血清高密度脂蛋白胆固醇与新发胆石症的关系

孙苗苗; 曹立瀛; 孙卫东; 刘希宁; 崔皓哲; 梁明扬; 魏垚臣; 王万超; 刘四清

doi:10.3969/j.issn.1001-5256.2019.08.019

血清高密度脂蛋白胆固醇与新发胆石症的关系

DOI: 10.3969/j.issn.1001-5256.2019.08.019

华北理工大学研究生院
华北理工大学附属开滦总医院肝胆外科
滦南县医院外四科

基金项目:

河北省卫生和计划生育委员会重点科技研究计划(20171435)；

详细信息

中图分类号: R575.62
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出版历程
- 收稿日期: 2019-03-27
- 出版日期: 2019-08-20

Association of serum high-density lipoprotein cholesterol with new-onset cholelithiasis

Graduate School of North China University of Science and Technology

Research funding:

摘要

摘要: 目的探讨血清高密度脂蛋白胆固醇（HDL-C）水平对新发胆石症的影响。方法采用前瞻性队列研究的方法,收集2006年7月-2015年12月开滦集团健康体检的在职及离退休职工87 891人的体检资料,并纳入统计分析。正态分布的计量资料多组间比较采用单因素方差分析,偏态分布的计量资料多组间比较采用Kruskal-Wallis H检验,计数资料组间比较采用χ2检验。将观察对象依据HDL-C四分位数分为4组,计算各组胆石症的发病密度,采用寿命表法计算各组胆石症的累积发病率,并采用log-rank检验比较组间差异;采用Cox回归模型分析不同HDL-C水平对新发胆石症的影响。结果 4组观察对象的临床特征比较:性别、年龄、BMI、LDL-C、HDL-C、FBG、hs-CRP、TG、TC、高血压病、糖尿病、饮酒、吸烟及体育锻炼比例差异均有统计学意义（P值均<0. 05）。在平均（8. 19±0. 85）年的随访期间,新发胆石症2881例,各组的胆石症发病密度分别为4. 36/千人年、3. 81/千人年、3. 96/千人年、3. 90/千人年,各组的累积发病率分别为6. 49%、6. 01%、6. 3...
- 胆结石 /
- 胆固醇,HDL /
- 危险因素 /
- 队列研究
Abstract: Objective To investigate the influence of serum high-density lipoprotein cholesterol (HDL-C) level on new-onset cholelithiasis. Methods A prospective cohort study was conducted. The physical examination data of 87 891 on-the-job and retired workers in Kailuan Group were collected from July 2006 to December 2015 and were included in the statistical analysis. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, the Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups, and the chi-square test was used for comparison of categorical data between groups. The subjects were divided into four groups according to HDL-C quartiles, and the incidence density of cholelithiasis was calculated for each group. The life-table method was used to calculate the cumulative incidence rate of cholelithiasis in each group, the log-rank test was used for comparison between groups, and the Cox regression model was used to analyze the influence of HDL-C level on new-onset cholelithiasis. Results There were significant differences between the four groups in sex, age, body mass index, low-density lipoprotein cholesterol, HDL-C, fasting blood glucose, high-sensitivity C-reactive protein, triglyceride, total cholesterol, hypertension, diabetes, drinking, smoking, and physical exercise (all P < 0. 05) . During the mean follow-up time of 8. 19 ± 0. 85 years, a total of 2881 cases of new-onset cholelithiasis were observed, and the incidence density of cholelithiasis in the four groups was 4. 36 per 1000 person-years, 3. 81 per 1000 person-years, 3. 96 per 1000 person-years, and 3. 90 per 1000 person-years, respectively. The cumulative incidence rates in the four groups were 6. 49%, 6. 01%, 6. 36%, and 6. 16%, respectively, and the log-rank test showed a significant difference between groups (χ2= 25. 34, P < 0. 05) . In the Cox proportional hazards regression model, after the adjustment for possible confounding factors, the results showed that compared with the first quartile group of HDL-C, the second, third, and fourth quartile groups had hazard ratios (95% confidence interval) for gallstone disease of 0. 84 (0. 75-0. 93) , 0. 86 (0. 78-0. 96) , and 0. 78 (0. 70-0. 86) , respectively (P for trend < 0. 05) . Conclusion A high serum level of HDL-C is an independent protective factor against new-onset chole-lithiasis, and the risk of cholelithiasis decreases with the increase in HDL-C.
- cholelithiasis /
- cholesterol, HDL /
- risk factors /
- cohort study

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