体检人群性别和血胆红素与心血管危险因素的关系

Influence of gender on the association between total bilirubin and cardiovascular risk factors in health checkup population

关键词:  血胆红素  心血管危险因素  体检

Key words:  total bilirubin  cardiovascular risk factors  health checkup

摘要:

目的　探讨不同性别体检人群血胆红素与心血管危险因素之间的关系。方法　采用横断面研究检测2458例常规体检者的身高、体重、血压、血胆红素、血糖、血脂和尿酸指标，同时行血管脉搏波（baPWV）测定。分别根据男女性血胆红素水平的四分位数，将人群分为4组（Q1、Q2、Q3和Q4组）。不同分组心血管危险因素水平的比较采用ANOVA检验和χ²检验。Spearman相关分析不同血胆红素水平与心血管危险因素的关系。采用Logistic回归模型进行多因素分析。结果　男性和女性甘油三酯均随血胆红素水平增高而降低（P＜0.05）；高密度脂蛋白-胆固醇随血胆红素水平增高而增高（P＜0.05）。女性BMI随血胆红素增高而显著降低（P＜0.05）。男性高TG、低HDL-C及血脂异常的检出率随胆红素增高而降低；女性低HDL-C、血脂异常和超重的检出率随胆红素增高而降低，差异有统计学意义（P＜0.05）。相关分析显示女性FPG、TC、TG、LDL-C和BMI均与胆红素水平显著负相关，HDL-C与胆红素显著正相关。男性仅TG与胆红素显著负相关，其它各因素未见明显相关性。Logistic回归分析结果显示，女性高血压和低HDL-C是高胆红素的危险因素。结论　女性体检者中血胆红素与心血管危险因素密切相关，可为心血管疾病治疗和预防提供参考。

Abstract:

Health Management Center, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China；DObjective To determine the influence of gender on the relationship between serum total bilirubin (TB) and cardiovascular risk factors. Methods In this cross-sectional study, 2458 healthy people for regular checkup were enrolled. Routine laboratory tests such as height, weight, total bilirubin, blood pressure, fasting blood glucose, blood lipid and uric acid, and branchial-ankle pluse wave velocity (baPWV) were conducted in fasting state. The individuals were divided into four groups (Q1, Q2, Q3 and Q4 group) according to the gender-specific quartiles of total bilirubin. The cardiovascular risk factor levels were compared using ANOVA test and χ²test . The relationships between the total bilirubin and the cardiovascular risk factors were assessed by Spearman’s correlation coefficients. Logistic regression was used for multifactor analysis. Results In both male and female, triglyceride levels decreased in association with increased serum total bilirubin levels (P＜0.05), high density lipoprotein cholesterol increased in association with increased serum total bilirubin levels (P＜0.05). Moreover, in female, BMI was also decreased in association with increased serum total bilirubin (P＜0.05). In male, the prevalence of high triglyceride, low high-density lipoprotein cholesterol, and dyslipidmia were decreased in association with increased serum total bilirubin levels. However, in female, the prevalence of low high-density lipoprotein cholesterol, dyslipidmia and overweight were decreased. Spearman’s correlation coefficients for the relationship between serum total bilirubin and fasting blood glucose, total cholesterol, triglycerides, low high-density lipoprotein cholesterol and BMI were significant in female, but only for triglycerides in male. In female, high blood pressure and low high-density lipoprotein cholesterol were independent risk factors of high bilirubin. Conclusions Total bilirubin is closely related to the cardiovascular risk factors in female. It also can provide reference for the treatment and prevention of cardiovascular disease.epartment of Ultrasound, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China