西藏与新疆地区常见代谢危险因素组合特点及其与左心室舒张功能障碍的相关性研究  

The combinations of common metabolic risk factors and the association with left ventricular diastolic dysfunction in Tibet and Xinjiang

作　　者：蒋琳琳 陈祚[1] 张林峰[1] 王馨[1] 杨瑛 郑聪毅 亢玉婷 邵澜[1] 田野[1] 郭岩斐[2] 吴静[3] 陈韵岱[4] 李南方[5] 王增武[1] JIANG Lin-lin;CHEN Zuo;ZHANG Lin-feng;WANG Xin;YANG Ying;ZHENG Cong-yi;KANG Yu-ting;SHAO Lan;TIAN Ye;GUO Yan-fei;WU Jing;CHEN Yun-dai;LI Nan-fang;WANG Zeng-wu(Division of Prevention and Community Health,National Center for Cardiovascular Disease,National Clinical Research Center of Cardiovascular Disease,State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,Peking Union Medical College&Chinese Academy of Medical Sciences,Beijing 102308,China;Department of Pulmonary and Critical Care Medicine,Beijing Hospital,National Hospital Center of Gerontology,Beijing 100730,China;National Center for Chronic and Non-communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China;Department of Cardiology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Institute of Hypertension of Xinjiang Uygur Autonomous Region,Center for Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]北京协和医学院中国医学科学院阜外医院,国家心血管病中心社区防治部,国家心血管病重点实验室,国家心血管病临床试验中心,北京市102308 [2]北京医院国家老年医学中心病理科,北京市102308 [3]中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京市102308 [4]解放军总医院第一医学中心心内科,北京市102308 [5]新疆维吾尔自治区人民医院高血压中心新疆高血压研究所,北京市102308

出　　处：《中国心血管病研究》2020年第5期388-394,共7页Chinese Journal of Cardiovascular Research

基　　金：公益性行业科研专项“西藏和新疆地区慢性心肺疾病现状调查研究”(201402002)。

摘　　要：目的了解西藏与新疆地区常住居民常见代谢危险因素的不同组合,并探讨其与左心室舒张功能障碍(LVDD)的相关性.方法采用分层多阶段随机抽样的方法于2015-2016年共抽取西藏与新疆地区≥35岁常住居民7529名进行慢性心肺疾病调查,最终5816名纳入分析,其中西藏地区1958名,新疆地区3858名.计算常见代谢危险因素不同组合的构成比和LVDD患病率,并用Logistic回归模型分析主要组合的LVDD患病风险.结果单一代谢危险因素中,西藏地区高血压占比最高,新疆地区是中心型肥胖;聚集数为2和3的组合中,中心型肥胖+高血压、中心型肥胖+高血压+高甘油三酯均为两地占比最高的组合.在西藏地区,中心型肥胖+高血压在所有组合中占比最高(34.0%),其次为高血压(21.1%),LVDD患病率分别为45.8%和40.2%;新疆地区中心型肥胖+高血压占构成比最高(20.1%),其次为中心型肥胖(18.6%),LVDD患病率分别为44.0%和27.8%.以无代谢危险因素的人群为参照,调整多种因素后的多元Logistic回归分析结果显示,西藏地区LVDD患病风险最高的组合是中心型肥胖+高血压+高甘油三酯(OR=6.342,95%CI 3.359~11.973),新疆地区为中心型肥胖+高血压(OR=2.872,95%CI 2.213~3.728).结论西藏与新疆地区中心型肥胖合并高血压人群LVDD的患病风险较高,应重点进行干预.Objective To investigate the different combinations of conunon metabolic risk factors and the correlation between them and left ventricular diastolic dysfunction(LVDD)among the residents in Tibet and Xinjiang.Methods A total of 7529 residents aged 35 years and above were selected for chronic cardiopulmonary disease investigation in 2015-2016 by multistage stratified random sampling method and 5816 were finally eligible for analysis,including 1958 in Tibet and 3858 in Xinjiang.The proportion of different combinations of common metabolic risk factors,as well as the prevalence of LVDD grouped by each combination,were calculated and the risk of LVDD in major combinations was analyzed by Logistic regression model.Results With respect to the single metabolic risk factor,high blood pressure accounted for the highest proportion in Tibet and central obesity in Xinjiang;for 2 and 3 cluster factors,the proportion of central obesity combined with high blood pressure,central obesity and high blood pressure combined with high triglycerides accounted for the largest proportion in both provinces.In Tibet,central obesity combined with high blood pressure accounted for the highest proportion among all the combinations(34.0%),followed by high blood pressure(21.1%);the prevalence of LVDD were 45.8%and 40.2%,respectively.In Xinjiang,the proportion of central obesity combined with high blood pressure was the highest(20.1%),followed by central obesity(18.6%),and the prevalence of LVDD were 44.0%and 27.8%,respectively.Compared with the no metabolic risk factors group,after adjusting multiple factors,multivariate Logistic regression analysis showed that central obesity and high blood pressure combined with high triglycerides had the highest risk of LVDD in Tibet(OR=6.342,95%CI 3.359-11.973),but central obesity combined with high blood pressure in Xinjiang(OR=2.872,95%CI 2.213-3.728).Conclusion People with central obesity combined with high blood pressure have a higher risk of LVDD both in Tibet and Xinjiang.Special attention should be gi

关 键 词：代谢危险因素 左心室舒张功能障碍 中心型肥胖 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]