中国全科医学 ›› 2023, Vol. 26 ›› Issue (28): 3520-3525.DOI: 10.12114/j.issn.1007-9572.2022.0808

• 论著·中老年人群健康研究 • 上一篇    下一篇

社区老年居民血脂异常患病率及其影响因素研究

黄绮娴1, 温燕婷2, 黄俊3, 李伟彬1, 徐永能3, 林夏仪3, 王皓翔1, 翁帆2,*(), 杨廉平1,*()   

  1. 1.510080 广东省广州市,中山大学公共卫生学院
    2.510055 广东省广州市越秀区疾病预防控制中心
    3.510080 广东省广州市,广东省人民医院(广东省医学科学院)广东省老年医学研究所老年医学科
  • 收稿日期:2022-11-21 修回日期:2023-04-13 出版日期:2023-10-05 发布日期:2023-05-24
  • 通讯作者: 翁帆, 杨廉平

  • 作者贡献:王皓翔、翁帆、杨廉平进行文章的构思与设计;黄绮娴、李伟彬、王皓翔、杨廉平进行研究的可行性分析;温燕婷、黄俊、徐永能、林夏仪、翁帆进行数据收集;黄绮娴负责数据整理、统计学分析、论文撰写;黄绮娴、杨廉平进行结果分析与解释,论文修订,对文章整体负责、监督管理;王皓翔、杨廉平负责文章的质量控制及审校。
  • 基金资助:
    国家自然科学基金-组织间国际合作研究项目(72061137002)

Prevalence of Dyslipidemia and Its Influencing Factors among Elderly Community Residents

HUANG Qixian1, WEN Yanting2, HUANG Jun3, LI Weibin1, XU Yongneng3, LIN Xiayi3, WANG Haoxiang1, WENG Fan2,*(), YANG Lianping1,*()   

  1. 1. School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
    2. Yuexiu District Center for Disease Control and Prevention, Guangzhou 510055, China
    3. Department of Geriatrics, Guangdong Institute of Geriatrics, Guangdong People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China
  • Received:2022-11-21 Revised:2023-04-13 Published:2023-10-05 Online:2023-05-24
  • Contact: WENG Fan, YANG Lianping

摘要: 背景 血脂异常是动脉粥样硬化性心血管疾病最重要且有因果关系的独立危险因素。广东省老年居民血脂异常患病率较高,亟须分析老年人血脂异常的具体患病情况及影响因素,针对性地对血脂异常进行预防和控制。 目的 调查广州市越秀区纳入国家基本公共卫生服务的老年居民血脂异常的流行病学现况及其危险因素。 方法 选取2020年广州市越秀区社区卫生服务中心信息系统中重要变量完整的41 469名≥65岁老年居民为研究对象,利用2020年健康体检数据描述患者的基本情况、BMI和血脂水平等流行病学特征,运用限制性立方样条(RCS)拟合Logistic回归模型分析年龄、BMI与血脂异常患病的变化关系。 结果 41 469名老年居民的血脂异常患病率为53.65%(22 247/41 469),标化患病率为53.89%。其中,高胆固醇血症的患病率为21.43%(8 887/41 469),标化患病率为21.57%;高三酰甘油血症的患病率为16.50%(6 843/41 469),标化患病率为16.53%;混合型高脂血症的患病率为14.51%(6 017/41 469),标化患病率为14.61%;低高密度脂蛋白胆固醇血症的患病率为3.80%(1 577/41 469),标化患病率为3.78%。多因素Logistic回归分析结果显示,性别、年龄、受教育程度、BMI、锻炼情况均是老年居民血脂异常的影响因素(P<0.05),其中,女性、低龄和高BMI为老年居民血脂异常的危险因素(P<0.05)。RCS拟合结果显示,老年居民的年龄、BMI与血脂异常患病呈非线性关系;随年龄的增长,老年居民的血脂异常患病率总体呈下降趋势;随着BMI水平升高,血脂异常患病风险呈先上升后下降的趋势,低BMI下,OR显著上升,而在高BMI下,OR稍微下降。 结论 广州市越秀区纳入国家基本公共卫生服务的≥65岁老年居民血脂异常患病率较高。该老年群体中血脂异常患病率随着年龄升高而降低,随着BMI水平升高血脂异常患病风险呈先上升后下降的趋势。提示老年人的血脂异常管理存在一定的特殊性,应重点关注老年群体血脂异常的特定危险因素并进行早期预防和控制。

关键词: 血脂异常, 老年人, 流行病学, 影响因素分析, 限制性立方样条模型

Abstract:

Background

Dyslipidemia is the most important and causal independent risk factor for atherosclerotic cardiovascular disease (ASCVD) . The prevalence of dyslipidemia in elderly residents in Guangdong Province is high, and it is urgent to analyze the specific prevalence of dyslipidemia and its influencing factors among the elderly, and to carry out targeted preventive and control measures for dyslipidemia.

Objective

To investigate the epidemiological status of dyslipidemia and its risk factors among elderly residents included in the national basic public health service in Yuexiu District, Guangzhou.

Methods

A total of 41 469 elderly residents aged 65 years and above with complete important variables were selected as subjects from the information system of community health service center in Yuexiu District, Guangzhou City in 2020, the 2020 health checkup data was used to describe the epidemiological characteristics of the included patients such as basic information, BMI and blood lipid levels. Restricted cubic spline (RCS) fitting Logistic regression model was used to analyze the relationship between age, BMI and the prevalence of dyslipidemia.

Results

The prevalence of dyslipidemia in 41 469 elderly residents was 53.65% (22 247/41 469) , with a standardized prevalence of 53.89%. The prevalence of hypercholesterolemia (HTC) , hypertriglyceridemia (HTG) , mixed hyperlipidemia and low high-density lipoprotein cholesterol was 21.43%, 16.50%, 14.51% and 3.80%, with the standardized prevalence of 21.57%, 16.53%, 14.61%, 3.78%, respectively. Multivariate Logistic regression analysis showed that gender, age, education level, exercise status, and BMI were all influencing factors for dyslipidemia in elderly residents, among which female, low age group, and high BMI were risk factors for dyslipidemia in elderly residents (P<0.05) . The results of RCS fitting showed a non-linear relationship between age, BMI and the prevalence of dyslipidemia in elderly residents. The overall prevalence of dyslipidemia in elderly residents showed a decreasing trend with the increase of age. The risk of dyslipidemia showed on increasing and then decreasing trend with the increase of BMI, the OR increased significantly at low BMI, while decreased at high BMI.

Conclusion

The prevalence of dyslipidemia is relative high among elderly residents aged 65 years and above included in the national basic public health services in Yuexiu District, Guangzhou. The prevalence of dyslipidemia in the elderly group tends to decrease with the increase of age, and the risk of dyslipidemia prevalence tends to increase and then decrease with the increase of BMI, suggesting special features in the management of dyslipidemia among the elderly, the analysis of risk factors for dyslipidemia in the elderly should be focused on and early preventive and control measures should be carried out.

Key words: Dyslipidemias, Aged, Epidemiology, Root cause analysis, Restricted cubic spline