新疆南疆地区维吾尔族人群LDL-C累积暴露对心血管病影响的队列研究  

A cohort study of the effect of cumulative exposure to LDL-C on cardiovascular disease among the uyghur population in southern Xinjiang

作　　者：程静 马儒林[1] 何佳[1] 芮东升[1] 李毓 张向辉[1] 简乐瑶 李嘉航 郭淑霞[1,2] 郭恒 CHENG Jing;MA Rulin;HE Jia;RUI Dongsheng;LI Yu;ZHANG Xianghui;JIAN Leyao;LI Jiahang;GUO Shuxia;GUO Heng(Department of Preventive Medicine,Shihezi University School of Medicine,Shihezi 832000,China;Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security,the Xinjiang Production and Construction Corps,Shihezi 832000,China)

机构地区：[1]石河子大学医学院预防医学系,石河子832000 [2]重要新发传染病防控与公共卫生安全兵团重点实验室,石河子832000

出　　处：《中华疾病控制杂志》2024年第7期770-776,共7页Chinese Journal of Disease Control & Prevention

基　　金：新疆生产建设兵团重点领域科技攻关计划(2021AB030);天山英才科技创新团队:中亚地区高发疾病防治应用研究创新团队(2023TSYCTD0020)。

摘　　要：目的探讨新疆维吾尔自治区(简称新疆)南疆维吾尔族人群中低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)累积暴露对心血管病(cardiovascular diseases,CVD)的影响。方法研究队列来自新疆生产建设兵团第三师五十一团,纳入在2016-2022年调查期间有3次LDL-C测量值,且相邻两次测量时间间隔≥2年的2950名维吾尔族人群作为研究对象。使用每个时间间隔LDL-C测量值的加权和(值×时间)计算LDL-C累积暴露(cumulative low density lipoprotein cholesterol,cumLDL-C)。按cumLDL-C三分位数分组,采用Log-rank检验比较各组CVD累积发病率的差异;使用Cox比例风险回归模型分析cumLDL-C对发生CVD的影响。结果随访期间共新发CVD事件322例(10.92%),cumLDL-C第一、二、三分位组CVD累积发病率分别为7.12%、11.08%、14.55%,经Log-rank检验,差异有统计学意义(χ^(2)=27.440,P<0.001)。Cox比例风险回归模型显示,校正多种混杂因素后,与cumLDL-C第一分位组相比,cumLDL-C第三分位组发生CVD的HR=1.51(95%CI:1.12~2.06);cumLDL-C每增加一个标准差,发生CVD的风险增加14%(HR=1.14,95%CI:1.01~1.28)。结论在新疆南疆维吾尔族人群中,高LDL-C累积暴露是该人群发生CVD的独立危险因素,长期保持较低的LDL-C水平,有助于降低该人群CVD的发生风险。Objective To explore the effect of cumulative exposure to low-density lipoprotein cholesterol(LDL-C)on cardiovascular disease(CVD)among the Uyghur population in southern Xinjiang.Methods We recruited 2950 Uyghurs from the 51st Corps of the 3rd division of Xinjiang Production and Construction Corps,who had measured LDL-C at least three times during the 2016-2022 survey period,and two adjacent measurement intervals≥2 years.Cumulative LDL-C(cumLDL-C)exposure was calculated by the weighted sum of LDL-C measured value for each time interval(value×time).Participants were grouped according to the cumLDL-C tertiles.The Log-rank test was used to compare the differences in the cumulative incidence of CVD among the groups.Cox proportional hazard regression models were used to estimate the effect of cumLDL-C on CVD.Results During the follow-up period,322(10.92%)CVD events occurred.The cumulative incidence of CVD from the first to third tertile group of cumLDL-C was 7.12%,11.08%,and 14.55%,respectively(χ^(2)=27.440,P<0.001).Cox proportional hazards model showed that after adjusting for multiple confounders,the risk of CVD in the third tertile of cumLDL-C compared with the first tertile was 1.51 times higher(HR=1.51,95%CI:1.12-2.06).Each standard deviation increase in cumLDL-C was associated with a 14%increased risk of CVD(HR=1.14,95%CI:1.01-1.28).Conclusions In the Uyghur population in southern Xinjiang,cumulative exposure to high LDL-C is an independent risk factor for CVD,and maintaining low LDL-C levels for a long period of time can help reduce the risk of CVD in this population.

关 键 词：低密度脂蛋白胆固醇 累积暴露 心血管病 队列研究 

分 类 号：R195.1[医药卫生—卫生统计学] R714.252[医药卫生—卫生事业管理]