摘要
目的分析血LDL-C水平升高伴或不伴代谢综合征（MS）对中国成人卒中发病的影响。方法将2002年中国居民营养与健康状况调查中42626例25—75岁成人，根据LDL—C水平分为〈2．00mmol／L组、2．00-2．50mmol／L组、2．51—3．31mmol／L组、≥3．32mmol／L组。MS采用2005年国际糖尿病联盟的诊断定义。比较各组MS和卒中的患病率，以及伴或不伴MS时致卒中危险性。结果（1）MS和卒中的患病率均随LDL—C水平升高而增加。与LDL-C〈2．00mmol／L组相比，LDL—C≥3．32mmol／L组MS和卒中的患病率分别增加了2．5倍（7．9％比20．1％）和4．2倍（0．5％比2．1％），P值均〈0．01。（2）在同一LDL—c水平组，卒中患病率均为伴MS亚组高于不伴MS亚组，P值均〈0．01。（3）logistic回归分析调整年龄、性别、吸烟后显示，LDL-C、MS与卒中发生正相关，致卒中的相对危险度（OR值）分别为2．35和3．15，P值均〈0．0001。（4）与LDL—C〈2．00mmol／L不伴MS亚组相比，LDL—C2．00～2．50、2．51～3．31和≥3．32mmol／L不伴MS各亚组发生卒中的OR值分别为1．03、1．89和2．08。LDL—C水平相似的伴MS亚组与不伴MS亚组相比，致卒中危险增加约3—4倍（OR值分别为4．38、5．23和6．15），P值均〈0．0001。结论LDL—C水平升高和MS均为卒中发生的独立危险因素，当二者并存时这种危险将进一步增加。对二者同时进行干预治疗对防治卒中十分重要。
Objective To investigate the impact of high plasma LDL-C level with or without metabolic syndrome（MS） on the incidence of stroke in Chinese adults. Methods Totally 42 626 subjects （25 -75 years old） from Chinese National Health and Nutrition Survey in 2002 were stratified four groups based on plasma LDL-C level： 〈2. 00 mmol/L group, 2. 00 -2. 50 mmol/L group, 2.51 -3.31 mmol/L group, and t〉 3.32 mmol/L group. The prevalence of MS （with 2005 International Diabetes Federation criteria） and stroke and the risk factors of stroke were compared among the four groups. Results （ 1 ） The prevalence of MS and stroke increased with rising of LDL-C level. The prevalence of MS in LDL-C≥3.32 mmol/L group increased ：2. 5 times （ 7.9% vs 20. 1% ） as compared with that in LDL-C 〈 2. 00 mmol/L group and the prevalence of stroke increased 4. ：2 times（0. 5% vs ：2. 1% ）, all P 〈0. 01. （2） In subjects with similar LDL-C level, the prevalence of stroke was significantly higher in a subgroup with MS than that without （P 〈0. 01 ）. （3） After adjustment for age, sex and smoking, logistic regression analysis showed that both LDL-C level and MS were positively associated with the development of stroke; the odds ratio （OR） was 2. 35 and 3.15 （ P 〈 0. 0001 ）, respectively. （4） Compared with the subgroup of LDL-C 〈 2. 00 mmol/L without MS, OR for stroke in the subgroups of LDL-C 2. 00 -2. 50 mmol/L, 2. 51 -3.31mmol/L, and I〉 3.32 mmol / L without MS was 1.03, 1.89, and 2. 08, whereas the OR for stroke in the subgroups with MS and similar level of LDL-C was 4. 38, 5.23 and 6. 15 ; this indicated that the risk of stroke in subjects with MS increased by 3 - 4 times compared with subjects without （ P 〈 0. 0001 ）. Conclusion Both high LDL-C level and MS are independent risk factors of stroke, but the risk of stroke will he further increased in the presence of high LDL-C level plus MS. It is suggested that combined intervention therapy of LDL-C and MS will play an important role in the prevention of stroke.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2009年第5期388-391,共4页
Chinese Journal of Internal Medicine
关键词
胆固醇
LDL
代谢综合征X
脑血管意外
Cholesterol, LDL
Metabolic syndrome X
Cerebrovascular accident
