脂代谢异常检出率比较差异均无统计学意义(P>0.05);2016年、2021年血脂异常谱比较显示,该群体2年检出率最高的均为TC升高+LDL-C升高,检出率分别达到12.20%和15.45%,其次为TG升高;与2016年相比较,2021年LDL-C升高的检出率显著降低,差异有统计学意义(P<0.01),而TG升高+TC升高+LDL-C升高的检出率增加,差异有统计学意义(P<0.05);2021年血脂异常情况Logistic回归分析显示,对TG的异常检出率有影响的是性别和BMI,男性TG异常检出率为女性的4.608倍。超重和肥胖人群(BMI≥24)高TG的检出率为BMI正常人群的2.889倍。结论5年随访数据显示,代谢相关性指标异常在该院军人医务人员中发生率较高,代谢相关性疾病仍是该群体健康维护和管理的工作重点,应进一步加强相关疾病的监测和管理工作,保障军队医务人员群体健康。

Objective To follow the lipid metabolism characteristics and changes of dyslipidemia in the same batch of military medical personnel in a military hospital in the last five years apart of 2016 and 2021,and analyze the effects of health education and management on metabolic diseases,so as to provide reference for future relevant work.Methods A total of 246 military medical personnel who had physical examination in 2016 were selected as study subjects and had medical follow‑ups for 5 years,focusing on those with abnormal metabolic indicators.Health management was carried out by means of health education,information push,telephone follow‑ups,review reminder,etc.Body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),blood lipid,blood uric acid(UA)and other metabolic indicators were extracted from this population in 2016 and 2021 for a two‑year comparative study,and the dyslipidemia and related influencing factors were analyzed.Results Compared with those in 2016,the BMI and FBG levels in this population significantly reduced in 2021,the levels of total cholesterol(TC),high‑density lipoprotein‑C(HDL‑C)and UA significantly increased,with statistical significance(P<0.01),while no differences could be seen in SBP,DBP,triglyceride(TC)and LDL‑C levels,when comparisons were made between them(P<0.05).There was no statistical significance in lipid metabolism index,when comparisons were made in these 2 years.The comparison of lipid abnormalities in 2016 and 2021 showed that the highest detection rate in this population in the two years were elevated TC+elevated LDL‑C,with detection rates of 12.20%and 15.45%respectively,followed by elevated TG.Compared with that in 2016,the detection rates of elevated LDL‑C in 2021 were significantly lowered(P<0.01),while the detection rates of elevated TG+elevated TC+elevated LDL‑C all increased(P<0.05).The Logistic regression analysis of dyslipidemia in 2021 indicated that gender and BMI had an impact on the abnormal detection rate.The detection rate of TG abnormalities in the male was 4.608 times higher than that of the female,while the detection rate of high TG in the overweight and obese people(BMI≥24)was 2.889 times higher than that of people with normal BMI.Conclusion The 5‑year follow‑up data showed that the incidence of abnormal metabolic indicators among the medical personnel of the hospital is high,and metabolic‑related diseases are still the focus of health maintenance and management of the population,and the monitoring and management of related diseases should be further strengthened to ensure the health of the military medical personnel.