社区老年居民血脂异常患病率及其影响因素研究

Prevalence of Dyslipidemia and Its Influencing Factors among Elderly Community Residents

背景血脂异常是动脉粥样硬化性心血管疾病最重要且有因果关系的独立危险因素。广东省老年居民血脂异常患病率较高,亟须分析老年人血脂异常的具体患病情况及影响因素,针对性地对血脂异常进行预防和控制。目的调查广州市越秀区纳入国家基本公共卫生服务的老年居民血脂异常的流行病学现况及其危险因素。方法选取2020年广州市越秀区社区卫生服务中心信息系统中重要变量完整的41469名≥65岁老年居民为研究对象,利用2020年健康体检数据描述患者的基本情况、BMI和血脂水平等流行病学特征,运用限制性立方样条(RCS)拟合Logistic回归模型分析年龄、BMI与血脂异常患病的变化关系。结果41469名老年居民的血脂异常患病率为53.65%(22247/41469),标化患病率为53.89%。其中,高胆固醇血症的患病率为21.43%(8887/41469),标化患病率为21.57%;高三酰甘油血症的患病率为16.50%(6843/41469),标化患病率为16.53%;混合型高脂血症的患病率为14.51%(6017/41469),标化患病率为14.61%;低高密度脂蛋白胆固醇血症的患病率为3.80%(1577/41469),标化患病率为3.78%。多因素Logistic回归分析结果显示,性别、年龄、受教育程度、BMI、锻炼情况均是老年居民血脂异常的影响因素(P<0.05),其中,女性、低龄和高BMI为老年居民血脂异常的危险因素(P<0.05)。RCS拟合结果显示,老年居民的年龄、BMI与血脂异常患病呈非线性关系;随年龄的增长,老年居民的血脂异常患病率总体呈下降趋势;随着BMI水平升高,血脂异常患病风险呈先上升后下降的趋势,低BMI下,OR显著上升,而在高BMI下,OR稍微下降。结论广州市越秀区纳入国家基本公共卫生服务的≥65岁老年居民血脂异常患病率较高。该老年群体中血脂异常患病率随着年龄升高而降低,随着BMI水平升高血脂异常患病风险呈先上升后下降的趋势。提示老年人的血脂异常管理存在一定的特殊性,应重点关注老年群体血脂异常的特定危险因素并进行早期预防和控制。

Background Dyslipidemia is the most important and causal independent risk factor for atherosclerotic cardiovascular disease(ASCVD).The prevalence of dyslipidemia in elderly residents in Guangdong Province is high,and it is urgent to analyze the specific prevalence of dyslipidemia and its influencing factors among the elderly,and to carry out targeted preventive and control measures for dyslipidemia.Objective To investigate the epidemiological status of dyslipidemia and its risk factors among elderly residents included in the national basic public health service in Yuexiu District,Guangzhou.Methods A total of 41469 elderly residents aged 65 years and above with complete important variables were selected as subjects from the information system of community health service center in Yuexiu District,Guangzhou City in 2020,the 2020 health checkup data was used to describe the epidemiological characteristics of the included patients such as basic information,BMI and blood lipid levels.Restricted cubic spline(RCS)fitting Logistic regression model was used to analyze the relationship between age,BMI and the prevalence of dyslipidemia.Results The prevalence of dyslipidemia in 41469 elderly residents was 53.65%(22247/41469),with a standardized prevalence of 53.89%.The prevalence of hypercholesterolemia(HTC),hypertriglyceridemia(HTG),mixed hyperlipidemia and low high-density lipoprotein cholesterol was 21.43%,16.50%,14.51%and 3.80%,with the standardized prevalence of 21.57%,16.53%,14.61%,3.78%,respectively.Multivariate Logistic regression analysis showed that gender,age,education level,exercise status,and BMI were all influencing factors for dyslipidemia in elderly residents,among which female,low age group,and high BMI were risk factors for dyslipidemia in elderly residents(P<0.05).The results of RCS fitting showed a non-linear relationship between age,BMI and the prevalence of dyslipidemia in elderly residents.The overall prevalence of dyslipidemia in elderly residents showed a decreasing trend with the increase of age.The risk of dyslipidemia showed on increasing and then decreasing trend with the increase of BMI,the OR increased significantly at low BMI,while decreased at high BMI.Conclusion The prevalence of dyslipidemia is relative high among elderly residents aged 65 years and above included in the national basic public health services in Yuexiu District,Guangzhou.The prevalence of dyslipidemia in the elderly group tends to decrease with the increase of age,and the risk of dyslipidemia prevalence tends to increase and then decrease with the increase of BMI,suggesting special features in the management of dyslipidemia among the elderly,the analysis of risk factors for dyslipidemia in the elderly should be focused on and early preventive and control measures should be carried out.