老年男性血清总胆红素水平与代谢综合征患病的关系

摘要

目的 探讨分析老年男性生理范围内血清总胆红素水平与代谢综合征及其各组份患病的相关性.方法 纳入老年男性住院患者430例,其中代谢综合征组227例、非代谢综合征组203例.同时,将所有研究对象按照所患代谢异常数量分为0项共存组、1项共存组、2项共存组、3项共存组、4项共存组5组.记录所有研究对象的一般情况及各项指标,包括身高、体重、体质量、总胆红素、肝功能、血糖、血脂、尿酸等生化指标.结果 5组患者血清总胆红素水平的比较,结果显示5组之间差异有统计学意义(P＜0.001),且两两比较后发现,两项代谢异常共存组较其他组血清总胆红素水平明显升高(P＜0.05).血清生理范围内总胆红素水平与高脂血症、糖尿病、高血压病患病呈显著负相关(r=-0.181,-0.21,-0.155,P=0.001).代谢综合征及其各组份危险因素多元logistic回归分析显示,老年男性血清生理范围内总胆红素水平与代谢综合征患病呈负相关(OR:0.943,95％CI:0.892～0.997,P=0.04);与高血压病患病呈负相关(OR:0.948,95％CI:0.940～0.999,P=0.048);与高脂血症患病呈负相关(OR:0.943,95％CI:0.898～0.991,P=0.021);与糖尿病患病呈负相关(OR:0.953,95％CI:0.909～0.998,P=0.042).按照血清总胆红素水平四分位数分组,发现随着总胆红素水平的升高,代谢综合征、高血压病、高脂血症及糖尿病患病比例呈逐渐下降趋势.结论 生理范围内的血清总胆红素水平低下可能是老年男性机体内的独立危险因素,且血清生理范围内总胆红素水平与代谢综合征及其组份高血压病、高脂血症及糖尿病患病呈负相关.%Objective To investigate the correlation between serum total bilirubin level and metabolic syndrome and its components in elderly men.Methods 430 cases of elderly male hospitalized patients were included,including 227 cases of metabolic syndrome group and 203 cases of non metabolic syndrome group.At the same time,all the subjects were divided into 5 groups according to the number of abnormal metabolic disorders.The general conditions and indicators of all the subjects were recorded,including height,body mass(BMI),total bilirubin(TB),liver function,blood sugar,blood lipids,uric acid and other biochemical indicators.Results According to the comparison of the serum TB level between the five groups,there is a significant difference between the five groups(P ＜ 0.001),and the serum TB level of the two metabolic abnormalities coexist group was significantly increased than in other groups(P＜0.05);The serum total bilirubin level was negatively correlated with hyperlipidemia,diabetes and hypertension(r=-0.181,P=0.001;r=-0.21,P=0.001,r=-0.155,P=0.001).Metabolism syndrome risk factors multivariate logistic regression analysis showed:elderly male serum TB level was negatively correlated with metabolism syndrome(OR:0.943,95％CI:0.892-0.997;P=0.04).Serum TB level was negatively correlated with hypertension(OR:0.948,95％CI:0.940-0.999;P=0.048).Serum TB level was negatively correlated with hyperlipidemia(OR:0.943,95％CI:0.898-0.991;P=0.021).Serum TB level was negatively correlated with diabetes(OR:0.953,95％CI:0.909-0.998;P=0.042).According to the four percentile of serum total bilirubin level,it was found that the proportion of metabolic syndrome,hypertension,hyperlipidemia and diabetes decreased with the increased total bilirubin level.Conclusion The low level of serum total bilirubin in physiological range may be an independent risk factor in elderly men,and the total bilirubin level in serum physiological range is negatively correlated with the metabolic syndrome and its components hypertension,hyperlipidemia and diabetes.