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基于 32 个健康检查中心的横断面研究:血脂水平与中国女性高血压患病率的相关性。

Association of Lipid Levels With the Prevalence of Hypertension in Chinese Women: A Cross-Sectional Study Based on 32 Health Check Centers.

机构信息

Department of Cardiovascular Medicine, The Third Hospital of Nanchang, Nanchang, China.

Department of Gastrointestinal Endoscopy, The Third Hospital of Nanchang, Nanchang, China.

出版信息

Front Endocrinol (Lausanne). 2022 Jul 7;13:904237. doi: 10.3389/fendo.2022.904237. eCollection 2022.

Abstract

BACKGROUND

Dyslipidemia is strongly associated with the development of hypertension. In our previous study, it was shown that elevated TC, LDL-c, and non-HDL-c were associated with the prevalence of hypertension in Chinese men, whereas the relationship between HDL-c and hypertension shifted from no association to a positive association after adjusting for the BMI. To further accumulate epidemiological evidence in Asian women, this study aimed to investigate the relationship between lipid profile and prevalence of hypertension in Chinese adult women.

METHODS

This is a cross-sectional study including 54,099 Chinese women aged>20 years at 32 health screening centers in 11 cities from 2010-2016. The original data were obtained from DATADRYAD database (www.datadryad.org). Besides, the overall women were classified into non-hypertensive and hypertensive groups based on baseline blood pressure levels. Differences between the two groups were examined by Man-Whitney test or Chi-square test. Spearman's correlation coefficient was employed to evaluate the correlation between systolic blood pressure (SBP), diastolic blood pressure (DBP) and lipid profiles. Multivariate logistic regression was performed to estimate the relationship between different lipid levels and the prevalence of hypertension. Odds ratios (ORs) and 95% confidence intervals (CIs) indicated the risk of lipid and hypertension. Bayesian model (BN) model was constructed to further assess the relationship between baseline characteristics and the prevalence of hypertension, as well as the importance of each variable for the prevalence of hypertension.

RESULTS

Compared to the non-hypertensive population, the hypertensive population was older, and had the higher body mass index (BMI), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), serum creatinine (Scr), fasting blood glucose (FPG), blood urea nitrogen (BUN), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and non-high-density lipoprotein cholesterol (non-HDL-c), but HDL-c and the presence concerning the family history of diabetes were lower. Multivariate logistic regression analysis revealed that TC, LDL-c, and non-HDL-c showed a positive trend with hypertension risk ( for trend < 0.05) whereas TC and HDL-c were not significantly associated with hypertension prevalence. Moreover, each 1 mg/dl increase in TC, LDL, and non-HDL hypertension prevalence increased by 0.2% [1.002 (1.000-1.003)], 0.2% [1.002 (1.000-1.004)], and 0.2% [1.002(1.001-1.004)], respectively. BN suggested that the importance of age, BMI, FPG, non-HDL-c on the prevalence of hypertension was 52.73%, 24.98%, 11.22%, and 2.34%, respectively.

CONCLUSION

Overall, in Chinese adult women, TC, LDL-c and non-HDL-c levels were higher and HDL-c level was lower in the hypertensive population, whereas TG did not differ significantly from the non-hypertensive population. Meanwhile, TC, LDL-c, and non-HDL-c were positively associated with prevalence of hypertension, and HDL-c was negatively associated with prevalence of hypertension but became nonsignificant after full adjustment for variables. Moreover, BN model suggested that age, BMI, FPG, and non-HDL-c had a greater effect on the development of hypertension.

摘要

背景

血脂异常与高血压的发生密切相关。在我们之前的研究中,已经表明在中国男性中,TC、LDL-c 和非 HDL-c 的升高与高血压的患病率有关,而 HDL-c 与高血压之间的关系在调整 BMI 后,从没有关联转变为正相关。为了进一步积累亚洲女性的流行病学证据,本研究旨在探讨中国成年女性血脂谱与高血压患病率之间的关系。

方法

这是一项横断面研究,纳入了 2010 年至 2016 年间来自 11 个城市的 32 个健康筛查中心的 54099 名年龄大于 20 岁的中国女性。原始数据来自于 DATADRYAD 数据库(www.datadryad.org)。此外,根据基线血压水平,将所有女性分为非高血压组和高血压组。两组间的差异采用曼-惠特尼检验或卡方检验进行检验。Spearman 相关系数用于评估收缩压(SBP)、舒张压(DBP)和血脂谱之间的相关性。采用多变量 logistic 回归模型来估计不同血脂水平与高血压患病率之间的关系。比值比(ORs)和 95%置信区间(CIs)用于表示血脂和高血压的风险。贝叶斯模型(BN)用于进一步评估基线特征与高血压患病率之间的关系,以及每个变量对高血压患病率的重要性。

结果

与非高血压人群相比,高血压人群年龄较大,体重指数(BMI)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-c)、血清肌酐(Scr)、空腹血糖(FPG)、血尿素氮(BUN)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)和非高密度脂蛋白胆固醇(non-HDL-c)较高,而高密度脂蛋白胆固醇(HDL-c)和糖尿病家族史的存在则较低。多变量 logistic 回归分析显示,TC、LDL-c 和 non-HDL-c 与高血压风险呈正相关(趋势检验<0.05),而 TC 和 HDL-c 与高血压患病率无显著相关性。此外,TC、LDL 和 non-HDL 每增加 1mg/dl,高血压患病率分别增加 0.2%[1.002(1.000-1.003)]、0.2%[1.002(1.000-1.004)]和 0.2%[1.002(1.001-1.004)]。BN 提示年龄、BMI、FPG 和 non-HDL-c 对高血压患病率的重要性分别为 52.73%、24.98%、11.22%和 2.34%。

结论

总的来说,在中国成年女性中,高血压人群的 TC、LDL-c 和 non-HDL-c 水平较高,HDL-c 水平较低,而 TG 与非高血压人群无显著差异。同时,TC、LDL-c 和 non-HDL-c 与高血压患病率呈正相关,而 HDL-c 与高血压患病率呈负相关,但在充分调整变量后变得无统计学意义。此外,BN 模型提示年龄、BMI、FPG 和 non-HDL-c 对高血压的发生有更大的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cbf/9300912/5ff5605fd7c0/fendo-13-904237-g001.jpg

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