北京地区表观健康成人血脂水平的调查

摘要

Objective To investigate on the gender and age distribution characteristics of serum lipid levels among apparently healthy adult population in Beijing and analyse its related risk factors .Methods This is a prospective study.1 712 healthy individuals between 18 and 79 years old were recruited from medical examination center of Peking University Third Hospital .By strict exclusion criteria , 951 healthy individuals (429 males and 522 females) were included in our study.A calibrated automatic biochemical analyzer was used to measure TC, TG, HDL-C, LDL-C, ApoA1, ApoB concentrations in serum.Test results were stratified by gender , age, related risk factors, and statistically analysed.Two groups of normally disthibuted data were compared using t test;multiple groups of data were compared using variance analysis . Results Results for TC (t=4.013, P<0.050), HDL-C(t=9.162, P<0.05) and ApoA1( t=8.225, P<0.05) appear generally higher in women than in men .On the contrary, males had greater levels of TG (Z=3.119, P<0.05) compared to females.There was an obvious increasing trend in TC ( F=47.984, P<0.05), TG(Chi square =146.616, P<0.05), LDL-C(F=46.024, P <0.05), non-HDL-C(F =45.027, P<0.05) and ApoB levels(F=52.020, P<0.05), as well as peaked in the 60-69 age group, decreased in 70-70 years old.The population of beneath the bachelor-degree had greater levels of ApoB ( t=5.989, P<0.05), LDL-C(t=4.445, P<0.05), TC(t=2.885, P<0.05), non-HDL-C(t=4.332, P<0.05) and TG(Z=3.346, P<0.05) compared to the group of bachelor degree or above .Meanwhile, The levels of TC(t=8.273, P<0.05), HDL-C(t=3.346, P<0.05), LDL-C(t=5.768, P<0.05), non-HDL-C(t=7.213, P<0.05), ApoA1(t=3.683, P<0.05), ApoB(t=6.267, P<0.05), TG(Z=5.626, P<0.05) of the population lived in urban area were higher than rural areas .Interestingly, the concentration of ApoA1(t=3.238, P<0.05), HDL-C( t=6.011, P<0.05) and TC(t=2.712, P<0.05) were much higher in the population of mental worker than the manual worker .BMI and waistline positively correlated with serum TG(rs=0.379, 0.443, P<0.01), TC(rs =0.160, 0.176, P<0.01), LDL-C(rs =0.238, 0.263, P <0.01), ApoB (rs =0.326, 0.371, P <0.01) and non-HDL-C(rs =0.304, 0.336, P<0.01) respectively, but negatively correlated with HDL-C(rs =-0.358, -0.386, P<0.01) and ApoA1 ( rs =-0.203, -0.209, P <0.01 ) .Conclusions The study obtained the distribution of lipid levels among apparently healthy a dult population in Beijing .It may offer objective basis for clinical risk assessment of ASCVD , and guid the clinician to choose the optimal individualized treatment .%目的：调查北京地区表观健康成人血脂水平的性别和年龄分布特征并分析其相关危险因素。方法前瞻性研究。从北京大学第三医院体检中心招募健康志愿者1712人，年龄18～79岁，通过严格的排除标准获得参考人群951名（男429名，女522名），用全自动生化分析仪检测血清TC、TG、HDL-C、LDL-C、ApoA1和ApoB的浓度，将检测结果按性别、年龄及各种危险因素分组后进行统计分析。正态分布资料的两组数据比较用t检验，多组间数据比较采用方差分析。结果女性TC （t＝4．013，P＜0．05）、HDL-C（t＝9．162，P＜0．05）、ApoA1（t＝8．225，P＜0．05）水平高于男性，而男性TG水平显著高于女性（Z＝3．119，P＜0．05）。随年龄增长，TC（F＝47．984，P＜0．05）、TG（秩和＝146．616，P＜0．05）、LDL-C（F＝46．024，P＜0．05）、non-HDL-C（F＝45．027，P＜0．05）和ApoB（F＝52．020，P＜0．05）有增加趋势，且60～69岁年龄组达高峰，70～79岁有所下降。本科以下学历组ApoB （t＝5．989，P＜0．05）、LDL-C（t＝4．445，P＜0．05）、TC（t ＝2．885，P＜0．05）、non-HDL-C（t＝4．332，P＜0．05）、TG（ Z＝3．346，P＜0．05）水平均高于本科及以上学历组；城市人群TC（ t＝8．273，P＜0．05）、HDL-C（t＝3．346，P＜0．05）、LDL-C（t＝5．768，P＜0．05）、non-HDL-C（t＝7．213，P＜0．05）、ApoA1（t＝3．683，P＜0．05）、ApoB（t＝6．267，P＜0．05）、TG（Z＝5．626，P＜0．05）水平均高于农村人群；脑力劳动者ApoA1（t＝3．238，P＜0．05）、HDL-C（t＝6．011，P＜0．05）、TC（t＝2．712，P＜0．05）浓度高于体力劳动者，差异有统计学意义。 BMI和腰围分别与TG（rs＝0．379、0．443，P＜0．01）、TC（rs ＝0．160、0．176，P＜0．01）、LDL-C（rs ＝0．238、0．263，P＜0．01）和ApoB （rs ＝0．326、0．371，P＜0．01）、non-HDL-C（rs ＝0．304、0．336，P ＜0．01）呈正相关，与HDL-C（rs ＝-0．358、-0．386，P＜0．01）和ApoA1（ rs＝-0．203、-0．209，P＜0．01）负相关，相关具有统计学意义。结论本研究获得了北京地区表观健康成人血脂水平的分布情况，为临床评估ASCVD的风险性，指导临床医师选择最佳的个体化治疗方案提供了客观依据。（中华检验医学杂志，2016，39：34-39）