儿童青少年外周总胆红素分布及其与血脂异常的关系

目的 为探索儿童青少年外周总胆红素（total bilirubin，TBIL）分布特点及其与血脂异常的关系。方法 采用普查方法调查宜兴市7所中小学的学生，3 787名资料完整对象被纳入分析。采用成组t检验分析男女TBIL的差异，方差分析比较不同年龄组TBIL水平。单因素和多因素Logistic回归分析TBIL与血脂异常的风险。结果 6~16岁男生和女生TBIL均随年龄的增加而上升（均有P_趋势<0.05），在7~岁、8~岁和10~岁年龄组，女生TBIL较男生偏高（均有P<0.05）。男生和女生TBIL与高密度脂蛋白正相关（均有P<0.001），与甘油三酯负相关（均有P<0.001）；女生中TBIL水平与总胆固醇和低密度脂蛋白正相关（均有P<0.001）；校正年龄、性别和体质指数后，与最低四分位数的TBIL对象（Q1）相比，Q2（OR=0.690，95%CI:0.568~0.739，P<0.001）、Q3（OR=0.575，95%CI:0.471~0.701，P<0.001）、Q4（OR=0.552，95%CI:0.451~0.676，P<0.001）的对象血脂异常风险降低。结论 儿童青少年TBIL随年龄的增加上升，高年龄组男生高于女生，高水平的TBIL可以降低血脂异常风险。

Serum total bilirubin distribution and its relation to dyslipidemia in children and adolescents

Objective To investigate serum total bilirubin(TBIL) distribution and its relation to dyslipidemia among children and adolescents. Methods A cross-sectional survey was performed among students from seven schools in Yixing City and 3 787 subjects who completed physical examination and blood biochemistry test after signing informed consent were included in the final analysis. Independent sample t test was performed to compare the differences of TBIL between male and female in different age groups. One-way ANOVA was performed to compare TBIL level among age group. Univariate and multiple logistic regression were applied to evaluate the risk of dyslipidemia according to TBIL level. Results The TBIL level increased with age continuously in 6-16 group both in male and female(all P_trend<0.05). The TBIL level of male were significantly lower than female in 7-, 8- and 10- age groups (all P<0.05). TBIL was positively correlated with high density lipoprotein and negatively correlated with triglyceride both in male and female (all P<0.001). TBIL was positively correlated with total cholesterol and low-density lipoprotein in female (all P<0.001). Compared with the lowest quartile TBIL subjects(Q1), the subjects in Q2(OR=0.690,95% CI:0.568-0.739,P<0.001),Q3(OR=0.575,95% CI:0.471-0.701,P<0.001),Q4(OR=0.552,95% CI:0.451-0.676,P<0.001) group were in lower risk of dyslipidemia after adjustment for age, sex and body mass index. Conclusions The serum TBIL ascended with age in children and adolescents, TBIL level of male was higher than female in old age group. High TBIL level could reduce the risk of dyslipidemia.