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上海中年人群不同脂肪分布指标与血脂异常的相关性流行病学研究

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  • 1. 上海市内分泌代谢病临床医学中心,上海市内分泌代谢病研究所,上海交通大学医学院附属瑞金医院内分泌代谢病科,上海 200025
    2. 上海市淞南镇社区卫生服务中心,上海 200441

收稿日期: 2018-01-30

  网络出版日期: 2019-04-25

基金资助

上海市宝山区科学技术委员会科技创新专项资金项目(18-E-31)

The correlation between different fat distribution indices and dyslipidemia in middle-aged population in Shanghai

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  • 1. Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    2. Songnan Community Health Service Center, Baoshan District, Shanghai 200441, China

Received date: 2018-01-30

  Online published: 2019-04-25

摘要

目的: 探讨上海市淞南地区人口不同脂肪分布指标与血脂异常风险的相关性。方法: 采取整群抽样法选取上海市淞南地区40~60岁的550名社区居民进行调查,发放调查问卷收集受检者的既往病史和生活方式等信息,并对进行身高、体重、腰围、血压等体格检查以及血糖、血脂等生化指标检测,采用计算机断层扫描及FATSCAN软件测量其腹部内脏脂肪及腹部皮下脂肪面积。结果: 上海市淞南地区550名社区中年居民血脂异常的患病比例为65.1%。血脂异常者的体质量指数(body mass index, BMI)、腰臀比、腰围、皮下脂肪面积、内脏脂肪面积均显著高于血脂正常者(P<0.05)。多元Logistic回归分析显示,在校正性别、年龄、目前吸烟、目前饮酒、高中以上学历、收缩压、糖化血红蛋白和胰岛素抵抗、使用降糖药物后,腰臀比每增加一个标准差(standard deviation,SD),患高低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-c)血症的风险增加0.87倍;腰围每增加一个SD,患低高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-c)血症的风险增加0.60倍,患血脂异常的风险增加0.45倍。结论: 大多数脂肪分布指标(包括BMI、腰臀比、腰围、皮下脂肪面积、内脏脂肪面积)均与血脂异常相关,但相关程度存在差异。腰臀比增加与高LDL-c血症风险间相关性最大,腰围增加与低HDL-c血症以及血脂异常风险间相关性最大。

本文引用格式

王姗姗, 周莹霞, 胡利娟, 牛静雅, 王天歌, 李勉, 赵志云, 徐瑜, 陆洁莉, 徐敏, 毕宇芳, 倪衡如 . 上海中年人群不同脂肪分布指标与血脂异常的相关性流行病学研究[J]. 诊断学理论与实践, 2019 , 18(2) : 177 -182 . DOI: 10.16150/j.1671-2870.2019.02.011

Abstract

Objective: To investigate the correlation between different fat distribution indices and dyslipidemia in community residents of Songnan District in Shanghai. Methods: A survey was conducted among 550 community residents in Songnan District, Shanghai. Questionnaires was used to collect information on health status, medical history, and lifestyle. Subjects received physical examinations for height, body weight, waist circumference, and blood pressure measurement. Venous blood sample was collected after an overnight fast and blood lipids and glucose were tested. CT and FATSCAN software were used to measure abdominal visceral fat area and subcutaneous fat area. Results: The proportion of dyslipidemia among 550 community residents in Songnan District was 65.1%. Measures of fat distribution indices such as body-mass index (BMI), waist-hip ratio, waist circumference, visceral fat area, subcutaneous fat area in individuals with dyslipidemia were significantly higher than individuals with normal blood lipids (P<0.05). Multivariable logistic regression analysis showed that after adjustment for sex, age, current smoking, current drinking, educational attainment, systolic pressure, HbA1c, blood glucose-lowering treatment and insulin resistance, one-SD increase in waist-hip ratio was associa-ted with 87% increase in risks of having high LDL-cholesterol; one-SD increase in waist circumference was associated with 60% increase in risks of having low HDL-cholesterol and 45% increase in risks of having dyslipidemia. Conclusions: Most indicators of fat distribution such as BMI, waist-hip ratio, waist circumference, visceral fat area, and subcutaneous fat area are correlated with dyslipidemia, however, the degree of correlation is different. Waist-hip ratio might be more important in the association with high LDL-cholesterol. Waist circumference might be more important in the association with low HDL-cholesterol and dyslipidemia.

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