累积脂质蓄积指数与新发代谢综合征相关性的队列研究  

A cohort study on the association between cumulative lipid accumulation index and new-onset metabolic syndrome

作　　者：李田田 王佑翔 陈静锋 闫肃 生士凤 秦迁[1] 丁素英[1,3] LI Tiantian;WANG Youxiang;CHEN Jingfeng;YAN Su;SHENG Shifeng;QIN Qian;DING Suying(Health Management Center,the First Affiliated Hospital,Zhengzhou University,Zhengzhou,Henan 450052,China;不详)

机构地区：[1]郑州大学第一附属医院健康管理中心,河南郑州450052 [2]郑州大学公共卫生学院 [3]河南省互联智慧健康管理研究院 [4]河南省疾病预防控制中心

出　　处：《中国预防医学杂志》2025年第2期150-156,共7页Chinese Preventive Medicine

基　　金：国家自然科学基金资助项目(72101236);中国博士后科学基金(2022M722900);郑州市协同创新专项项目(XTCX2023006);郑州大学第一附属医院护理科研专项团队项目(HLKY2023005)。

摘　　要：目的分析累积脂质蓄积指数(lipid accumulation product,LAP)与新发代谢综合征(metabolic syndrome,MetS)的相关性,为MetS防治提供科学依据。方法选取2017—2019年在郑州大学第一附属医院健康体检且均未患MetS的3209人纳入队列,记录2020—2022年体检时MetS发病情况。高LAP水平为≥横断面研究中分性别LAP预测MetS确定的最佳切点值,采用Cox比例风险回归和限制性立方样条(restricted cubic spline,RCS)模型研究高LAP次数和累积LAP与新发MetS之间的关联性及剂量反应关系。结果男性和女性LAP预测MetS的最佳截断值分别为40.95和37.15。该队列平均随访829 d,新发MetS 395例,MetS的累积发病率为12.31%,男性发病率(17.13%)高于女性(4.49%),差异有统计学意义(χ^(2)=111.980,P<0.001)。MetS发病率随着高LAP次数和累积LAP四分位数的增加呈增长趋势(P<0.01)。Cox回归调整多种混杂因素后,与累积LAP最低四分位组相比,第2、第3和最高四分位组MetS的发病风险分别增加,HR(95%CI)分别为2.15(1.07~4.31)、3.03(1.54~5.97)和5.40(2.65~11.02);RCS回归分析结果显示,累积LAP与MetS发病风险呈非线性关联,两者的剂量反应关系呈现先升高后平缓的变化趋势。结论累积LAP与MetS发病风险呈正向关联,长期将LAP控制在低水平是预防MetS发生发展的关键措施。Objective To analyze the association between the cumulative lipid accumulation product(LAP)and the new-onset metabolic syndrome(MetS),and to provide a scientific basis for the prevention and treatment of MetS.Methods A cohort of 3209 individuals who underwent health check-ups at the First Affiliated Hospital of Zhengzhou University from 2017 to 2019 and were free of MetS was selected.The incidence of MetS was recorded during follow-up check-ups from 2020 to 2022.A high LAP level was defined as greater than or equal to the optimal cut-off value determined by sex in the cross-sectional study.The associations between the frequency of high LAP and cumulative LAP with incident MetS were analyzed using Cox proportional hazards regression and restricted cubic spline(RCS)models.Results The optimal cut-off values for LAP predicting MetS were found to be 40.95 for males and 37.15 for females.The cohort had an average follow-up duration of 829 days,during which 395 new cases of MetS were identified,resulting in a cumulative incidence rate of 12.31%.The incidence rate was significantly higher in males(17.13%)compared to females(4.49%)(χ^(2)=111.980,P<0.001).The incidence of MetS showed an increasing trend with the number of high LAP occurrences and across quartiles of cumulative LAP(P<0.001).After adjusting for various confounding factors,the risk of developing MetS in the second,third,and highest quartiles of cumulative LAP compared to the lowest quartile increased,with HR(95%CI)of 2.15(1.07–4.31),3.03(1.54–5.97),and 5.40(2.65–11.02),respectively.RCS regression analysis indicated a nonlinear relationship between cumulative LAP and the risk of MetS,showing a doseresponse relationship that initially increased and then plateaued.Conclusions There is a positive association between cumulative LAP and the risk of developing MetS.Maintaining low levels of LAP over the long term is a key measure to prevent the occurrence and development of MetS.

关 键 词：脂质蓄积指数 累积效应 代谢综合征 队列研究 危险因素 

分 类 号：R589[医药卫生—内分泌]