人体成分分析及人体测量对绝经后女性血脂异常的预测价值

doi:10.3969/j.issn.1004-583X.2022.08.006

摘要/Abstract

摘要：

目的探讨人体成分分析及人体测量对绝经后女性血脂异常的预测价值。方法采用横断面研究,选择同期在我院参加体检的绝经后中老年女性201例,指定专业临床营养医师进行人体测量,使用生物电阻抗法分析人体成分;采集病史资料及实验室检测结果;结合数据转换获得腰臀比、腰高比、骨骼肌质量指数(SMI)、总胆固醇/高密度脂蛋白(TC/HDL-C)比值,综合分析上述指标对绝经后女性血脂的影响。结果本研究中绝经后女性血脂异常患病率为68.7%,其中甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)升高和高密度脂蛋白(HDL-C)降低的比率分别为48.8%,34.8%,22.4%,19.4%。体质指数、体脂肪、体脂百分比、内脏脂肪面积、腰围、臀围、腰高比、腰臀比与TG和TC/HDL-C比值呈正相关;SMI与TG呈负相关;体脂百分比、腰高比和腰臀比与LDL-C正相关(P<0.05)。多因素分析发现,绝经后女性体脂百分比是导致TG和LDL-C增高的独立危险因素(P<0.01);腰高比对TC/HDL-C比值的影响更显著(P<0.01);腰臀比为绝经后女性发生血脂异常的预测因素(OR=1.124,95%CI:1.062~1.190)。结论绝经后女性血脂异常患病率高,人体成分分析所测体脂百分比及人体测量所获腰臀比、腰高比均与之关系密切,其中腰臀比为绝经后女性血脂异常的有效预测因素,对血脂异常预警和血脂水平监测具有参考价值。

关键词: 血脂异常, 绝经后女性, 人体成分, 人体测量

Abstract:

Objective To investigate the predictive value of body composition and anthropometry for dyslipidemia in postmenopausal women. Methods In the cross sectional study, postmenopausal women(n=201) who participated in the physical examination in our hospital during the same period were enrolled. Anthropometric measurements were performed by a professional clinical nutritionist, while the bioelectrical impedance was used to analyze human body composition.At the same time, medical history data and laboratory test results were collected; waist-hip ratio, waist-height ratio, skeletal muscle mass index(SMI), total cholesterol/high density lipoprotein ratio(TC/HDL-C) were obtained by data conversion, aiming to comprehensively analyze the influence of the above indexes on the blood lipid of postmenopausal women. Results The prevalence of dyslipidemia in postmenopausal women was 68.7%, of which, the rates of TG, TC, LDL-C increased and HDL-C decreased, for 48.8%, 34.8%, 22.4% and 19.4% respectively.Body mass index(BMI), body fat and fat percentage, visceral fat area, waist and hip circumference, waist-height ratio, waist-hip ratio were all positively correlated with TG and TC/HDL-C ratio (P<0.05). SMI was negatively correlated with TG, while body fat percentage, waist to height ratio and waist to hip ratio were positively correlated with LDL-C(P<0.05). Multivariate analysis found that the percentage of body fat of postmenopausal women was an independent risk factor for increased TG and LDL-C(P<0.01), waist-height ratio had significant effect on TC/HDL-C ratio(P<0.01). Waist-hip ratio was the predictor of dyslipidemia in postmenopausal women(OR=1.124,95%CI:1.062-1.190). Conclusion The prevalence of dyslipidemia in postmenopausal women is high, while in composition analysis, anthropometry measured body fat percentage, waist-height ratio and waist-hip ratio are all closely related to it. Among them, waist-hip ratio is an effective predictor for dyslipidemia in postmenopausal women, which has reference value for early warning of dyslipidemia and monitoring of lipid level.

Key words: dyslipidemia, postmenopausal women, body composition, anthropometry

中图分类号:

R589.2

张舒, 包云, 陈芳, 单清. 人体成分分析及人体测量对绝经后女性血脂异常的预测价值[J]. 临床荟萃, 2022, 37(8): 708-712.

