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昆山地区社区老年高血压人群血浆致动脉粥样硬化指数与心血管疾病发病风险的队列研究

A cohort study of atherogenic index of plasma and the risk of cardiovascular disease in community elderly hypertensive population of Kunshan area

    摘要
  • 摘要:
    目的 探讨昆山地区社区老年高血压人群血浆致动脉粥样硬化指数(AIP)与心血管疾病发病风险的关系。
    方法 本研究共纳入在社区接受年度健康检查的21 226例老年高血压患者为研究对象。收集基线年龄、性别、吸烟史、高血压、糖尿病和心血管疾病史等人口学信息，对患者身高、体质量、体质量指数(BMI)、腰围、血压和空腹血糖、血脂进行测量。记录血脂指标，包括AIP、血脂综合指数(LCI)、Castelli风险指数1(CRI-Ⅰ)和Castelli风险指数2(CRI-Ⅱ)。随访观察终点是首次发生心血管疾病。采用多因素Cox比例风险模型探讨基线AIP水平与高血压人群心血管疾病发病风险的关系。
    结果 中位随访时间5.62(3.53, 7.16)年后, 3 179例出现心血管疾病事件。Cox回归分析结果显示，不调整混杂因素时, AIP基线水平与心血管疾病发病风险呈正相关(HR=1.16, 95%CI: 1.02~1.32)。进一步调整年龄、性别、BMI、腰围、血压、血糖、吸烟史、糖尿病史后, AIP水平与心血管疾病发病风险仍密切相关。限制性立方样条分析提示AIP与心血管疾病风险总体呈线性相关。Kaplan-Meier生存曲线显示，与最低分位比较，最高分位血管疾病累积风险更高(P < 0.001)。
    结论 在昆山地区社区老年高血压人群中，基线AIP水平与心血管疾病发病风险有关。监测AIP水平可能有助于预测、评估心血管疾病的发病风险。

     

    Abstract:
    Objective To investigate the relationship between plasma atherosclerosis index (AIP) and the risk of cardiovascular disease in community elderly hypertensive patients in Kunshan area.
    Methods A total of 21, 226 elderly hypertensive patients who underwent annual health examinations in community were enrolled in this study. Demographic information such as baseline age, gender, smoking history, hypertension, diabetes, and history of cardiovascular disease were collected. Patients' height, body weight, body mass index (BMI), waist circumference, blood pressure, fasting blood glucose, and blood lipids were measured. Lipid indicators including AIP, lipid composite index (LCI), Castelli risk index-Ⅰ (CRI-Ⅰ), and Castelli risk index-Ⅱ(CRI-Ⅱ) were recorded. The primary endpoint was the first occurrence of cardiovascular disease. The multivariate Cox proportional hazards model was used to explore the relationship between baseline AIP level and cardiovascular disease risk in hypertensive patients.
    Results After a median follow-up period of 5.62 (3.53, 7.16) years, 3, 179 patients occurred cardiovascular disease events. Cox regression analysis showed that a higher baseline AIP level was positively correlated with cardiovascular disease risk without adjusting for confounding factors (HR=1.16; 95%CI, 1.02 to 1.32). After further adjustment for age, gender, BMI, waist circumference, blood pressure, blood glucose, smoking history, and diabetes history, the AIP level remained closely related to cardiovascular disease risk. Restricted cubic spline analysis suggested an overall linear relationship between AIP and cardiovascular disease risk. Kaplan-Meier survival curve analysis showed that compared with the lowest quartile, the cumulative risk of cardiovascular disease was higher in the highest quartile (P < 0.001).
    Conclusion In community elderly hypertensive patients in Kunshan area, baseline AIP level is associated with cardiovascular disease risk. Monitoring AIP levels may aid in predicting and assessing the risk of cardiovascular disease.

     

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