袁宁，黄晓波，刘雅，欧阳凌云，张廷杰，陈祥吉

冠心病研究

中老年人群高甘油三酯血症-腰围表型与心血管危险因素聚集关系探讨

袁宁，黄晓波，刘雅，欧阳凌云，张廷杰，陈祥吉

目的：探讨40～79岁中老年人群高甘油三酯（TG）血症-腰围（HTWC）表型与心血管危险因素聚集的关系。

方法: 利用2013年成都市4个社区横断面流行病学调查的1 004例40～79岁中老年人群数据，将HTWC定义为TG≥2.0 mmol/L，男性腰围≥90 cm，女性腰围≥85 cm。分为（1）TG和腰围正常组（492例）即血TG＜2.0 mmol/L，男性腰围＜90 cm，女性腰围＜85 cm；（2）单纯腹型肥胖组（301例）即血TG＜2.0 mmol/L，男性腰围≥90 cm，女性腰围≥85 cm；（3）单纯高TG组（79例）即血TG≥2.0 mmol/L，男性腰围＜90 cm，女性腰围＜85 cm；（4）HTWC组（132例）即血TG≥2.0 mmol/L，男性腰围≥90 cm，女性腰围≥85 cm，共4组。分析该人群HTWC检出率及其与心血管危险因素聚集的相关性。

结果：40～79岁中老年人群HTWC表型的检出率为13.15%（男性12.69%，女性13.37%），40～79岁人群中HTWC组心血管危险因素聚集检出率为41.67%，而TG和腰围正常组心血管危险因素聚集检出率为13.21%。多因素Logistic逐步回归分析显示，经校正年龄、性别、体重指数、吸烟史、糖尿病家族史及高血压家族史后，HTWC组发生心血管危险因素聚集的检出率仍为TG和腰围正常组的4.50倍（比值比：4.50，95%可信区间： 2.84～7.12，P＜0.05）。

结论：中老年人群HTWC与心血管危险因素聚集密切相关，可作为筛查心血管危险因素聚集的指标。

高甘油三酯血症；流行病学；腰围；危险因素

Objective: To explore the relationship between hypertriglyceridemic-waist (HTWC) phenotype and clustering of cardiovascular risk factors in middle and aged population.

Methods: A community-based cross-sectional survey was conducted in 5 communities of Chengdu city from 2013-10 to 2014-05 and 1004 subjects from (40-79) years of age were investigated. HTWC was defined by TG≥2.0 mmol/L and waist circumference≥90 cm in male, ≥85 cm in female. The subjects were divided into 4 groups:①Normal group, the subjects with TG＜2.0 mmol/L, waist circumference＜90 cm in male, ＜85 cm in female, n=492, ②Simple abdominal obesity group, TG＜2.0 mmol/L, waist circumference≥90 cm in male, ≥85 cm in female, n=301,③ Simple hipertrigliceridemia group, TG≥2.0 mmol/L, waist circumference＜90 cm in male, ＜85 cm in female, n=79 and④ HTWC group, n=132. The detection rate of HTWC and its correlation with clustering of cardiovascular risk factors were analyzed.

Results: The prevalence of HTWC phenotype was 13.15% (12.69% in male and 13.37% in female). In HTWC group, the detection rate of clustering of cardiovascular risk factors was 41.67% (13.21% in both Simple abdominal obesity group and Simple hipertrigliceridemia group). Multi Logistic regression analysis indicated that with adjusted age, gender, body mass index, smoking history and family history of diabetes and hypertension, the detection rate of clustering of cardiovascular risk factors in HTWC group was 4.50 folds of Simple abdominal obesity group and Simple hipertrigliceridemia group (OR=4.50, 95% CI 2.84-7.12, P＜0.05).

Conclusion: HTWC phenotype was closely related to clustering of cardiovascular risk factors, it could be used as an indicator for screening clustering of cardiovascular risk factors in middle and aged population.

(Chinese Circulation Journal, 2016,31:1079.)

当今中国高血压、糖尿病、高脂血症等心血管病危险因素流行趋势呈明显上升态势，导致了心血管病的发病人数持续增加，心血管病患病人数快速增长，进而威胁患者生命[1]。尽早发现心血管危险因素聚集的个体并全面干预心血管危险因素对人群心血管疾病的预防有着重要意义。……