Zhang Shu, Bao Yun, Chen Fang, Shan Qing. Predictive value of body composition and anthropometry for dyslipidemia in postmenopausal women[J]. Clinical Focus, 2022, 37(8): 708-712.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2022.08.006

https://huicui.hebmu.edu.cn/CN/Y2022/V37/I8/708

图/表 4

表1 两组各指标比较

指标	血脂正常组( $n$ =63)	血脂异常组( $n$ =138)	$F$ / $Z$ /χ²值	$P$ 值
年龄[M(Q), 岁]	72.00(14.00)	70.00(15.25)	0.041	0.839
糖尿病患病率[例(%)]	19(30.2)	39(28.3)	2.612	0.455
空腹血糖[M(Q), mmol/L]	5.54(0.95)	5.60(0.91)	-0.505	0.614
尿酸(μmol/L)	307.99±74.37	328.96±78.11	3.210	0.075
白蛋白(g/L)	42.90±1.58	42.88±1.88	0.002	0.967
TG(mmol/L)	1.08±0.44	2.11±1.32	-8.922	<0.01
LDL-C(mmol/L)	1.97±0.94	2.99±1.33	-7.254	<0.01
TC/HDL-C	2.86±0.49	4.17±0.92	87.037	<0.01
体重(kg)	58.85±10.36	62.12±10.71	3.293	0.070
BMI(kg/m²)	22.54±3.64	23.85±4.93	5.628	0.018
去脂体重(kg)	42.27±8.27	39.90±9.45	0.036	0.849
体脂肪(kg)	17.27±5.24	20.10±8.65	10.457	0.01
体脂百分比(%)	28.57±6.93	32.28±6.60	13.173	<0.01
VFA(cm²)	95.71±28.56	108.46±25.64	-3.146	<0.01
腰围(cm)	75.60±9.22	80.81±8.60	15.154	<0.01
腰高比(%)	47.18±5.52	50.44±4.88	16.586	<0.01
臀围(cm)	91.50±5.32	92.96±5.11	-1.845	0.066
腰臀比(%)	82.30±8.57	86.31±7.22	23.03	<0.01
四肢肌肉量(kg)	16.97±3.91	16.80±4.39	0.036	0.849
SMI(kg/m²)	6.53±1.02	6.50±1.03	0.160	0.873

表1 两组各指标比较

指标	血脂正常组( $n$ =63)	血脂异常组( $n$ =138)	$F$ / $Z$ /χ²值	$P$ 值
年龄[M(Q), 岁]	72.00(14.00)	70.00(15.25)	0.041	0.839
糖尿病患病率[例(%)]	19(30.2)	39(28.3)	2.612	0.455
空腹血糖[M(Q), mmol/L]	5.54(0.95)	5.60(0.91)	-0.505	0.614
尿酸(μmol/L)	307.99±74.37	328.96±78.11	3.210	0.075
白蛋白(g/L)	42.90±1.58	42.88±1.88	0.002	0.967
TG(mmol/L)	1.08±0.44	2.11±1.32	-8.922	<0.01
LDL-C(mmol/L)	1.97±0.94	2.99±1.33	-7.254	<0.01
TC/HDL-C	2.86±0.49	4.17±0.92	87.037	<0.01
体重(kg)	58.85±10.36	62.12±10.71	3.293	0.070
BMI(kg/m²)	22.54±3.64	23.85±4.93	5.628	0.018
去脂体重(kg)	42.27±8.27	39.90±9.45	0.036	0.849
体脂肪(kg)	17.27±5.24	20.10±8.65	10.457	0.01
体脂百分比(%)	28.57±6.93	32.28±6.60	13.173	<0.01
VFA(cm²)	95.71±28.56	108.46±25.64	-3.146	<0.01
腰围(cm)	75.60±9.22	80.81±8.60	15.154	<0.01
腰高比(%)	47.18±5.52	50.44±4.88	16.586	<0.01
臀围(cm)	91.50±5.32	92.96±5.11	-1.845	0.066
腰臀比(%)	82.30±8.57	86.31±7.22	23.03	<0.01
四肢肌肉量(kg)	16.97±3.91	16.80±4.39	0.036	0.849
SMI(kg/m²)	6.53±1.02	6.50±1.03	0.160	0.873

