上海市社区中老年人群健康的血管衰老和心血管疾病患病风险的相关性研究

doi:10.3969/j.issn.1674-8115.2021.02.015

上海交通大学学报(医学版) ›› 2021, Vol. 41 ›› Issue (2): 223-227.doi: 10.3969/j.issn.1674-8115.2021.02.015

上海市社区中老年人群健康的血管衰老和心血管疾病患病风险的相关性研究

代华杰(), 禤立平, 项家丽, 林泓, 赵志云, 王天歌, 李勉, 徐瑜, 陆洁莉, 王卫庆, 毕宇芳, 徐敏()

上海交通大学医学院附属瑞金医院内分泌代谢病科，国家代谢性疾病临床医学研究中心，上海市内分泌代谢病研究所，上海 200025

收稿日期:2020-05-29 出版日期:2021-02-28 发布日期:2021-02-28
通讯作者: 徐敏 E-mail:huajie_dai@163.com;della.xumin@163.com
作者简介:代华杰（1994—），男，硕士生；电子信箱：huajie_dai@163.com。
基金资助:
上海市科技发展专项资金(YDZX20173100004881);上海申康医院发展中心临床科技创新项目(SHDC12016202);上海交通大学医学院高水平地方高校创新团队;上海市教育委员会高峰高原学科建设计划(20152508)

Correlation between healthy vascular aging and prevalent cardiovascular disease risk in middle-aged and elderly people in the community of Shanghai

Hua-jie DAI(), Li-ping XUAN, Jia-li XIANG, Hong LIN, Zhi-yun ZHAO, Tian-ge WANG, Mian LI, Yu XU, Jie-li LU, Wei-qing WANG, Yu-fang BI, Min XU()

Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Metabolic Diseases; Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai 200025, China

Received:2020-05-29 Online:2021-02-28 Published:2021-02-28
Contact: Min XU E-mail:huajie_dai@163.com;della.xumin@163.com
Supported by:
Shanghai Science and Technology Commission Special Funds(YDZX20173100004881);Clinical Science and Technology Innovation Project of Shanghai Shenkang Hospital Development Center(SHDC12016202);Innovative Research Team of High-Level Local Universities in Shanghai;Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support(20152508)

摘要/Abstract

摘要：

目的·研究上海市社区中老年人群健康的血管衰老（healthy vascular aging，HVA）与心血管疾病患病风险的相关性。方法·对上海市嘉定社区9 922名40岁及以上常住居民进行问卷调查、体格检查、生化指标检测及臂-踝脉搏波传导速度（brachial-ankle pulse wave velocity，baPWV）测定。根据HVA状态，将受试者分为HVA组和非HVA组。HVA定义为无高血压病史且baPWV≤15.20 m/s。心血管疾病包括脑卒中、心肌梗死和冠状动脉粥样硬化性心脏病。采用Logistic回归模型分析HVA与心血管疾病患病风险的相关性。结果·在男性和女性中，与非HVA组相比，HVA组受试者的年龄、体质量指数、收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇、空腹血糖、血肌酐、baPWV、糖尿病和血脂紊乱的患病率均较低，受教育程度（高中及以上）占比、估算的肾小球滤过率均较高（均P=0.000）。Logistic回归分析表明，校正多种混杂因素后，HVA组的心血管疾病患病风险显著低于非HVA组（OR=0.53，95%CI 0.41~0.69，P=0.000）。结论·在上海市社区40岁及以上的中老年人群中，HVA与较低的心血管疾病患病风险相关，提示其可作为心血管疾病预防的潜在指标。

关键词: 健康的血管衰老, 心血管疾病, 中老年人群

Abstract:

Objective·To study the correlation between healthy vascular aging (HVA) and prevalent cardiovascular diseases (CVDs) risk in middle-aged and elderly people in the community of Shanghai.

Methods·A total of 9 922 participants aged 40 and above who lived in a Jiading community of Shanghai were included. The questionnaire interview, physical examination, biochemical index detection and brachial-ankle pulse wave velocity (baPWV) measurement were conducted in all participants. According to HVA status, the participants were divided into HVA group and non-HVA group. HVA was defined as baPWV≤15.20 m/s with no history of hypertension. The CVDs include stroke, myocardial infarction and coronary atherosclerotic heart disease. Logistic regression model was used to analyze the correlation between HVA and prevalent CVDs risk.

Results·Compared with those in the non-HVA group, the age, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, low density lipoprotein-cholesterol, fasting blood glucose, serum creatinine, baPWV and prevalence of diabetes mellitus and lipid disorders in the HVA group were lower, and the proportion of education level (high school or above) and estimated glomerular filtration rate in the HVA group were higher in both men and women (all P=0.000). Logistic regression analysis showed that after multiple confounding factors being adjusted, prevalent CVDs risk in the HVA group was significantly lower than that in the non-HVA group (OR=0.53, 95%CI 0.41?0.69, P=0.000).

