目的探讨不同糖代谢状态、性别、年龄、体质量指数(BMI)、血压与血脂水平的关系。方法对山东省40岁以上城市社区中老年人10 028名行横断面调查,收集人口学资料,同时行口服葡萄糖耐量试验,测定空腹总胆固醇(Cho)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和甘油三酯(TG)。结果山东省40岁以上城市社区中老年人血清Cho、LDL-C、HDL-C、TG平均水平分别为(5.35±1.05)mmol/L、(3.18±0.86)mmol/L、(1.51±0.38)mmol/L、1.34 mmol/L。女性血清Cho、LDL-C、HDL-C、TG平均水平均高于男性,其中Cho、LDL-C、HDL-C差异有统计学意义(P〈0.001)。血清Cho、LDL-C、TG平均水平随血压升高而升高(P=0.005,P=0.012,P=0.043),血清HDL-C平均水平随血压升高而降低(P=0.002)。血清Cho、LDL-C、TG平均水平随体质量指数增加而升高(P=0.013,P=0.023,P=0.007),血清HDL-C平均水平随体质量指数增加而降低(P=0.010)。糖耐量正常人群、糖尿病前期[空腹血糖受损(IFG)、糖耐量减低(IGT)及空腹血糖受损并糖耐量减低]人群、糖尿病人群血清Cho、LDL-C平均水平先升高后降低(P〈0.001),血清HDL-C平均水平逐渐降低(P=0.007),TG平均水平逐渐升高(P〈0.001)。血清Cho边缘升高(5.18~6.21 mmol/L)和升高(≥6.22 mmol/L)的人群分别为36.92%、19.10%;LDL-C边缘升高(3.37~4.13 mmol/L)和升高(≥4.14 mmol/L)人群分别为25.24%、13.39%;TG边缘升高(1.70~2.25 mmol/L)和升高(≥2.26 mmol/L)人群分别为16.70%、17.47%;HDL-C降低(≤1.04 mmol/L)的人群为5.64%。结论山东省城市中老年人群血清总胆固醇和低密度脂蛋白胆固醇水平升高。性别、年龄、BMI、血压、糖代谢状态均可影响血脂水平。如不采取有效的预防和控制措施,中国心脑血管疾病的发病率仍将持续升高。
Objective To explore the relationship between age, gender, BMI, blood pressure, status of glucose metab- olism and serum lipids and lipoproteins among the middle-aged and elderly Chinese men and women in Shandong Prov- ince. Methods A cross-sectional study was conducted in Shandong Province among 10,028 adults aged ≥40 years. Demographic data were collected and oral glucose tolerance test was performed. Fasting serum total (Cho), low-density lipoprotein cholesterol ,( LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) were meas- ured by standard methods. Results The estimates of serum Cho, LDL-C, HDL-C and TG were (5.35 ± 1.05 ) mmol/L, ( 3.18 ± 0.86) mmol/L, ( 1.51 ± 0.38 ) mmol/L and 1.34 mmoL/L, respectively. The estimates of serum Cho, LDL-C, HDL-C and TG in female were higher than those in male, and differences in Cho, LDL-C and HDL-C were statistically significant ( P 〈0. 001 ). The levels of serum Cho, LDL-C and TG increased ( P =0.005, P =0.012, P = 0. 043 ), while the level of serum HDL-C decreased ( P = 0. 002 ) with the elevation of blood pressure. The levels of serum Cho, LDL-C and TG increased (P =0. 013, P =0. 023, P =0.007), while the level of serum HDL-C decreased with the increase of BMI ( P = 0.010 ). The levels of serum Cho, LDL-C between normal glucose tolerance population, pre-diabetes [ impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and IFG accompany with IGT] popu- lation and diabetic population increased ftrst and then decreased ( P 〈 0.001 ), the level of serum HDL-C decreased gradually (P =0.007), and the level of TG increased gradually (P 〈0.001 ). Up to 36.92% and 19.10% adults had borderline high total cho (5.18-6.21 mmol/L) and high total cho (≥6.22 mmol/L) ; 25.24% and 13.39% popula- tion had borderline high (3.37-4.13 mmol/L) and high ( ≥4.14 mmol/L) HDL-C; 16.70% and 17.47% of the population had borderline high (1.70-2.25 mmol/L) and hig