老年血脂紊乱与代谢综合征及心、脑血管事件相关性研究

目的 调查老年人群的血脂紊乱状况及与代谢综合征(MS)其他组分间的相互关系,并探讨这些异常状态对心、脑血管病变的影响.方法 对1996～2005年连续在解放军总医院门诊查体的2 547例老年人群的资料进行回顾性分析,并对不同类型血脂异常与糖代谢异常、高血压和肥胖的伴存状况,及对心脑血管病变发生的影响进行比较.结果 本组老年人群中血脂紊乱的MS患病率为69.6%,其中合并单纯高胆固醇(HTC)者占23.6%(602例),单纯高甘油三酯(HTG)者占21.7%(552例),HTG伴低高密度脂蛋白胆固醇(HTG-LHDL)者占5.03%(128例),HTC伴HTG(混合组)者占19.3%(491例);血脂正常者仅占30.4%.合计有HTG者46.0%(1 171例),略多于HTC者(1 093例).单纯HTG组及混合型组2型糖尿病(T2DM)和肥胖患病率较高.本组人群中的高血压患病率高达66.2%,其中HTG者的高血压患病率最高,达70.8%,与血脂正常者比较差异显著(P＜0.01).各型血脂异常合并糖代谢异常、肥胖、高血压均增加了心、脑血管病的患病率,HTC合并高血压和糖尿病增加心了血管病变患病率,HTG合并任一项异常均增加心脑血管病变患病率.结论 本组老年人群中约2/3存在血脂紊乱,MS其他组分的患病率也较高,是心脑血管病变的高危人群.其中HTG较HTC对心脑血管病变影响更大,需在今后的防治中给予关注.

Studies on the correlation of senile blood lipid abnormity and metabolic syndrome with cardiac and cerebrovascular events

Objective To investigate the correlation of blood lipid metabolism abnormity and other components of metabolic syndrome on angiocardiopathy and cerebrovascular diseases in the elderly people. Methods The clinical data of elderly people, who underwent medical examination during 1996 to 2005 in the General Hospital of PLA, were retrospectively analyzed. Based on the analysis, the co-existence of blood lipid disorders with glucose metabolic abnormity, hypertension and obesity, as well as their influence on cardio-cerebrovascular diseases were further analyzed. Results The prevalence of blood lipid metabolic disturbance was 69.6%, in which the prevalence of hyper-cholesteremia and hyper-triglyceride were 23.6% and 21.7%, respectively. The prevalence of hyper-cholesteremia accompanied by hyper-triglyceride (mixed group) was 19.3%, that of hyper-triglyceride with lower high density lipoprotein cholesterol was 5.03%, while it was 30.4% in the normal group. There was a higher risk of having the above abnormal condition in patients with type 2 diabetes mellitus (T2DM) and obesity, and they were more frequently complicated by hypertension in the hyper-triglyceride group (70.8%). When the patients with lipid metabolic disturbance were complicated by T2DM, hypertension and obesity, the prevalence of cardiovascular or cerebrovascular diseases increased. The prevalence of CHD was higher in the patients with hyper-cholesteremia and hypertension or diabetes, and incidence of both CHD and CVD was higher in the patients with hyper-triglyceride and either one of hypertension, diabetes or obesity. Conclusion There is high prevalence of lipid metabolic disturbance (more than two thirds) and other components of metabolic syndrome, and high risk of suffering from cardiovascular or cerebrovascular diseases in elderly people. The aging patients with hyper-triglyceride are vulnerable to cardiovascular or cerebrovascular diseases, and more attention should be paid in clinical practice in future.