Conclusions·HVA is significantly associated with a lower risk of CVDs in middle-aged and elderly people (aged≥40) in the community of Shanghai, which suggests that HVA can be used as a potential indicator of CVDs prevention.

Key words: healthy vascular aging (HVA), cardiovascular disease (CVD), middle-aged and elderly people

中图分类号:

R543.5

代华杰, 禤立平, 项家丽, 林泓, 赵志云, 王天歌, 李勉, 徐瑜, 陆洁莉, 王卫庆, 毕宇芳, 徐敏. 上海市社区中老年人群健康的血管衰老和心血管疾病患病风险的相关性研究[J]. 上海交通大学学报(医学版), 2021, 41(2): 223-227.

Hua-jie DAI, Li-ping XUAN, Jia-li XIANG, Hong LIN, Zhi-yun ZHAO, Tian-ge WANG, Mian LI, Yu XU, Jie-li LU, Wei-qing WANG, Yu-fang BI, Min XU. Correlation between healthy vascular aging and prevalent cardiovascular disease risk in middle-aged and elderly people in the community of Shanghai[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(2): 223-227.

图/表 3

参考文献 21

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Item	Total (N=9 922)	Male			Female
Item	Total (N=9 922)	Non-HVA group (N=2 746)	HVA group (N=1 026)	P value	Non-HVA group (N=4 173)	HVA group (N=1 977)	P value
Basic information
Age/year	58.5±9.6	61.0±9.8	53.4±7.9	0.000	60.9±9.2	52.6±7.3	0.000
Education level (high school or above)^①/n(%)	2 132 (21.58)	647 (23.66)	302 (29.52)	0.000	602 (14.51)	581 (29.48)	0.000
Current smoking^①/n(%)	1 995 (20.33)	1 301 (47.45)	668 (65.17)	0.000	14 (0.34)	12 (0.62)	0.127
Current drinking^①/n(%)	987 (10.28)	700 (26.02)	240 (23.81)	0.169	30 (0.75)	17 (0.90)	0.552
Active physical activity/n(%)	1 924 (19.39)	615 (22.40)	220 (21.44)	0.530	740 (17.73)	349 (17.65)	0.939
Physical examination index
BMI/(kg·m^-2)	25.1±3.3	25.5±3.1	24.2±2.9	0.000	25.5±3.4	23.8±3.0	0.000
SBP/mmHg	141.1±20.0	147.8±17.0	123.0±9.6	0.000	150.5±17.7	121.6±10.0	0.000
DBP/mmHg	82.8±10.3	87.1±10.1	77.6±6.8	0.000	84.7±10.2	75.4±7.0	0.000
Biochemical index
TAG/(mmol·L^-1)	1.4 (1.0, 2.0)	1.4 (1.0, 2.0)	1.3 (0.9, 1.8)	0.058	1.5 (1.1, 2.1)	1.1 (0.8, 1.6)	0.002
TC/(mmol·L^-1)	5.3±1.0	5.2±1.0	5.0±0.9	0.000	5.6±1.0	5.3±0.9	0.000
LDL-Ch/(mmol·L^-1)	3.2±0.9	3.1±0.8	2.9±0.8	0.000	3.4±0.9	3.1±0.8	0.000
HDL-Ch/(mmol·L^-1)	1.3±0.3	1.2±0.3	1.2±0.3	0.815	1.4±0.3	1.4±0.3	0.000
FBG/(mmol·L^-1)	5.6±1.5	5.8±1.7	5.4±1.5	0.000	5.7±1.6	5.1±0.8	0.000
Scr/(μmol·L^-1)	61.9±17.5	73.4±20.4	70.8±10.0	0.000	56.1±15.2	53.8±7.6	0.000
eGFR/ [mL·(min·1.73 m2)^-1]	109.3±21.3	105.0±21.3	110.2±18.6	0.000	109.0±22.2	115.6±19.3	0.000
Diabetes mellitus/n(%)	1 798 (18.12)	647 (23.56)	116 (11.31)	0.000	914 (21.90)	121 (6.12)	0.000
Dyslipidemia^①/n(%)	3 982 (40.14)	1 232 (44.87)	391 (38.15)	0.000	1 848 (44.28)	511 (25.85)	0.000
baPWV/(m·s^-1)	16.2±3.7	17.3±3.5	13.2±1.1	0.000	17.7±3.7	12.9±1.3	0.000

