2002—2019年山西农村地区18~59岁居民血清胆固醇水平分析

Analysis of serum cholesterol levels in adult residents(18-59 years old)of rural areas in Shanxi Province from 2002 to 2019

目的了解山西省农村地区18~59岁居民血清胆固醇水平及变化情况,为进一步制定胆固醇防控策略提供参考依据。方法研究数据来自山西营养与慢性病家庭队列研究,选取其中完成2002年、2015年和2019年3次调查的18~59岁农村地区居民为研究对象进行横断面分析,3次调查均包括问卷调查、体格检查和实验室检测。运用SAS 9.4软件进行t检验、方差分析、Bonferroni两两比较、χ2检验。结果2002年、2015年和2019年的调查对象人数分别为1321、1748和1291人,平均年龄分别为(41.5±10.4)、(45.7±10.1)和(47.8±9.2)岁,男女比例分别为1∶1.18、1∶1.14、1∶1.21。2015年、2019年总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)均高于2002年;2002年女性血清TC和LDL-C水平低于男性,而2019年变为女性高于男性,差异均有统计学意义(P<0.05)。2015年和2019年高密度脂蛋白胆固醇(HDL-C)均低于2002年,差异均有统计学意义(P<0.05)。3次调查结果均显示,50~59岁人群血清TC和LDL-C水平显著高于18~29岁人群(P<0.05);超重、肥胖人群的TC和LDL-C水平均高于体重正常者(除2019年TC水平外);中心性肥胖人群的TC和LDL-C水平均高于正常腰围人群;女性HDL-C水平均高于男性;不吸烟组HDL-C水平均高于吸烟组;超重、肥胖人群HDL-C水平均低于体重正常人群;中心性肥胖人群HDL-C水平低于正常腰围人群,差异均有统计学意义(P<0.05;P<0.01)。各年龄组人群性别间比较结果显示,3次调查30~39岁组女性TC水平均低于男性,2015年和2019年50~59岁组女性TC和LDL-C水平均高于男性;3次调查40~49岁和50~59岁年龄组女性HDL-C水平均高于男性,差异均有统计学意义(P<0.05)。结论山西省农村居民2015年和2019年血清TC和LDL-C水平与2002年相比明显上升,HDL-C水平显著下降。血脂异常防治工作需要重点关注农村地区血清胆固醇水平。

Objective To understand the serum cholesterol levels and their changes among residents(18-59 years old)in rural areas of Shanxi Province,and provide the reference basis for further development of cholesterol prevention and control strategies.Methods The data were from the Shanxi Family Cohort Study on Nutrition and Chronic Diseases,the rural residents(18-59 years old)in the investigations who performed in 2002,2015,and 2019 served as the subjects for the across section study.The three investigations were performed with the questionnaires,physical examinations and laboratory tests.The t test,analysis of variance,Bonferroni two-by-two comparison,and χ^(2) test were used to analyze the data.The used software was SAS 9.4.Results The number of subjects in 2002,2015 and 2019 investigations were 1321,1748 and 1291 cases,respectively;and the mean age of the subjects was(41.5±10.4),(45.7±10.1)and(47.8±9.2)years old,respectively.The ratios of male to female in 2002,2015 and 2019 investigations were 1∶1.18,1∶1.14 and 1∶1.21,respectively.Serum cholesterol(TC)and low density lipoprotein cholesterol(LDL-C)levels in 2015 and 2019 were significantly higher than those in 2002;the serum TC and LDL-C levels of females in 2002 were significantly lower than those of males,but the serum TC and LDL-C levels of females in 2019 were significantly higher than those of males(P<0.05).Serum high density lipoprotein cholesterol(HDL-C)level were lower in 2015 and 2019 than that in 2002.Three investigations showed that TC and LDL-C levels in 50-59 years old group were significantly higher than those in 18-29 years old group(P<0.05);TC and LDL-C levels in overweight and obese group were significantly higher than those in normal weight group(except for TC level in 2019),TC and LDL-C levels in central obese group were significantly higher than those in normal waistline group;HDL-C level in females was significantly higher than that in males;HDL-C level in non-smokers was significantly higher than that in smokers;HDL-C level in overweight and obese group was significantly lower than that in normal weight group;HDL-C level in central obese group was significantly lower than that in normal waistline group(P<0.05).The results of gender comparison among all age groups showed that TC levels of 30-39 years old group in females in three investigations were significantly lower than those in males;in 2015 and 2019 investigations,TC and LDL-C levels of 50-59 years old group in females were significantly higher than those in males;in three investigations,HDL-C levels of 40-49 years old and 50-59 years old groups in females were significantly higher than those in males(P<0.05).Conclusion Serum TC and LDL-C levels of Shanxi rural residents in 2015 and 2019 increased significantly,as compared with 2002,but HDL-C level decreased significantly.In the prevention and treatment of dyslipidemia,it should pay attention to serum cholesterol level in rural areas.