血糖和血脂指标检测在老年人群5年内心脑血管疾病发病风险评估中的作用

Role of detection of blood glucose and blood lipid indexes in 5-year risk assessment of cardiovascular and cerebrovascular diseases in elderly population

目的 探讨血糖和血脂指标检测在老年人群5年内心脑血管疾病发病风险评估中的作用。方法 选择2016年1—8月在哈尔滨市第四医院进行健康体检的2 400名健康体检者作为研究对象,使用全自动生化分析仪检测所有受检者的血糖和血脂指标[包括空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]。进行5年随访,应用Cox比例回归分析方法评估全部研究对象的心脑血管疾病发生风险。结果 通过5年的随访观察,在2 400名健康体检者中,有186例(占7.8%)出现心脑血管疾病。随着对受检者随访时间的延长,相应疾病的发生率也呈逐年上升趋势。与发病前比较,186例心脑血管疾病患者在发病后的TC、TG、FBG、LDL-C水平均明显上升,HDL-C水平明显下降[TC(mmol/L):5.62±0.37比4.81±0.23,TG(mmol/L):3.96±1.04比1.72±0.15,FBG(mmol/L):7.21±0.76比5.19±0.28,LDL-C(mmol/L):3.70±0.36比2.88±0.13,HDL-C(mmol/L):0.88±0.09比1.02±0.08,均P<0.05]。与未发生心脑血管疾病的患者比较,心脑血管疾病患者的TC、TG、LDL-C和FBG水平均呈逐年上升趋势,HDL-C呈逐年下降趋势。Cox分析结果表明,高TC水平[风险比(HR)为2.256,95%可信区间(95%CI)为1.372~3.720]、高TG水平(HR为1.201,95%CI为1.022~1.407)、高FBG水平(HR为1.391,95%CI为1.152~1.682)和高LDL-C水平(HR为3.425,95%CI为2.091~5.608)均为导致心脑血管疾病发生的危险因素,高HDL-C水平(HR为0.030,95%CI为0.001~0.516)为心脑血管疾病发生的保护因素。结论 在老年人群中,血糖和血脂指标异常者在5年内具有较高的心脑血管疾病发生率,应予以高度重视,第一时间加以干预。

Objective To explore the role of detection of blood glucose and blood lipid indexes in the 5-year risk assessment of cardiovascular and cerebrovascular diseases in elderly population.Methods The 2400 healthy individuals undergoing physical examinations in Harbin Fourth Hospital from January to August 2016 were selected as research objects.The fully automated biochemical analyzer was used to detect blood glucose and blood lipid indexes[including fasting blood glucose(FBG),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)].The 5-year follow-up was conducted on all research objects,and Cox proportional regression analysis was used to evaluate the corresponding risk of cardiovascular and cerebrovascular diseases.Results Through a 5-year follow-up observation,out of 2400 healthy examinees,186 cases(accounting for 7.8%)developed cardiovascular and cerebrovascular diseases.As the follow-up time of the research objects prolonged,the incidence of corresponding diseases also showed an increasing trend year by year.Compared with those before the onset,the levels of TC,TG,FBG and LDL-C in 186 patients with cardiovascular and cerebrovascular diseases were significantly increased after the onset,while the level of HDL-C was significantly decreased[TC(mmol/L):5.62±0.37 vs.4.81±0.23,TG(mmol/L):3.96±1.04 vs.1.72±0.15,FBG(mmol/L):7.21±0.76 vs.5.19±0.28,LDL-C(mmol/L):3.70±0.36 vs.2.88±0.13,HDL-C(mmol/L):0.88±0.09 vs.1.02±0.08,all P<0.05].Compared with patients without cardiovascular and cerebrovascular diseases,the levels of TC,TG,LDL-C and FBG in patients with cardiovascular and cerebrovascular diseases were increased year by year,while the level of HDL-C was decreased year by year.The Cox analysis results showed that high TC level[hazard ratio(HR)was 2.256,95%confidence interval(95%CI)was 1.372-3.720],high TG level(HR was 1.201,95%CI was 1.022-1.407),high FBG level(HR was 1.391,95%CI was 1.152-1.682)and high LDL-C level(HR was 3.425,95%CI was 2.091-5.608)were all risk factors for the occurrence of cardiovascular and cerebrovascular diseases,while high HDL-C level(HR was 0.030,95%CI was 0.001-0.516)was protective factor for the occurrence of cardiovascular and cerebrovascular diseases.Conclusion In the elderly population,individuals with abnormal blood glucose and blood lipid indexes have a higher incidence of cardiovascular and cerebrovascular diseases within 5 years,and should be highly valued and intervened as soon as possible.