Item	Total (N=9 922)	Male			Female
Item	Total (N=9 922)	Non-HVA group (N=2 746)	HVA group (N=1 026)	P value	Non-HVA group (N=4 173)	HVA group (N=1 977)	P value
Basic information
Age/year	58.5±9.6	61.0±9.8	53.4±7.9	0.000	60.9±9.2	52.6±7.3	0.000
Education level (high school or above)^①/n(%)	2 132 (21.58)	647 (23.66)	302 (29.52)	0.000	602 (14.51)	581 (29.48)	0.000
Current smoking^①/n(%)	1 995 (20.33)	1 301 (47.45)	668 (65.17)	0.000	14 (0.34)	12 (0.62)	0.127
Current drinking^①/n(%)	987 (10.28)	700 (26.02)	240 (23.81)	0.169	30 (0.75)	17 (0.90)	0.552
Active physical activity/n(%)	1 924 (19.39)	615 (22.40)	220 (21.44)	0.530	740 (17.73)	349 (17.65)	0.939
Physical examination index
BMI/(kg·m^-2)	25.1±3.3	25.5±3.1	24.2±2.9	0.000	25.5±3.4	23.8±3.0	0.000
SBP/mmHg	141.1±20.0	147.8±17.0	123.0±9.6	0.000	150.5±17.7	121.6±10.0	0.000
DBP/mmHg	82.8±10.3	87.1±10.1	77.6±6.8	0.000	84.7±10.2	75.4±7.0	0.000
Biochemical index
TAG/(mmol·L^-1)	1.4 (1.0, 2.0)	1.4 (1.0, 2.0)	1.3 (0.9, 1.8)	0.058	1.5 (1.1, 2.1)	1.1 (0.8, 1.6)	0.002
TC/(mmol·L^-1)	5.3±1.0	5.2±1.0	5.0±0.9	0.000	5.6±1.0	5.3±0.9	0.000
LDL-Ch/(mmol·L^-1)	3.2±0.9	3.1±0.8	2.9±0.8	0.000	3.4±0.9	3.1±0.8	0.000
HDL-Ch/(mmol·L^-1)	1.3±0.3	1.2±0.3	1.2±0.3	0.815	1.4±0.3	1.4±0.3	0.000
FBG/(mmol·L^-1)	5.6±1.5	5.8±1.7	5.4±1.5	0.000	5.7±1.6	5.1±0.8	0.000
Scr/(μmol·L^-1)	61.9±17.5	73.4±20.4	70.8±10.0	0.000	56.1±15.2	53.8±7.6	0.000
eGFR/ [mL·(min·1.73 m2)^-1]	109.3±21.3	105.0±21.3	110.2±18.6	0.000	109.0±22.2	115.6±19.3	0.000
Diabetes mellitus/n(%)	1 798 (18.12)	647 (23.56)	116 (11.31)	0.000	914 (21.90)	121 (6.12)	0.000
Dyslipidemia^①/n(%)	3 982 (40.14)	1 232 (44.87)	391 (38.15)	0.000	1 848 (44.28)	511 (25.85)	0.000
baPWV/(m·s^-1)	16.2±3.7	17.3±3.5	13.2±1.1	0.000	17.7±3.7	12.9±1.3	0.000

Gender	Age<65 years			Age≥65 years
Gender	Prevalence in HVA group/%	Prevalence in non-HVA group/%	P value	Prevalence in HVA group/%	Prevalence in non-HVA group/%	P value
Male	2.1	6.6	0.000	12.1	18.1	0.154
Female	2.9	7.6	0.000	8.9	16.5	0.044

Gender	Age<65 years			Age≥65 years
Gender	Prevalence in HVA group/%	Prevalence in non-HVA group/%	P value	Prevalence in HVA group/%	Prevalence in non-HVA group/%	P value
Male	2.1	6.6	0.000	12.1	18.1	0.154
Female	2.9	7.6	0.000	8.9	16.5	0.044

Model	Total		Male		Female		Age<65 years		Age≥65 years
Model	OR (95%CI)	Pvalue	OR (95%CI)	Pvalue	OR (95%CI)	Pvalue	OR (95%CI)	Pvalue	OR (95%CI)	Pvalue
Model 1	0.56 (0.44?0.70)	0.000	0.55 (0.37?0.83)	0.004	0.55 (0.41?0.74)	0.000	0.51 (0.39?0.67)	0.000	0.75 (0.46?1.21)	0.239
Model 2	0.55 (0.43?0.70)	0.000	0.57 (0.38?0.86)	0.007	0.53 (0.40?0.72)	0.000	0.51 (0.39?0.67)	0.000	0.76 (0.47?1.24)	0.274
Model 3	0.53 (0.41?0.69)	0.000	0.55 (0.35?0.84)	0.006	0.52 (0.38?0.73)	0.000	0.45 (0.33?0.62)	0.000	0.82 (0.49?1.37)	0.446

上海市社区中老年人群健康的血管衰老和心血管疾病患病风险的相关性研究

Correlation between healthy vascular aging and prevalent cardiovascular disease risk in middle-aged and elderly people in the community of Shanghai

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