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预防医学  2020, Vol. 32 Issue (6): 563-568    DOI: 10.19485/j.cnki.issn2096-5087.2020.06.006
  论著 本期目录 | 过刊浏览 | 高级检索 |
直接胆红素和血脂对颈动脉粥样硬化及颈动脉斑块发生风险的交互作用
范为群1, 罗文良2, 邵布勒2, 余运贤2
1.杭州市五云山疗养院,浙江 杭州 310008;
2.浙江大学公共卫生学院
The interaction between direct bilirubin and blood lipids on carotid atherosclerosis and carotid plaque
FAN Weiqun*, LUO Wenliang, SHAO Bule, YU Yunxian
*Hangzhou Wuyunshan Sanatorium,Hangzhou,Zhejiang 310008,China
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摘要 目的 分析直接胆红素和血脂对颈动脉粥样硬化及颈动脉斑块发生风险的交互作用。方法 选取2016年3月—2018年12月在杭州市五云山疗养院健康体检者为研究对象,收集人口学资料、生化检测和颈动脉超声检查资料,采用多因素多分类Logistic回归模型分析直接胆红素、血脂以及直接胆红素和血脂交互作用对颈动脉粥样硬化和颈动脉斑块发生的影响。结果 共纳入分析8 308人,其中颈动脉粥样硬化616例,占7.41%;颈动脉斑块2 409例,占29.00%。多因素多分类Logistic回归分析结果显示,直接胆红素升高是颈动脉粥样硬化(OR=0.701,95%CI:0.537~0.916)和颈动脉斑块(OR=0.647,95%CI:0.527~0.795)的保护因素;总胆固醇(TC)升高(OR=1.335,95%CI:1.106~1.611)、低密度脂蛋白胆固醇(LDL-C)升高(OR=1.338,95%CI:1.098~1.629)和高密度脂蛋白胆固醇(HDL-C)降低(OR=1.431,95%CI:1.148~1.783)是颈动脉粥样硬化的危险因素;TC升高(OR=1.325,95%CI:1.151~1.525)和LDL-C升高(OR=1.311,95%CI:1.130~1.520)是颈动脉斑块的危险因素。直接胆红素和TC、直接胆红素和LDL-C均对颈动脉斑块发生风险存在交互作用(P<0.05);与直接胆红素升高且TC正常组比较,直接胆红素正常且TC升高组颈动脉斑块发生风险增加(OR=1.831,95%CI:1.438~2.333);与直接胆红素升高且LDL-C正常组比较,直接胆红素正常且LDL-C升高组颈动脉斑块发生风险增加(OR=1.814,95%CI:1.427~2.306)。结论 TC、LDL-C与直接胆红素对颈动脉斑块发生风险存在交互作用,对于直接胆红素水平正常而TC或LDL-C升高患者更应加强血脂控制以预防颈动脉斑块。
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关键词 颈动脉粥样硬化颈动脉斑块直接胆红素血脂交互作用    
AbstractObjective To learn the interaction of serum direct bilirubin and blood lipids on the risk of carotid atherosclerosis and carotid plaque. Methods The subjects were selected from Hangzhou Wuyunshan Sanatorium from March 2016 to December 2018. Demographic information,laboratory testing results and carotid intima-media thickness(IMT)were collected. The logistic regression model was employed for the association of direct bilirubin,blood lipids and their interaction with the risk of carotid atherosclerosis and carotid plaque. Results Totally 8 308 subjects were recruited. Among them,616(7.41%) subjects had carotid atherosclerosis,and 2 409(29.00%)subjects had plaques. The results of multivariate and multinomial logistic regression analysis showed that high level of direct bilirubin was associated with decreased risks of carotid atherosclerosis(OR=0.701,95%CI:0.537-0.916)and carotid plaque(OR=0.647,95%CI:0.527-0.795);high TC level(OR=1.335,95% CI:1.106-1.611), high LDL-C level(OR=1.338,95%CI:1.098-1.629)and low HDL-C level(OR=1.431,95%CI:1.148-1.783)were associated with increased risks of carotid atherosclerosis;high TC level(OR=1.325,95% CI:1.151-1.525)and high LDL-C(OR=1.311,95%CI:1.130-1.520)were associated with increased risks of carotid plaque. There were interactions between direct bilirubin and TC or LDL-C on the risk of carotid plaque(P<0.05). Compared with the subjects with high level of direct bilirubin and normal level of TC,the subjects with normal level of direct bilirubin and high level of TC had significantly higher risk of carotid plaque(OR=1.831,95%CI:1.438-2.333);compared with the subjects with high level of direct bilirubin and normal level of LDL-C,the subjects with normal level of direct bilirubin and high level of LDL-C had significantly higher risk of carotid plaque(OR=1.814,95%CI:1.427-2.306).Conclusion The interactions between direct bilirubin and TC or LDL-C increase the risk of carotid plaque. It is important to strengthen blood lipid control in the patients with normal level of direct bilirubin and hyperlipidemia.
Key wordscarotid atherosclerosis    carotid plaque    direct bilirubin    blood lipid    interaction
收稿日期: 2019-10-31      出版日期: 2020-06-22
ZTFLH:  R445  
通信作者: 余运贤,E-mail:yunxianyu@zju.edu.cn   
作者简介: 范为群,本科,副主任医师,主要从事健康管理与预防保健工作
引用本文:   
范为群, 罗文良, 邵布勒, 余运贤. 直接胆红素和血脂对颈动脉粥样硬化及颈动脉斑块发生风险的交互作用[J]. 预防医学, 2020, 32(6): 563-568.
FAN Weiqun, LUO Wenliang, SHAO Bule, YU Yunxian. The interaction between direct bilirubin and blood lipids on carotid atherosclerosis and carotid plaque. Preventive Medicine, 2020, 32(6): 563-568.
链接本文:  
http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2020.06.006      或      http://www.zjyfyxzz.com/CN/Y2020/V32/I6/563
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