甘孜县藏族成年人群脂代谢指标参考区间及血脂异常分析

目的初步调查甘孜县藏族成年人血脂代谢指标的参考区间及该人群血脂异常情况。方法采集甘孜县661名健康体检者血清,测定总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)和载脂蛋白B(ApoB)水平。依据美国临床实验室标准化协会(CLSI)C28-A3文件及国际临床化学和检验医学联合会(IFCC)的相关要求制定的参考区间的合理方法和可靠依据,建立上述脂代谢指标的参考区间。参照2007年《中国成人血脂异常防治指南》,分析该人群中的血脂异常情况。结果该人群中,男性血清中TG、LDL-C和ApoB较女性高,而HDL-C、ApoA1较女性低,差异均具有统计学意义(P0.05)。TC、LDL-C和TG水平随年龄变化趋势明显,HDL-C、ApoA1和ApoB水平随年龄变化不明显。该人群中,TC、LDL-C和ApoB参考区间分别为2.75~6.82、1.36~4.3、0.24~1.38 mmol/L;男性人群中TG、HDL-C和ApoA1参考区间分别为0.5~2.36、0.9~1.93、0.82~1.87mmol/L;女性人群中TG、HDL-C和ApoA1参考区间分别为0.47~3.19、0.96~2.19、0.94~2.02mmol/L。该区藏族成人血脂紊乱异常发生率高,高胆固醇血症、高三酰甘油血症、混合型高脂血症和低高密度脂蛋白血症发生率分别为32.07%、21.18%、12.86%和6.51%。结论初步建立了甘孜县藏族成人血脂代谢指标的参考区间,分析了该人群高脂血症临床分型的发生率,为甘孜地区藏族人群高脂血症患者的临床干预治疗提供了参考数据,有助于指导该地区血脂异常防治工作的开展。

The analysis of the reference intervals of lipid metabolism indexes and dyslipidaemia among the adults of Tibetan in Ganzi County

Objective To investigate the reference intervals of lipid metabolism indexes and dyslipidaemia situation among the a-dult of Tibetan in Ganzi County .Methods The serum samples were collected from 661 healthy subjects in Ganzi county ,total cho-lesterol(TC) ,triglyceride(TG) ,high density lipoprotein cholesterol(HDL-C) ,low density lipoprotein cholesterol(LDL-C) ,apoli-poprotein A1(ApoA1) and apolipoprotein B(ApoB) levels were measured .According to the American Society for Clinical Laborato-ry Standards(CLSI) C28-A3 documentation and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) guidelines for establishing of reference interval with reasonable method and reliable basis ,the interval value of this lipid metabolism indexes were calculated .The dyslipidemia situation was analyzed based on "The Guideline of Prevention and Treatment of Dyslipi-demia in Chinese Adults in 2007".Results In these population ,TG ,LDL-C and ApoB in the serum of male were higher than those of female ,while HDL-C and ApoA1 were lower than those of female ,the difference was statistically significant (P<0 .05) .TC , LDL-C and TG level had a change tendency with ages obviously ,while the changes of HDL-C ,ApoA1 and ApoB metabolism level were not inconspicuous .In this population ,TC ,LDL and ApoB reference intervals were 2 .75 -6 .82 mmol/L ,1 .36 -4 .3 mmol/L and 0 .24-1 .38 mmol/L respectively .The reference interval of TG ,LDL-C and ApoA1 in male population were 0 .5-2 .36 mmol/L ,0 .9-1 .93 mmol/L and 0 .82-1 .87 mmol/L respectively ,meanwhile ,the reference range of TG ,HDL-C and ApoA1 in female population were 0 .47-3 .19 mmol/L ,0 .96-2 .19 mmol/L and 0 .94-2 .02 mmol/L respectively .The incidence of dyslipidemia in Tibetan adults was high ,the incidence of hypercholesterolemia ,hypertriglyceridemia ,mixed hyperlipidemia and low high-density lip-oprotein were 32 .07% ,21 .18% ,12 .86% and 6 .51% respectively .Conclusion In this research ,we established the reference inter-val of blood lipid metabolism indexes of Tibetan adults in Ganzi county and analyzed the incidence of hyperlipidemia in this popula-tion initially .This results provide reference data for clinical intervention treatment of patients with hyperlipidemia in Tibetan popu-lation in Ganzi area ,which is helpful for guiding the prevention and treatment of dyslipidemia in this region .