既往有偿献血地区血脂水平与丙型肝炎病毒的关联研究

王炎; 黄鹏; 叶翔宇; 倪泽阳; 王秋伟; 侯雨晴; 喻荣彬

doi:10.16462/j.cnki.zhjbkz.2020.11.004

既往有偿献血地区血脂水平与丙型肝炎病毒的关联研究

doi: 10.16462/j.cnki.zhjbkz.2020.11.004

211166 南京，南京医科大学公共卫生学院流行病学系

基金项目:

国家自然科学基金 81703273

江苏省自然科学基金 BK20171054

详细信息

通讯作者:
喻荣彬，E-mail:rongbinyu@njmu.edu.cn

中图分类号: R183.3; R563.1
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出版历程
- 收稿日期: 2020-06-10
- 修回日期: 2020-08-12
- 刊出日期: 2020-11-10

Study on association between lipid levels and HCV infection in remunerated blood donation

Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing 211166, China

Funds:

National Natural Science Foundation of China 81703273

Natural Science Foundation of Jiangsu Province BK20171054

More Information

Corresponding author: YU Rong-bin, E-mail:rongbinyu@njmu.edu.cn

摘要

摘要: 目的探讨既往有偿献血地区丙型肝炎病毒(hepatitis C virus，HCV)感染与血脂的相关性及血脂异常的影响因素。方法 2015年3月至5月对江苏省某地区＞50周岁人群进行横断面调查，通过问卷调查获取一般人口学资料及既往献血史等信息，并采集5 ml空腹静脉血进行相关指标的检测；分析比较不同HCV感染状况血脂水平，并进行单因素、多因素逐步Logistic回归分析模型探索血脂异常的影响因素。结果共纳入1 537例研究对象，其中未感染者1 234例(80.3%)，自限清除者117例(7.6%)，持续感染者186例(12.1%)。倾向得分匹配后3组血清甘油三酯(triglyceride，TG)、总胆固醇(total cholesterol，TC)水平均存在统计学差异(均有P＜0.05)，且持续感染组血清TG和TC水平均低于其余两组。该地区血脂异常率为18.6%(286/1 537)，多因素Logistic回归分析模型结果显示性别(OR=1.41，95% CI：1.06~1.87，P=0.018)、较高的空腹血糖(OR=2.54，95% CI：1.75~3.68，P＜0.001)以及HCV持续感染者(OR=0.22，95% CI：0.12~0.41，P＜0.001)是血脂异常发生的独立影响因素。结论江苏省既往有偿献血地区，持续感染者血清TG和TC水平均低于未感染者或自限清除者；HCV感染、性别及空腹血糖水平是该地区血脂异常的独立影响因素。
- 丙型肝炎病毒 /
- 总胆固醇 /
- 甘油三酯 /
- 影响因素 /
- 既往有偿献血
Abstract: Objective To explore the correlation between hepatitis C virus (HCV) infection and lipid, and determine the influencing factors of dyslipidemia in remunerated blood donation. Methods From March to May 2015, a cross-sectional study was conducted among people over 50 years old in Jiangsu Province. We obtained demographic data and related measurements through questionnaire surveys and blood test. We compared the lipid levels of different HCV infection groups. The influencing factors of dyslipidemia were explored by univariate and multivariate Logistic regression analysis. Results Of a total of 1 537 participants were included, of which 1 234 (80.3%) were uninfected HCV, 117 (7.6%) were HCV spontaneous clearance, and 186 (12.1%) were HCV persistent infection clients. Differences in serum TG and TC levels among the three groups after PSM were statistically significan (all P < 0.05), and those were lower in the participants with persistent infection than the other groups. Dyslipidemia occurred in 286 participants and the prevalence was 18.6%. Multivariate Logistic regression analysis showed that sex (OR=1.41, 95%CI: 1.06-1.87, P=0.018), higher fasting plasma glucose (OR=2.54, 95% CI: 1.75-3.68, P < 0.001) and HCV persistent infection (OR=0.22, 95% CI: 0.12-0.41, P < 0.001) were independent influencing factors for dyslipidemia. Conclusions The serum levels of TG and TC are lower in patients with persistent infection than those uninfected or with spontaneous clearance in remunerated blood donation. HCV infection, sex and fasting plasma glucose are related with dyslipidemia.
- Hepatitis C virus /
- Total cholesterol /
- Triglyceride /
- Influencing factors /
- Remunerated blood donation

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图 1 PSM后3组血清TG、TC水平比较

Figure 1. Comparison of serum TG and TC levels among three groups after PSM

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图 2 血清TG、TC水平与HCV病毒载量的散点图

Figure 2. Scatter plots of HCV viral load and serum TG and TC levels

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表 1 研究对象一般人口学特征及部分血液检测结果[n(%)]