表2 各指标与TG、LDL-C以及TC/HDL-C的相关性

指标	TG		LDL-C		TC/HDL-C
指标	$r$ 值	$P$ 值	$r$ 值	$P$ 值	$r$ 值	$P$ 值
年龄(岁)	0.070	0.323	-0.078	0.272	0.052	0.464
糖尿病患病率(%)	-0.028	0.699	-0.060	0.405	-0.023	0.754
空腹血糖(mmol/L)	0.118	0.096	0.039	0.587	0.101	0.154
尿酸(μmol/L)	0.073	0.301	0.030	0.674	-0.019	0.793
白蛋白(g/L)	-0.026	0.711	-0.016	0.824	0.030	0.668
体重(kg)	0.121	0.088	-0.007	0.917	0.219	<0.01
BMI(kg/m²)	0.250	<0.01	0.040	0.571	0.285	<0.01
去脂体重(kg)	-0.116	0.103	-0.118	0.097	0.038	0.590
体脂肪(kg)	0.355	<0.01	0.098	0.169	0.338	<0.01
体脂百分比(%)	0.420	<0.01	0.167	0.018	0.288	<0.01
VFA(cm²)	0.323	<0.01	0.086	0.227	0.304	<0.01
四肢肌肉量(kg)	-0.089	0.212	-0.124	0.080	0.006	0.933
SMI(kg/m²)	-0.142	0.045	-0.111	0.118	0.049	0.495
腰围(cm)	0.269	<0.01	0.108	0.126	0.339	<0.01
腰高比(%)	0.369	<0.01	0.160	0.023	0.384	<0.01
臀围(cm)	0.144	0.042	-0.004	0.960	0.215	<0.01
腰臀比(%)	0.300	<0.01	0.198	<0.01	0.378	<0.01

表2 各指标与TG、LDL-C以及TC/HDL-C的相关性

指标	TG		LDL-C		TC/HDL-C
指标	$r$ 值	$P$ 值	$r$ 值	$P$ 值	$r$ 值	$P$ 值
年龄(岁)	0.070	0.323	-0.078	0.272	0.052	0.464
糖尿病患病率(%)	-0.028	0.699	-0.060	0.405	-0.023	0.754
空腹血糖(mmol/L)	0.118	0.096	0.039	0.587	0.101	0.154
尿酸(μmol/L)	0.073	0.301	0.030	0.674	-0.019	0.793
白蛋白(g/L)	-0.026	0.711	-0.016	0.824	0.030	0.668
体重(kg)	0.121	0.088	-0.007	0.917	0.219	<0.01
BMI(kg/m²)	0.250	<0.01	0.040	0.571	0.285	<0.01
去脂体重(kg)	-0.116	0.103	-0.118	0.097	0.038	0.590
体脂肪(kg)	0.355	<0.01	0.098	0.169	0.338	<0.01
体脂百分比(%)	0.420	<0.01	0.167	0.018	0.288	<0.01
VFA(cm²)	0.323	<0.01	0.086	0.227	0.304	<0.01
四肢肌肉量(kg)	-0.089	0.212	-0.124	0.080	0.006	0.933
SMI(kg/m²)	-0.142	0.045	-0.111	0.118	0.049	0.495
腰围(cm)	0.269	<0.01	0.108	0.126	0.339	<0.01
腰高比(%)	0.369	<0.01	0.160	0.023	0.384	<0.01
臀围(cm)	0.144	0.042	-0.004	0.960	0.215	<0.01
腰臀比(%)	0.300	<0.01	0.198	<0.01	0.378	<0.01

表3 各血脂指标影响因素的回归分析

项目	指标	B	SE	Beta	$t$ 值	$P$ 值	R²	$F$ 值
TG的影响因素	体脂百分比	0.056	0.016	0.244	3.536	<0.01	0.244	12.502
LDL-C的影响因素	体脂百分比	0.026	0.009	0.195	2.794	<0.01	0.195	7.804
TC/HDL-C的影响因素	腰高比	0.061	0.013	0.317	4.691	<0.01	0.317	22.005

表3 各血脂指标影响因素的回归分析

项目	指标	B	SE	Beta	$t$ 值	$P$ 值	R²	$F$ 值
TG的影响因素	体脂百分比	0.056	0.016	0.244	3.536	<0.01	0.244	12.502
LDL-C的影响因素	体脂百分比	0.026	0.009	0.195	2.794	<0.01	0.195	7.804
TC/HDL-C的影响因素	腰高比	0.061	0.013	0.317	4.691	<0.01	0.317	22.005

图1 腰臀比预测绝经后女性血脂异常的ROC曲线

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