天津地区纵向体检资料血脂异常特征及其与肝肾功能指标的动态相关性分析  

Characteristics of dyslipidemia and dynamic correlation with liver and kidney function index based on a longitudinal health check-up study in Tianjin area

作　　者：李曼[1,3] 麻馨月[2,3] 朱林敏 张丹[1] 孙续国[1] LI Man;MA Xin-yue;ZHU Lin-min;ZHANG Dan;SUN Xu-guo(School of Medical Laboratory,Tianjin Medical University,Tianjin 300203,China;不详)

机构地区：[1]天津医科大学医学检验学院,天津300203 [2]天津医科大学基础医学院,天津300070 [3]天津市泰达医院检验科,天津300457

出　　处：《现代预防医学》2020年第10期1909-1913,共5页Modern Preventive Medicine

摘　　要：目的分析2008-2018年间天津市滨海新区部分职业群体纵向健康体检资料血脂异常的流行病学特征,探索肝肾功能指标与血脂异常的动态相关性。方法回顾性分析10年间2812名体检人员血脂异常的发病密度及特征;构建动态纵向队列,运用广义估计方程分析不同分层水平(四分位间距Q1-Q4)的血清总胆红素(TBIL)、谷氨酰转肽酶(GGT)、谷丙转氨酶(ALT)及尿酸(UA)对血脂异常的相关影响。结果体检人群总体血脂异常发病密度为10.01/100人年,男性高于女性(P<0.001),基线年龄≥42岁时发病密度显著性增加(P<0.001),类型男性较女性丰富,总体首次发生以1项异常为特征,HDL-C降低、TG升高最为常见。GEE多因素分析,年龄(B=0.016,OR=1.016,P<0.0001)、男性(B=0.889,OR=2.434,P<0.0001)、GGT(Q2:B=0.333,OR=1.396,P<0.01;Q3:B=0.552,OR=1.736,P<0.0001;Q4:B=0.744,OR=2.104,P<0.0001)、高水平(第四分位数)ALT(Q4:B=0.531,OR=1.701,P<0.0001)、UA(Q2:B=0.272,OR=1.313,P<0.05;Q3:B=0.526,OR=1.691,P<0.0001;Q4:B=0.822,OR=2.275,P<0.0001)与血脂异常呈正相关,TBIL(Q2:B=-0.299,OR=0.742,P<0.01;Q3:B=-0.387,OR=0.679,P<0.0001;Q4:B=-0.678,OR=0.507,P<0.0001)与血脂异常呈负相关。结论高龄、男性是血脂异常发生的防治重点,不同水平的肝肾功能指标与血脂异常具有一定相关性,通过建立个体化疾病预测模型思路,将体检重心从疾病发现向预防转移。Objective The aim of this study was to analyze the epidemiological characteristics of dyslipidemia on a longitudinal health check-up study about some occupational groups in Tianjin Binhai New Area from 2008 to 2018,and explore the dynamic correlation between liver and kidney function index and dyslipidemia.Methods The incidence density and characteristics of the dyslipidemia of 2,812 medical examiners in 10 years were retrospective analyzed,and the dynamic longitudinal queue was constructed and analyzed for related effects of serum total bilirubin(TBIL),γ-glutamyl transpeptadase(GGT),alanine aminotransferase(ALT)and uric acid(UA)at different levels(interquantile range Q1-Q4)on the dyslipidemia using generalized estimation equations.Results The overall incidence density of the medical examination population was 10.01/100 person-year,and the males were higher than the females(P<0.001).When the baseline age was equal or over 42 years old,the incidence density increased significantly(P<0.001).The type of dyslipidemia in men was more abundant than that in women.The first occurrence of dyslipidemia was characterized as single abnormality.The most common types were HDL-C reduction and TG increase.In the multi-factor analysis of GEE,age(B=0.016,OR=1.016,P<0.0001),male(B=0.889,OR=2.434,P<0.0001),GGT(Q2:B=0.333,OR=1.396,P<0.01;Q3:B=0.552,OR=1.736,P<0.0001;Q4:B=0.744,OR=2.104,P<0.0001),high-level of ALT(the fourth quartile)(Q4:B=0.531,OR=1.701,P<0.0001),UA(Q2:B=0.272,OR=1.313,P<0.05;Q3:B=0.526,OR=1.691,P<0.0001;Q4:B=0.822,OR=2.275,P<0.0001)were positive correlated with the dyslipidemia,and TBIL(Q2:B=-0.299,OR=0.742,P<0.01;Q3:B=-0.387,OR=0.679,P<0.0001;Q4:B=-0.678,OR=0.507,P<0.0001)was negative correlated with the dyslipidemia.Conclusion Old age and being male were the focus of prevention and treatment of dyslipidemia.The indexes of liver and kidney function at different levels had certain correlation with dyslipidemia. Through the establishment of individual disease prediction model, the focus of physical examination shoul

关 键 词：血脂异常 血清总胆红素 血清尿酸 动态队列研究 广义估计方程 

分 类 号：R181.3[医药卫生—流行病学]