中国长寿地区80岁以上高龄老人血脂比值与死亡风险的关联研究  

Follow-up study on the effects of lipid ratios on all-cause mortality among elderly adults in longevity areas of China

作　　者：施小明[1] 吕跃斌[2] 殷召雪[3] 苏丽琴[1] 张娟[3] 蔡军芳[1] 罗杰斯[3] 

机构地区：[1]中国疾病预防控制中心环境与健康相关产品安全所,北京100021 [2]北京出入境检验检疫局 [3]中国疾病预防控制中心慢性病防治与社区卫生处,北京100021

出　　处：《中华预防医学杂志》2016年第7期594-599,共6页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金(81273160、71233001、71110107025)；联合国人口基金会和美国国立卫生研究院联合提供资助

摘　　要：目的：探讨我国长寿地区80岁以上高龄老人血脂比值与死亡风险的关系。方法基线数据资料来自中国老年人口健康影响因素跟踪调查（CLHLS）项目，于2009年6月在7个长寿地区选取874名80岁以上高龄老人，进行问卷调查、身体测量及血生化指标检测,并计算LDL-C/HDL-C、TG/HDL-C和动脉粥样硬化指数（AI）等血脂比值。于2012年8月进行随访调查，收集调查对象的生存结局。根据老年人的血脂比值三分位数将其等分为低、中、高水平3组。采用Cox比例风险回归模型分析LDL-C/HDL-C、TG/HDL-C和AI对其死亡风险的影响。结果随访时，874名高龄老人中死亡427名，存活378名，失访69名。死亡率为50.5%。死亡组、存活组及失访组LDL-C/HDL-C的P50（P25~P75）分别为1.68（1.22~2.05）、1.85（1.34~2.16）、1.78（1.33~2.08）（H=6.93，P=0.025）；TG/HDL-C分别为1.00（0.79~1.34）、1.20（0.97~1.53）、1.23（0.95~1.72）（H=9.18，P=0.008）；AI分别为2.12（1.72~2.61）、2.27（1.84~2.75）、2.13（1.80~2.58）（H=6.37，P=0.041）。低、中、高水平LDL-C/HDL-C（〈1.39、1.39~1.92、≥1.92）的高龄老人38个月死亡率分别为53.1%、50.0%和44.0%（χ2=7.54，P=0.024）；低、中、高水平AI（〈1.83、1.83~2.39、≥2.39）的高龄老人死亡率分别为54.0%、46.4%和45.3%（χ2=6.67，P=0.035）。Cox比例风险回归模型分析结果显示，在调整混杂因素后，LDL-C/HDL-C、TG/HDL-C和AI每升高1个单位，高龄老人死亡风险分别降低17%、15%和13%[HR（95%CI）分别为0.83（0.72~0.97）、0.85（0.74~0.99）和0.87（0.76~0.99）]；与低LDL-C/HDL-C水平组高龄老人相比，高LDL-C/HDL-C水平组高龄老人死亡风向相对较低[HR（95%CI）=0.88（0.78~0.99）]；与AI水平较低的高龄老人相比，中等水平和高水平的高龄老人死亡风险相对较低[HR（95%CI）分别为0.84（0.72~0.98）和0.87（0.78~0.98）]。结论 LDL-C/HDL-C、TG/HDL-C和AI比值与我�Objective To explore the association between lipid ratios and all-cause mortality among elderly adults aged 80 years and older living in longevity areas of China. Methods A total of 874 participants in the Chinese Longitudinal Healthy Longevity Survey during June 2009 were included in our baseline survey. Lipid concentrations were measured and lipid ratios including LDL-C/HDL-C, TG/HDL-C, and atherosclerosis index （AI） were calculated at baseline, and the information on questionnaires, body measurement, and blood biochemical profiles was collected. Survival time and survival status were followed up in August 2012. Subjects were stratified into three groups （low, middle and high） by tertiles of lipid ratios. All-cause mortality was calculated. Cox regression models were used to assess the association of lipid ratios with mortality. Results During 38 months of follow-up, a total of 427 participants had died, 378 participants survived, and 69 participants were lost to follow-up; overall mortality was 50.5%. For these＆amp;nbsp;participants, P50 （P25-P75） values for LDL-C/HDL-C were 1.68 （1.22-2.05）, 1.85 （1.34-2.16）, and 1.78 （1.33-2.08）, respectively （H=6.93, P=0.025）; values for TG/HDL-C were 1.00 （0.79-1.34）, 1.20 （0.97-1.53）, and 1.23 （0.95-1.72）, respectively （H=9.18, P=0.008）. AIs were 2.12 （1.72-2.61）, 2.27 （1.84-2.75）, and 2.13 （1.80-2.58）, respectively （H=6.37, P=0.041）. Values for 38-month all-cause mortality were 53.1%, 50.0%, and 44.0%among participants with low, middle, and high LDL-C/HDL-C ratios （〈1.39, 1.39-1.92, ≥1.92）, respectively （χ2=7.54, P=0.024）; these values were 54.8%, 46.4%, and 45.3% among participants with low, middle, and high AIs （〈1.83, 1.83-2.39, ≥2.39）, respectively （χ2=6.67, P=0.035）. Each 1 unit increase of LDL-C/HDL-C, TG/HDL-C , and AI corresponded to a 17%, 15%, and 13%decrease in 38-month all-cause mortality, respectively; adjusted HRs were 0.83 （0.72-0.97）, 0.85 （0.74-0.99）, and 0.87

关 键 词：长寿 老年人  80以上 死亡 血脂比值 随访研究 

分 类 号：R592[医药卫生—老年医学]