Table 1. General demographic characteristics and blood test results [n(%)]

变量	全人群					PSM后人群
变量	未感染组	自限清除组	持续感染组	χ²值	P值	未感染组	自限清除组	持续感染组	χ²值	P值
性别				81.186	＜0.001				3.037	0.219
男	516 (41.8)	10 (8.5)	34 (18.3)			18 (8.9)	7 (6.9)	14 (13.9)
女	718 (58.2)	107 (91.5)	152 (81.7)			184 (91.1)	94 (93.1)	87 (86.1)
年龄(岁)				16.452	＜0.001				2.953	0.228
＜60	434 (35.4)	63 (53.8)	75 (40.5)			115 (56.9)	53 (52.5)	47 (46.5)
≥60	793 (64.6)	54 (46.2)	110 (59.5)			87 (43.1)	48 (47.5)	54 (53.5)
文化程度				24.974	＜0.001				0.057	0.972
小学及以下	734 (62.0)	86 (76.8)	134 (78.4)			156 (77.2)	79 (78.2)	79 (78.2)
小学以上	450 (38.0)	26 (23.2)	37 (21.6)			46 (22.8)	22 (21.8)	22 (21.8)
献全血史				397.562	＜0.001				25.495	＜0.001
无	1 129 (92.5)	44 (38.3)	86 (48.0)			139 (68.8)	41 (40.6)	49 (48.5)
有	92 (7.5)	71 (61.7)	93 (52.0)			63 (31.2)	60 (59.4)	52 (51.5)
献全血次数				5.173	0.075				0.573	0.751
＜3	37 (43.5)	21 (32.8)	24 (27.3)			20 (31.7)	18 (30.0)	19 (36.5)
≥3	48 (56.5)	43 (67.2)	64 (72.7)			43 (68.3)	42 (70.0)	33 (63.5)
单采血浆史				617.873	＜0.001				49.837	＜0.001
无	1 053 (86.3)	15 (12.9)	27 (15.0)			97 (48.0)	15 (14.9)	16 (15.8)
有	167 (13.7)	101 (87.1)	153 (85.0)			105 (52.0)	86 (85.1)	85 (84.2)
单采血浆次数				12.094	0.002				11.670	0.003
＜10	54 (32.5)	18 (18.6)	26 (17.2)			6 (5.7)	16 (18.6)	19 (22.4)
≥10	112 (67.5)	79 (81.4)	125 (82.8)			99 (94.3)	70 (81.4)	66 (77.6)
ALT(IU/L)				454.230	＜0.001				30.866	＜0.001
≤40	1 189 (96.4)	111 (94.9)	87 (46.8)			187 (92.6)	95 (94.1)	73 (72.3)
>40	45 (3.6)	6 (5.1)	99 (53.2)			15 (7.4)	6 (5.9)	28 (27.7)
AST(IU/L)				473.988	＜0.001				19.601	＜0.001
≤40	1 206 (97.7)	113 (96.6)	96 (51.6)			193 (95.5)	97 (96.0)	83 (82.2)
>40	28 (2.3)	4 (3.4)	90 (48.4)			9 (4.5)	4 (4.0)	18 (17.8)
FPG(mmol/L)				6.543	0.038				0.663	0.718
＜7.0	1 117 (90.5)	105 (89.7)	157 (84.4)			174 (86.1)	89 (88.1)	85 (84.2)
≥7.0	117 (9.5)	12 (10.3)	29 (15.6)			28 (13.9)	12 (11.9)	16 (15.8)
注：所有研究对象中，8人无年龄信息，70人无文化程度信息，22人无献全血史信息，41人无献全血次数信息，57人无单采血浆史信息，28人无单采血浆史次数信息。

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表 2 既往有偿献血地区血脂异常影响因素分析

Table 2. Analysis of influencing factors of dyslipidemiain remunerated blood donation

变量	血脂异常 /正常	β值	多因素分析
变量	血脂异常 /正常	β值	OR (95% CI)值	P值
性别
男	91/469		1.00
女	195/782	0.344	1.41 (1.06~1.87)	0.018
FPG(mmol/L)
＜7.0	235/1 144		1.00
≥7.0	51/107	0.932	2.54 (1.75~3.68)	＜0.001
HCV感染状况
未感染组	249/985		1.00
自限清除组	26/91	0.020	1.02 (0.64~1.63)	0.937
持续感染组	11/175	-1.514	0.22 (0.12~0.41)	＜0.001

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