基于不同年龄和性别人群血清总胆固醇的冠心病发生风险评估

S. Bernikova, E. Zakharova
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引用次数: 0

摘要

对240名不同年龄、相对健康的男性和女性的血液中总胆固醇水平进行了测定和比较,并在此基础上估计了库尔干地区Shchuchansky地区居民患冠心病的可能性。在20岁以下人群和21-30岁人群中,男性和女性血液中的总胆固醇水平有显著差异。在随后的年龄组中没有发现显著的性别差异。在两种性别的人群中,总胆固醇水平在一生中都有显著的增加:在男性中,该指标从青春期到老年显著增加了58.3%,在女性中增加了40.2%。对发生冠心病(CHD)的风险进行了人群评估。在这两个性别群体中,我们注意到,随着年龄的增长,患冠状动脉疾病的高概率人群比例逐渐增加,低概率人群比例逐渐减少,这是由于内部危险因素(动脉高血压、激素变化、代谢减慢)和外部危险因素(体力活动减少、饮食不平衡、吸烟等)造成的。在所有20岁以下的男性和女性中,患冠状动脉疾病的风险很低。在男女两组中,中等风险的出现在生命的第三个十年,在第四个十年出现高风险。在老年人中,30%的男性和40%的女性有患冠状动脉疾病的高风险,这是与所有其他年龄组相比的最高指标。在女性中,与男性相比,21-30岁的中度风险人群比例较低,31-40岁的高风险人群比例较低,这可能与女性生殖期雌激素的保护作用有关。在群老人温和的患冠状动脉疾病的风险,适度的高胆固醇血症记录(血液中的总胆固醇水平男性人口为5.74±0.23更易与L,女性人口- 5.71±0.23更易/ L)和组的人患冠状动脉疾病的风险高,高血胆脂醇过多在男性和女性(8.24±0.37更易/ L和8.10±0.28更易/ L,分别)。在患冠状动脉疾病的中等风险人群中,平均总胆固醇含量比低风险人群高40.4%,而在高风险人群中,平均总胆固醇含量比中等风险人群高42.6%。因此,研究结果表明,进行诊断检查对于早期诊断由血液中总胆固醇含量升高引起的疾病,以及编制不同年龄和性别的未患病人群的生化参数参考水平,以便在医疗实践中进一步使用的重要性。作为预防心血管疾病发展的预防措施,在教育和工业组织中,儿童和成人的健康保护和健康生活方式的优先形成也起着重要作用。
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ASSESSMENT OF THE RISK OF DEVELOPING CORONARY HEART DISEASE BASED ON TOTAL CHOLESTEROL IN BLOOD SERUM IN INDIVIDUALS OF DIFFERENT AGE AND GENDER GROUPS
The determination and comparison of the level of total cholesterol in the blood in 240 relatively healthy men and women of different ages was carried out, and on its basis the likelihood of developing coronary heart disease in residents of the Shchuchansky district of the Kurgan region was estimated. There were revealed significant differences in the level of total cholesterol in the blood of men and women in the group under 20 years old and in the group of 21–30 years old. No significant gender differences were found in subsequent age groups. There was a significant increase in total cholesterol during life in both gender groups: in men, the indicator significantly increased from adolescence to old age by 58.3 %, in women – by 40.2 %. A population assessment of the risk of developing coronary heart disease (CHD) was carried out. In both gender groups, during life, we noted a gradual increase towards old age in the proportion of people who have a high probability of developing coronary artery disease, and a decrease in the proportion of people with a low probability, which is due to both internal risk factors (arterial hypertension, hormonal changes, slowing down of metabolism), and external (decreased physical activity, unbalanced diet, smoking, etc.). In 100 % of men and women under 20 years of age, the risk of developing coronary artery disease is low. The emergence of moderate risk in both gender groups was noted in the third decade of life, high – in the fourth. In old age, 30 % of men and 40 % of women with a high risk of developing coronary artery disease were identified, which is the highest indicator in comparison with all other age groups. Among women, a lower percentage of persons with moderate risk at the age of 21–30 years old and with a high risk in the group of 31–40 years old was found compared to men, which is probably associated with the protective effect of estrogens during the reproductive period of women. In the group of elderly people with a moderate risk of developing coronary artery disease, moderate hypercholesterolemia was recorded (the level of total cholesterol in the blood in the male population was 5.74±0.23 mmol / L, in the female population – 5.71±0.23 mmol / L) and in the group of persons with a high risk of developing coronary artery disease, high hypercholesterolemia was noted in men and women (8.24±0.37 mmol / L and 8.10±0.28 mmol / L, respectively). In persons with a moderate risk of developing coronary artery disease, the average total cholesterol content is 40.4 % significantly higher than in persons with a low level of risk, and in persons with a high risk – 42.6 % significantly higher than in the group of persons with a moderate risk. Thus, the results of the study showed the importance of conducting diagnostic examinations for the purpose of early diagnosis of diseases caused by an increased content of total cholesterol in the blood, as well as compiling reference levels of biochemical parameters for non-sick people of different age and sex for their further use in medical practice. As preventive measures to prevent the development of cardiovascular pathology, health protection and the formation of the priority of a healthy lifestyle in children and adults in educational and industrial organizations also play an important role.
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