大连市中老年人脂质蓄积指数与高血压的相关性研究  

Correlation between lipid accumulation product index and hypertension in middle-aged and elderly people in Dalian area

作　　者：罗兰 李欣宇 高政南 LUO Lan;LI Xin-yu;GAO Zheng-nan(Department of Endocrinology and Metabolism,Dalian Central Hospital Affiliated to Dalian Medical University,Dalian 116033,China)

机构地区：[1]大连医科大学附属大连市中心医院内分泌科

出　　处：《实用老年医学》2019年第11期1064-1068,共5页Practical Geriatrics

基　　金：国家科技支撑项目计划资助(2013BAI09B13);大连市科技惠民项目(2018J13SN127)

摘　　要：目的探讨中老年人群中脂质蓄积指数(LAP)与高血压的相关性。方法选取2011年7月至12月REACTION研究的年龄≥40周岁的大连社区居民9913例。根据性别及LAP四分位数分组(Q1、Q2、Q3和Q4),比较各组间高血压现患率,分析LAP是否为高血压的独立危险因素。应用受试者工作特征(ROC)曲线计算LAP预测高血压的界值点。结果(1)男女高血压现患率分别为54.6%、48.1%,差异有统计学意义(P<0.001)。(2)男性LAP Q1、Q2、Q3和Q4组高血压现患率分别为40.4%、55.8%、59.8%及62.5%,除Q2与Q3及Q3与Q4组外,其他各组间现患率差异均有统计学意义(P<0.05)。女性LAP Q1、Q2、Q3和Q4组现患率分别为29.7%、42.7%、57.1%及63.0%,组间现患率差异均有统计学意义(P<0.001)。(3)Spearman相关分析显示,男女LAP与收缩压及舒张压均呈正相关。(4)以LAP为自变量,是否患有高血压为因变量进行二元Logistic回归分析,在男、女性中,校正年龄、心率、体质量指数、吸烟及饮酒、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白、胰岛素抵抗指数后,LAP每增加一个标准差,男女高血压患病风险分别增加1.166倍及1.182倍(P<0.05)。(5)以LAP为自变量,是否高血压为因变量,绘制ROC曲线,男女曲线下面积(AUC)分别为0.595及0.657(P<0.001)。结论(1)随着LAP增加,收缩压、舒张压逐渐增加,高血压现患率有逐渐增加趋势。LAP是中老年人患高血压的独立危险因素。(2)中老年人群中男性LAP≥29.36,女性LAP≥39.54为预测高血压最佳的诊断界限值。Objective To explore the correlation between lipid accumulation product(LAP)and hypertension in middle-aged and elderly people.Methods A total of 9913 Dalian community residents aged over 40 who participated in the REACTION study initiated by the Chinese Medical Association from July to December 2011 were selected.All cases were divided into four groups according to LAP quartile in male or female,the prevalence rates of hypertension in each group were compared,as well as whether LAP was an independent risk factor for hypertension.Results(1)The hypertension prevalence rates of male groups Q1,Q2,Q3 and Q4 were 40.4%,55.8%,59.8% and 62.5% respectively.Except Q2 vs.Q3 and Q3 vs.Q4 group,the hypertension prevalence rates between other groups were significantly different(P<0.05).The prevalence rates of hypertension in female groups Q1,Q2,Q3 and Q4 were 29.7%,42.7%,57.1% and 63.0% respectively,with significant statistical differences between each group(P<0.001).(2)LAP were positively correlated with systolic blood pressure and diastolic blood pressure.The Logistic regression analysis showed that for each one additional standard deviation of LAP,the risk of hypertension increased 1.166 and 1.182 times(P<0.001)in male or female respectively,after further adjustment for age,heart rate,bady mass index,smoking and drinking,low density lipoprotein cholesterol(LDL-C),high density poprotein cholesterol(HDL-C),creatinine,fasting blood glucose(FBG),glycosylated hemoglobin A1c(HbA1c)and homeostasis model assessment of insulin resistance(HOMA-IR).The working characteristic curve of the subjects was drawn to show:the area under the curve was 0.595 and 0.657 in male and femle(P<0.001).Conclusions With the increase of LAP,systolic blood pressure,diastolic blood pressure increase gradually,and the prevalence rate of hypertension increases gradually.LAP is an independent risk factor of hypertension in the middle-aged and elderly people.The LAP in the middle-aged and elderly males with LAP≥29.36 and females with LAP≥39.54 are the bes

关 键 词：脂质蓄积指数 高血压 中老年 

分 类 号：R544.1[医药卫生—心血管疾病]