动脉粥样硬化性心血管疾病高危人群血脂控制达标的影响因素研究

Factors affecting blood lipid control among residents at a high risk ofatherosclerotic cardiovascular disease

目的 了解动脉粥样硬化性心血管疾病(ASCVD)高危人群血脂控制达标情况及其影响因素,为制订ASCVD高危人群血脂管理措施提供依据。方法 于2021年5—7月,采用多阶段整群抽样方法从绍兴市6个县(市、区)抽取35~70岁ASCVD高危人群为研究对象。通过问卷调查收集人口学信息、吸烟、饮酒和慢性病史等;测量身高、体重、腰围和血压;检测总胆固醇(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)和空腹血糖;分析血脂控制达标率,并采用多因素logistic回归模型分析血脂控制达标的影响因素。结果 纳入ASCVD高危人群1 695人,其中男性940人,占55.46%,女性755人,占44.54%;年龄为(62.56±6.08)岁。血脂控制达标285人,达标率为16.81%。多因素logistic回归分析结果显示,性别(男,OR=1.962,95%CI:1.396~2.758)、年龄(OR=1.037,95%CI:1.013~1.061)、腰围(OR=0.979,95%CI:0.964~0.995)、舒张压(OR=0.981,95%CI:0.967~0.994)、吸烟(OR=1.485, 95%CI:1.034~2.133)、饮酒(OR=0.684, 95%CI:0.498~0.941)、高血压(OR=1.428, 95%CI:1.006~2.207)和服用降糖药物(OR=2.326,95%CI:1.720~3.144)是ASCVD高危人群血脂控制达标的影响因素。结论ASCVD高危人群中,腰围较大、舒张压较高和饮酒者血脂控制达标率较低,男性、年龄较大、患高血压和服用降糖药物者血脂控制达标率较高。

Objective To investigate the proportion of achieving the blood lipid control target and its influencing factors among residents at a high risk of atherosclerotic cardiovascular disease(ASCVD),so as to provide insights into manage⁃ment of blood lipid among residents at a high risk of ASCVD.Methods Residents at a high risk of ASCVD and at ages of 35 to 70 years were sampled using a multi-stage cluster sampling method from 6 counties (districts) in Shaox⁃ing City from May to July 2021. The residents' demographics, smoking, alcohol consumption and medical history ofchronic diseases were collected using questionnaires, the height, weight, waist circumference (WC) and blood pressurewere measured, and the total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), high-den⁃sity lipoprotein cholesterol (HDL-C) and fasting blood glucose were detected. The proportion of blood lipids achievingthe control target was analyzed, and factors affecting the proportion of blood lipids achieving the control target were iden⁃tified using a multivariable logistic regression model. Results A total of 1 695 individuals at a high risk of ASCVDwere enrolled, including 940 men (55.46%) and 755 women (44.54%), with a mean age of (62.56±6.08) years. Therewere 285 participants that achieved the target of blood lipid control (16.81%). Multivariable logistic regression analysisidentified gender (male, OR=1.962, 95%CI: 1.396-2.758), age (OR=1.037, 95%CI: 1.013-1.061), WC (OR=0.979,95%CI: 0.964-0.995), diastolic blood pressure (OR=0.981, 95%CI: 0.967-0.994), smoking (OR=1.485, 95%CI: 1.034-2.133), alcohol consumption (OR=0.684, 95%CI: 0.498-0.941), hypertension (OR=1.428, 95%CI: 1.006-2.207), administra⁃tion of hypoglycemic drugs (OR=2.326, 95%CI: 1.720-3.144) as factors affecting the achievement of the target for bloodlipid control among residents at a high risk of ASCVD. Conclusion Individuals at a high risk of ASCVD with higherWC, higher diastolic blood pressure and alcohol consumption are less likely to achieve the target for blood lipid con⁃trol, while male individuals with older age, hypertension and administration of hypogcemic drugs are more likely toachieve the target for blood lipid control.