A Cohort Study Of The Incidence And Risk Factors Of Abnormal Lipid Metabolism In A Rural Population

Objective: The aim of this study is to investigate the incidence and risk factors of dyslipidemia in a rural population of Henan Province,China,and to provide scientific evidence for intervention measures of dyslipidemia.Methods: A total of 20194 participants aged ≥18 years were selected randomly by cluster sampling from two towns in Henan Province from July to August 2007 and July to August 2008.Investigations included questionnaires,anthropometric measurements,fasting plasma glucose,and lipid profile examination.A total of 17265 participants were followed up from July to August 2013 and July to October 2014.Overall,7720 participants were included in the study.Logistic regression model was used to analyze the risk factors for dyslipidemia,and the OR value was converted into RR.Δ was defined as the value at follow-up minus the corresponding value at baseline.Results: 1.The cumulative incidence of total dyslipidemia was 36.61%(95% CI: 35.53-37.69)for residents aged 18 years and over living in rural area of Henan Province during 6-year follow-up,and was higher among men(39.62% [95% CI: 37.74─41.53])than women(35.07% [95% CI: 33.76─36.40]).The cumulative incidence of low HDL-C,high TG,high TC and high LDL-C were 28.71%(95% CI: 27.70─29.74),11.24%(95% CI: 10.54─11.96),2.54%(95% CI: 2.20─2.91)and 2.14%(95% CI: 1.82─2.48),respectively.2.After adjustment for sex,age,educational level,marital status and income status,multivariate logistic regression analysis showed that:(1)Overweight/obesity(RR=1.12,95% CI: 1.01─1.24),abnormal WC(RR=1.17,95% CI: 1.06─1.28),abnormal WHt R(RR=1.17,95% CI: 1.05─1.30),abnormal DBP(RR=1.14,95% CI: 1.01─1.28),FPG≥6.1 mmol/L(RR=1.15,95% CI: 1.03─1.27),weight gain(2.50─5.00 kg: RR=1.11,95% CI: 1.01─1.21;≥5.00 kg: RR=1.36,95% CI: 1.25─1.46),and ΔWC≥6.20 cm(RR=1.17,95% CI: 1.06─1.27)were significant independent risk factors,and underweight(RR=0.58,95% CI: 0.42─0.77),weight loss(RR=0.81,95% CI: 0.71─0.91)and WC reduction(RR=0.86,95% CI: 0.77─0.96)were protective factors for total dyslipidemia.(2)Alcohol consumption(RR=2.14,95% CI: 1.12─4.03),overweight/obesity(RR=1.76,95% CI: 1.06─2.88)and Δweight≥5.00 kg(RR=2.00,95% CI: 1.31─3.02)were independent risk factors for high TC.(3)Alcohol consumption(RR=1.33,95% CI: 1.02─1.72),abnormal WC(RR=1.29,95% CI: 1.05─1.57),abnormal WHt R(RR=1.73,95% CI: 1.39─2.16),FPG≥6.1 mmol/L(RR=1.30,95% CI: 1.05─1.60),weight gain(2.50─5.00 kg: RR=1.32,95% CI: 1.07─1.59;≥5.00 kg: RR=2.01,95% CI: 1.68─2.38)and ΔWC≥6.20 cm(RR=1.52,95% CI: 1.24─1.85)were independent risk factors,and WC reduction(RR=0.71,95% CI: 0.56─0.90)was protective factor for high TG.(4)Abnormal WC(RR=1.16,95% CI: 1.03─1.30),abnormal WHt R(RR=1.17,95% CI: 1.03─1.33),weight gain(≥5.00 kg: RR=1.29,95% CI: 1.16─1.42)and ΔWC≥6.20 cm(RR=1.13,95% CI: 1.01─1.26)were independent risk factors,and underweight(RR=0.46,95% CI: 0.31─0.68)and weight loss(RR=0.85,95% CI: 0.74─0.99)were protective factors for low HDL-C.(5)The risk of high LDL-C was not associated with any above mentioned factors.Conclusion: 1.The cumulative incidence of dyslipidemia during 6 years was high for this rural population.The main types of abnormal lipid metabolism were high TG and low HDL-C.2.Overweight/obesity,abnormal WC,abnormal WHt R,abnormal DBP,FPG≥6.1 mmol/L,weight gain and ΔWC≥6.20 cm were independent risk factors,and underweight,weight loss,and WC reduction were independent protective factors for dyslipidemia.