新疆塔吉克族、哈萨克族健康成年人脂蛋白(a)水平及相关因素分析

Analysis of lipoprotein(a) level and related factors in healthy Tajik and Kazak adults in Xinjiang

目的了解我国塔吉克族和哈萨克族健康成年人脂蛋白(a)[Lp(a)]水平的分布情况及相关因素。方法横断面研究。于2021年5—10月和2022年3—6月,分别在新疆塔什库尔干塔吉克自治县和富蕴县收集2637名塔吉克族[男1010人,年龄(40.08±14.74)岁;女1627人,年龄(38.27±12.90)岁]和1911名哈萨克族[男720人,年龄(42.10±12.26)岁,女1191人,年龄(40.30±10.28)岁]健康成年人的血液样本,检测空腹血糖(FBG)、肌酐(Cr)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和Lp(a),描述Lp(a)水平在不同性别和年龄人群中的分布情况,比较塔吉克族和哈萨克族Lp(a)水平,使用多因素线性回归分析两民族Lp(a)水平相关因素。结果塔吉克族人和哈萨克族人Lp(a)水平分布均呈偏态分布,Lp(a)水平范围分别为0.40~1229.40 mg/L和0.62~2108.58 mg/L,Lp(a)水平分别为78.90(38.60,190.20)和103.30(49.57,234.27)mg/L,差异有统计学意义(P<0.001)。塔吉克族男性和女性Lp(a)水平分别为77.45(39.80,187.10)和79.90(38.60,192.30)mg/L,差异无统计学意义(P=0.948);哈萨克族男性和女性Lp(a)水平分别为109.42(50.49,230.38)和99.01(49.11,237.25)mg/L,差异无统计学意义(P=0.578)。将两民族数据合并分析,调整年龄、性别、BMI、吸烟、饮酒、血压、血糖等因素后,Lp(a)水平与LDL-C水平(标准偏回归系数0.136,P<0.001)和民族(标准偏回归系数0.066,P=0.008)相关。结论塔吉克族和哈萨克族健康成年人Lp(a)水平均存在较大的个体差异,哈萨克族Lp(a)水平高于塔吉克族,塔吉克族和哈萨克族不同性别间Lp(a)水平均无差异,LDL-C和民族是Lp(a)水平的独立相关因素。

Objective To investigate the distribution and related factors of lipoprotein(a)[Lp(a)]level in healthy Tajik and Kazak adults in China.Methods A cross-sectional study was conducted from May to October 2021 and March to June 2022,and blood samples were collected from 2,637 healthy Tajik adults[1010 men,average age:(40.08±14.74)years;1627 women,average age:(38.27±12.90)years]in Tashkurgan Tajik Autonomous County and 1911 healthy Kazak adults[720 men,average age:(42.10±12.26)years;1191 women,average age:(38.27±12.90)years]in Fuyun County of Xinjiang.Fasting blood glucose(FBG),creatinine(Cr),total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and Lp(a)were measured.The distribution of Lp(a)levels in different sex and age groups was compared.The Lp(a)level of Tajik and Kazakh ethnic groups was compared by Mann-WhitneyU test,and correlation factors of Lp(a)level were analyzed by multiple logistic regression.Results The distribution of Lp(a)level in Tajik and Kazak population was skewed.Lp(a)levels of Tajik and Kazak ranged from the lowest 0.40 mg/L and 0.62 mg/L to the highest 1229.40 mg/L and 2108.58 mg/L,respectively,and the median Lp(a)level was 78.90(38.60,190.20)mg/L and 103.30(49.57,234.27)mg/L,respectively.Median Lp(a)level of Kazak was significantly higher than that of Tjik(P<0.001).The median Lp(a)levels of Tajik males and females were similar:77.45(39.80,187.10)mg/L and 79.90(38.60,192.30)mg/L(P=0.948).The median Lp(a)levels of Kazakh males and females were also similar:109.42(50.49,230.38)mg/L and 99.01(49.11,237.25)mg/L,respectively(P=0.578).After pooling the data of Tajik and Kazak and adjusting for age,sex,BMI,smoking,drinking,blood pressure,blood glucose and other factors,Lp(a)level was correlated with ethnic(standard partial regression coefficient 0.066,P=0.008)and LDL-C level(standard partial regression coefficient 0.136,P<0.001).Conclusions Lp(a)level in healthy Tajik and Kazak adults varied greatly among individuals,and Kazak residents had a higher Lp(a)level than Tajik residents.There was no significant sex difference in Lp(a)level among Tajik and Kazakh,and LDL-C and ethnicity are independent factors related to Lp(a)level.