健康体检人群残余胆固醇对动脉硬化进展的影响

Impact of residual cholesterol on the progression of arteriosclerosis in individuals receiving physical examination

目的分析健康体检人群残余胆固醇(RC)对动脉硬化进展的影响。方法本研究为横断面研究,选取2023年1至12月在自贡市第四人民医院健康管理中心完成动脉硬化检测的≥18岁受检者为研究对象。共9016例,其中动脉硬化6213例,提取检测结论、基本情况(年龄、性别、体重指数、腰围、血压、高血压史、吸烟史、饮酒史)和生化指标(血脂、空腹血糖、肝功能和肾功能),根据检测结论将受检者分为动脉硬化组和正常组,通过公式计算得到受检者RC水平,分别将其按照二值化和四分位数分组,利用4种回归模型分析校正不同混杂因素后RC水平对动脉硬化进展的影响。结果正常组RC水平为(0.63±0.44)mmol/L,动脉硬化组为(0.76±0.61)mmol/L。正常组RC升高652例,RC正常2241例;动脉硬化组RC升高2069例,RC正常4144例。正常组RC处于Q1~Q4区间的人数分别为838(28.97%)、752(25.99%)、760(26.27%)、543(18.77%),逐渐递减;动脉硬化组RC处于Q1~Q4区间人数分别为1414(22.76%)、1438(23.15%)、1589(25.58%)、1771(28.51%),逐渐递增。利用4种回归模型校正各种混杂因素后,RC升高增加了动脉硬化进展的风险,OR值分别为1.38、1.24、1.23、1.21;RC水平在Q4区间者动脉硬化进展风险相比Q1区间者分别增加1.50、1.32、1.31、1.28倍。结论RC升高是动脉硬化进展的独立危险因素,对动脉硬化进展的影响趋于稳定且始终保持一致。

Objective To investigate the impact of residual cholesterol(RC)on the progression of arteriosclerosis in individuals receiving physical examination.Methods A cross-sectional study.Participants aged 18 years and above who underwent arteriosclerosis testing at the Health Management Center of Zigong Fourth People′s Hospital from January to December 2023 were selected as the subjects of the study.A total of 9016 subjects were included in this study,of whom 6213 were considered to have arteriosclerosis.The physical examination conclusions,basic information(age,gender,body mass index,waist circumference,blood pressure,history of hypertension,history of smoking and drinking),and biochemical indicators(lipids,fasting blood glucose,liver and kidney function)were extracted in those individuals.Based on the examination results,the subjects were categorized into arteriosclerosis and normal groups.The RC levels of the participants were calculated using a formula and then the subjects were categorized into binary and quartile RC groups.Additionally,four regression models were used to analyze the impact of RC levels on the progression of arteriosclerosis while adjusting for various confounding factors.Results The RC level was(0.63±0.44)mmol/L in the normal group and(0.76±0.61)mmol/L in the arteriosclerosis group.Based on level of RC,the normal group was divided into two subgroups:652 individuals with elevated RC level and 2241 with normal RC level.In the arteriosclerosis group,there were 2069 individuals with elevated RC level and 4144 with normal RC level.Grouped according to quartiles of RC level,the number of individuals with RC in the Q1-Q4 interval in the normal group was 838(28.97%),752(25.99%),760(26.27%),and 543(18.77%),respectively,showing a gradual decreasing trend.The number of individuals with RC in the Q1-Q4 interval in the arteriosclerosis group was 1414(22.76%),1438(23.15%),1589(25.58%),and 1771(28.51%),respectively,showing a gradual increasing trend.The difference between the groups was statistically significant(P<0.05).After adjusting for various factors by four regression models,it was found that elevated RC levels increased the risk of arteriosclerosis progression,with a odds ratio(OR)of 1.381,1.242,1.233,and 1.214,respectively.Additionally,individuals in the Q4 RC level quartile had 1.502,1.318,1.311,and 1.284-times higher risk of arteriosclerosis progression when compared to those in the Q1 quartile.Conclusion The impact of RC on the progression of arteriosclerosis tend to stabilize and remain consistent,indicating that elevated RC is an independent risk factor for the progression of arteriosclerosis.