中国成年双生子高脂血症的分布特征  

A descriptive analysis of hyperlipidemia in adult twins in China

作　　者：缪珂 曹卫华[1] 吕筠[1] 余灿清[1] 王胜锋[1] 黄涛 孙点剑一 廖春晓[1] 庞元捷[1] 逄增昌[2] 俞敏[3] 汪华[4] 吴先萍[5] 董忠[6] 吴凡[7] 江国虹[8] 王晓节[9] 刘彧 邓健[11] 陆林[12] 高文静[1] 李立明[1] Miao Ke;Cao Weihua;Lyu Jun;Yu Canqing;Wang Shengfeng;Huang Tao;Sun Dianjianyi;Liao Chunxiao;Pang Yuanjie;Pang Zengchang;Yu Min;Wang Hua;Wu Xianping;Dong Zhong;Wu Fan;Jiang Guohong;Wang Xiaojie;Liu Yu;Deng Jian;Lu Lin;Gao Wenjing;Li Liming(Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing 100191,China;Qingdao Municipal Center for Disease Control and Prevention,Qingdao 266033,China;Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,China;Jiangsu Provincial Center for Disease Control and Prevention,Nanjing 210009,China;Sichuan Center for Disease Control and Prevention,Chengdu 610041,China;Beijing Center for Disease Prevention and Control,Beijing 100013,China;Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Tianjin Centers for Disease Control and Prevention,Tianjin 300011,China;Qinghai Center for Disease Prevention and Control,Xining 810007,China;Heilongjiang Provincial Center for Disease Control and Prevention,Harbin 150090,China;Handan Center for Disease Control and Prevention of Hebei Province,Handan 056001,China;Yunnan Center for Disease Control and Prevention,Kunming 650034,China)

机构地区：[1]北京大学公共卫生学院流行病与卫生统计学系,北京100191 [2]青岛市疾病预防控制中心,青岛266033 [3]浙江省疾病预防控制中心,杭州310051 [4]江苏省疾病预防控制中心,南京210009 [5]四川省疾病预防控制中心,成都610041 [6]北京市疾病预防控制中心,北京100013 [7]上海市疾病预防控制中心,上海200336 [8]天津市疾病预防控制中心,天津300011 [9]青海省疾病预防控制中心,西宁810007 [10]黑龙江省疾病预防控制中心,哈尔滨150090 [11]河北省邯郸市疾病预防控制中心,邯郸056001 [12]云南省疾病预防控制中心,昆明650034

出　　处：《中华流行病学杂志》2023年第4期544-551,共8页Chinese Journal of Epidemiology

基　　金：公益性行业科研专项(201502006,201002007);国家自然科学基金(81973126,82073633);北京大学流行病与卫生统计学顶尖学科建设项目。

摘　　要：目的描述中国双生子登记系统(CNTR)成年双生子高脂血症的分布特征,初步探索遗传和环境因素对高脂血症的影响。方法研究对象来自CNTR在全国11个项目地区募集的双生子,纳入成年且具有高脂血症信息的69130名(34565对)双生子进行分析。采用随机效应模型描述高脂血症的人群、地区分布特征。分别计算不同卵型双生子的高脂血症同病率,估算遗传度。结果研究对象年龄为(34.2±12.4)岁。双生子人群高脂血症患病率为1.3%(895/69130)。男性、年长、城镇、已婚、大专及以上文化程度、超重、肥胖、体力活动不足、当前吸烟和曾经吸烟、当前饮酒和曾经饮酒人群中高脂血症患病率较高。双生子对内分析发现,同卵双生子高脂血症同病率为29.1%(118/405),高于异卵双生子的18.1%(57/315),差异有统计学意义(P<0.05)。在不同年龄、地区及性别分层中,同卵双生子同病率仍呈现高于异卵双生子的趋势。进一步同性别双生子对内分析发现,在北方组和女性组中,高脂血症遗传度分别为13.04%(95%CI:2.61%~23.47%)、18.59%(95%CI:4.43%~32.74%)。结论成年双生子高脂血症患病率低于一般人群,存在人群和地区差异。高脂血症受到遗传因素的影响,但遗传效应大小在不同人群中可能不同。Objective To describe the distribution characteristics of hyperlipidemia in adult twins in the Chinese National Twin Registry(CNTR)and explore the effect of genetic and environmental factors on hyperlipidemia.Methods Twins recruited from the CNTR in 11 project areas across China were included in the study.A total of 69130(34565 pairs)of adult twins with complete information on hyperlipidemia were selected for analysis.The random effect model was used to characterize the population and regional distribution of hyperlipidemia among twins.The concordance rates of hyperlipidemia were calculated in monozygotic twins(MZ)and dizygotic twins(DZ),respectively,to estimate the heritability.Results The age of all participants was(34.2±12.4)years.This study's prevalence of hyperlipidemia was 1.3%(895/69130).Twin pairs who were men,older,living in urban areas,married,had junior college degree or above,overweight,obese,insufficient physical activity,current smokers,ex-smokers,current drinkers,and ex-drinkers had a higher prevalence of hyperlipidemia(P<0.05).In within-pair analysis,the concordance rate of hyperlipidemia was 29.1%(118/405)in MZ and 18.1%(57/315)in DZ,and the difference was statistically significant(P<0.05).Stratified by gender,age,and region,the concordance rate of hyperlipidemia in MZ was still higher than that in DZ.Further,in within-same-sex twin pair analyses,the heritability of hyperlipidemia was 13.04%(95%CI:2.61%-23.47%)in the northern group and 18.59%(95%CI:4.43%-32.74%)in the female group,respectively.Conclusions Adult twins were included in this study and were found to have a lower prevalence of hyperlipidemia than in the general population study,with population and regional differences.Genetic factors influence hyperlipidemia,but the genetic effect may vary with gender and area.

关 键 词：高脂血症 双生子研究 现况研究 遗传因素 环境因素 

分 类 号：R589.2[医药卫生—内分泌]