2020 年第 5 期 第 15 卷

中老年卒中风险人群血清营养学指标及血管危险因素的性别差异

Gender difference in serum nutritional indexes and vascular risk factors in middle age people with stroke risk

作者：周筠1;于学英2;詹炯3;王桂红2

英文作者：Zhou Yun1， Yu Xueying2， Zhan Jiong3， Wang Guihong2

单位：1首都医科大学附属北京天坛医院国家神经系统疾病临床医学研究中心100070；2首都医科大学附属北京天坛医院神经病学中心100070；3首都医科大学附属北京天坛医院放射科100070

英文单位：1China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital Capital Medical University Beijing 100070 China; 2Neurology Center Beijing Tiantan Hospital Capital Medical University， Beijing 100070 China; 3Department of Radiology Beijing Tiantan Hospital Capital Medical University Beijing 100070 China

关键词：卒中；白蛋白；叶酸；同型半胱氨酸;体重指数

英文关键词：Stroke;Albumin;Folicacid;Homocysteine；Bodymassindex

• 摘要：

• 目的探讨中老年卒中风险人群血清营养学指标及血管危险因素的性别差异，为卒中及痴呆的早期预防提供更多数据。方法选择2009年7月至2015年7月于首都医科大学附属北京天坛医院神经内科门诊就诊的中老年卒中风险人群550例，根据性别分为男性组250例、女性组300例。比较不同性别组卒中风险人群的血清营养学指标及常见血管危险因素指标的差异，分别分析男性组和女性组与血清肌酐、同型半胱氨酸（Hcy）相关的血清营养学指标及血管危险因素。结果男性组年龄、体重指数和高血压、糖尿病比例以及三酰甘油、维生素B12水平与女性组比较差异均无统计学意义（均P＞0.05）。女性组吸烟比例和血红蛋白、白蛋白、Hcy、肌酐水平均低于男性组，叶酸、高密度脂蛋白胆固醇及低密度脂蛋白胆固醇水平均高于男性组，差异均有统计学意义（均P＜0.05）。男性组血清白蛋白及体重指数与肌酐水平呈正相关（r=2.509、1.981，P=0.013、0.049)，血清叶酸与肌酐水平呈负相关(r=-2.027，P=0.040)。女性组年龄、Hcy及吸烟与肌酐水平呈正相关（r=2.883、4.170、2.701，P=0.004、<0.001、=0.007），血清叶酸水平与肌酐水平呈负相关(r=-2.499，P=0.013)。男性组维生素B12及叶酸水平与血清Hcy水平呈负相关（r=-5.359、-1.998，P<0.001、=0.047）。女性组肌酐与Hcy水平呈正相关（r=4.170，P<0.001），维生素B12与Hcy水平呈负相关（r=-6.391，P<0.001）。结论与女性相比，男性卒中风险人群具有较高的血清白蛋白、Hcy及肌酐水平，较低的叶酸及高密度脂蛋白胆固醇水平及更高的吸烟率，提示可能有较高的卒中及肾功能损害的风险；而女性卒中风险人群血清蛋白水平较低、胆固醇水平较高，提示可能有较高的卒中及痴呆的风险。

• Objective To explore the gender difference in serum nutritional indexes and vascular risk factors in middle age people with stroke risk. Methods Totally 550 middle age people with stroke risk(including 250 males and 300 females ) were selected in Beijing Tiantan Hospital, Capital Medical University from July 2009 to July 2015 . Serum nutritional parameters and vascular risk factors of stroke risk population were compared.Creatinine, homocysteine(HCY)-related serum nutritional parameters and common vascular risk factors were analyzed. Results  The age, body mass index, hypertension, diabetes rate, tricholesterol, and vitamin B12 levels of the male group were not statistically different from those of the female group (all P> 0.05). The smoking rate, hemoglobin， serum albumin(ALB), HCY, creatinine in female group were significantly lower than those in male group; the levels of serum folic acid(FA), high density lipoprotein cholesterol(HDL-C) and low density lipoprotein cholesterol(LDL-C) in female group were significantly higher than those in male group  (P＜0.05). Creatinine in male group was positively correlated with ALB and body mass index（r=2.509, 1.981，P=0.013, 0.049)and was negative correlated with FA(r=-2.027， P=0.040). Creatinine  in female group was positively correlated with Hcy, age and smoking rate（r=4.170, 2.883, 2.701， P＜0.001, =0.004, =0.007） and was negatively correlated with FA(r=-2.499， P=0.013). Hcy in male group was negatively correlated with B12 and FA(r=-5.359, -1.998, P＜0.001, =0.047). Hcy in female group was positively correlated with creatinine level（r=4.170， P＜0.001）and was negatively correlated with B12（r=-6.391，P＜0.001）. ConclusionAmong males at risk of stroke, high smoking rates, high serum albumin, Hcy and creatinine levels, and low levels of folate and high-density lipoprotein cholesterol suggest a higher risk of stroke and renal impairment. Among females at risk of stroke, lower serum protein levels and higher cholesterol levels suggest a higher risk of stroke and dementia.