摘要
目的探讨开滦集团在职和离退休职工不同基线空腹血清三酰甘油水平对新发急性胰腺炎(AP)的影响。方法采用前瞻性队列研究方法,以参加开滦集团2006年至2009年健康体格检查、无AP病史和三酰甘油资料完整的开滦集团在职和离退休职工为观察队列,最终纳入统计学分析者125178例。研究人群按基线空腹血清三酰甘油三分位数水平分为<1.01mmol/L组(42128例)、1.01~1.64mmol/L组(41711例)和>1.64mmol/L组(41339例),分析这3组的新发AP发病率。经Kaplan-Meier法绘制生存曲线,计算累积发病率,以log-rank法进行检验,并采用多因素Cox比例风险回归模型分析基线空腹血清三酰甘油水平对新发AP事件的影响。结果随访(7.36±1.23)年,共发生AP193例,<1.01mmol/L组、1.01~1.64mmol/L组和>1.64mmol/L组发病密度分别为1.43例/万人年、2.37例/万人年、2.49例/万人年。<1.01mmol/L组、1.01~1.64mmol/L组和>1.64mmol/L组AP的累积发病率分别为0.10%(44/42128)、0.18%(73/41711)、0.18%(76/41339),差异有统计学意义(χ2=9.998,P=0.007)。多因素Cox回归模型分析显示,与<1.01mmol/L组比较,1.01~1.64mmol/L组和>1.64mmol/L组AP发病风险增加,风险比(HR)(95%CI)分别为1.56(1.07~2.29)、1.57(1.06~2.32)。排除1年内发病的AP病例,多因素Cox比例风险回归分析显示,以<1.01mmol/L组为对照,1.01~1.64mmol/L组和>1.64mmol/L组发生AP的HR(95%CI)分别为1.70(1.11~2.58)和1.69(1.10~2.60)。结论基线空腹血清三酰甘油水平在1.01mmol/L以上可能增加AP的发病危险。
Objective To investigate the effects of fasting serum triglycerides (TG) levels at different baseline on the risk of new-onset acute pancreatitis (AP) in in-service and retired employees of Kailuan Group. Methods A total of 125 178 in-service and retired employees of Kailuan Group who received health check-ups from 2006 to 2009 and had no AP history but had complete TG data were prospectively enrolled. According to quantile level, the baseline serum fasting TG level of study subjects were divided into <1.01 mmol/L group (n=42 128), 1.01 to 1.64 mmol/L group (n=41 711) and >1.64 mmol/L group (n=41 339). The incidence of new-onset AP of these three groups was analyzed. The survival curve was plotted by Kaplan-Meier method. The cumulative incidence rate was calculated and tested by log-rank method. And multivariate Cox proportional hazards regression model was performed to calculate hazard ratios (HR) of baseline fasting serum TG level for AP. Results After followed up for (7.36±1.23) years, a total of 193 cases of AP occurred. The incidences of AP in <1.01 mmol/L group, 1.01 to 1.64 mmol/L group and >1.64 mmol/L group were 1.43 events/10 000 person-years, 2.37 events/10 000 person-years and 2.49 events/10 000 person-years, respectively. The cumulative incidence rates of AP in <1.01 mmol/L group, 1.01 to 1.64 mmol/L group and >1.64 mmol/L group were 0.10% (44/42 128), 0.18% (73/41 711) and 0.18% (76/41 339), respectively, and the difference was statistically significant (χ2=9.998, P=0.007). The results of multivariate Cox proportional hazards regression model analysis indicated that the risk of AP increased in 1.01 to 1.64 mmol/L group and >1.64 mmol/L group compared with that of <1.01 mmol/L group, HR and 95% confidence interval (CI) were 1.56 (1.07 to 2.29) and 1.57 (1.06 to 2.32), respectively. After excluded onset AP within one year, with a control group of <1.01 mmol/L group, the results of multivariate Cox proportional hazards regression model analysis indicated that the HR and 95%CI for AP of 1.01 to 1.64 mmol/L group and >1.64 mmol/L group were 1.70 (1.11 to 2.58) and 1.69 (1.10 to 2.60), respectively. Conclusion Baseline fasting serum TG levels over 1.01 mmol/L may increase the risk of AP.
作者
朱国玲
张冰
吉瑞更
孙秋
张艳敏
汪海涛
王珊
佟博
张海玲
王谦
张杰
蒋晓忠
陈朔华
门秀丽
吴寿岭
Zhu Guoling;Zhang Bing;Ji Ruigeng;Sun Qiu;Zhang Yanmin;Wang Haitao;Wang Shan;Tong Bo;Zhang Hailing;Wang Qian;Zhang Jie;Jiang Xiaozhong;Chen Shuohua;Men Xiuli;Wu Shouling(Department of Gastroenterology, Kailuan General Hospital, Tangshan City 063000, Hebei Province, China)
出处
《中华消化杂志》
CAS
CSCD
北大核心
2018年第12期829-834,共6页
Chinese Journal of Digestion
基金
河北省卫计委专项科研基金(20171437)
国家自然科学基金(81370918).
