摘要
背景 心血管疾病(CVD)是我国乃至全世界的首要致死病因,脂质代谢紊乱是CVD的重要危险因素.了解儿童青少年时期血脂异常流行情况有助于成年期血脂异常的早期预防.目的 系统评价国内儿童青少年血脂异常流行现状.方法 在中国生物医学文献数据库、中国知网、万方数据知识服务平台、维普网、Embase、PubMed、Web of Science和Cochrane Library数据库中,对 2015 年 1 月—2023 年 7 月发表的有关中国儿童青少年血脂异常患病率的横断面研究进行计算机检索.文献筛选、数据提取和纳入文献的偏倚风险评估由 2 名研究人员独立完成.使用Stata 17.0软件进行Meta分析.结果 最终纳入 34 项横断面研究,包含 134 438 例儿童青少年.Meta分析结果显示:中国儿童青少年血脂异常总患病率为19%(95%CI=16%～21%),高总胆固醇血症、高三酰甘油血症、高低密度脂蛋白胆固醇血症、低高密度脂蛋白胆固醇血症患病率分别为 6%(95%CI=5%～7%)、9%(95%CI=6%～12%)、4%(95%CI=3%～5%)、10%(95%CI=7%～13%).时间分布显示,血脂异常总患病率呈波动下降趋势;高总胆固醇血症和高低密度脂蛋白胆固醇血症患病率随时间变化呈上升趋势,但 2023 年数据稍有回落;高三酰甘油血症和低高密度脂蛋白胆固醇血症患病率波动较大,其中 2018-2022 年高三酰甘油血症患病率逐渐下降,2023 年稍有回升.亚组分析结果显示:年龄方面,儿童青少年血脂异常总体患病率和高三酰甘油血症患病率随年龄增长呈上升趋势(3～6 岁为 10%、2%,7～11 岁为 17%、10%,12～18 岁为 27%、14%),12～18 岁低高密度脂蛋白胆固醇血症患病率(20%)高于 7～11 岁(9%),3～6 岁高总胆固醇血症患病率(9%)高于 7～11 岁和 12～18 岁(4%和 3%)(P<0.05).地区方面,西部地区低高密度脂蛋白胆固醇血症患病率(15%)高于东部(7%),东部地区高总胆固醇血症和高低密度脂蛋白胆固醇血症患病率(7%和 6%)高于西部(3%和 2%)(P<0.05).BMI方面,肥胖儿童青少年血脂异常、高总胆固醇血症、高三酰甘油血症和高低密度脂蛋白胆固醇血症患病率(48%、18%、25%和 7%)高于超重(27%、6%、9%和 4%)和正常儿童青少年(15%、4%、3%和 3%)(P<0.05).结论 中国儿童青少年血脂异常患病率较高,不同年龄段、不同调查地区和不同BMI的儿童青少年血脂异常患病率存在差异.受纳入研究数量及质量的限制,上述研究结果有待更多高质量研究予以验证.
Abstract
Background Cardiovascular disease(CVD)is the leading cause of death in China and the world as a whole,and lipid metabolism disorder is the key factor for this disease.A comprehensive understanding of the prevalence of dyslipidemia in children and adolescents can contribute to the early prevention of dyslipidemia in adulthood.Objective To systematically evaluate the status quo of the prevalence of dyslipidemia in Chinese children and adolescents.Methods Cross-sectional studies on the morbidity rate of dyslipidemia among Chinese children and adolescents and published from January 2015 to July 2023 were retrieved from databases of CBM,CNKI,Wanfang,VIP,Embase,Web of Science and Cochrane Library.Processes of literature screening,data extraction and risk bias analysis were performed by two researchers.A meta-analysis was performed by taking advantage of Stata 17.0.Results 34 cross-sectional studies were collected and a total of 134 438 children and adolescents were involved.Results of the meta-analysis indicated that the overall morbidity rate of dyslipidemia in Chinese children and adolescents was 19%(95%CI=16%-21%),and the morbidity rates of high cholesterol(TC),high triacylglycerol(TG),high low-density lipoprotein cholesterol(LDL-C),low high-density lipoprotein cholesterol(HDL-C)were 6%(95%CI=5%-7%),9%(95%CI=6%-12%),4%(95%CI=3%-5%)and 10%(95%CI=7%-13%)respectively.Regarding time distribution,the detection rate of dyslipidemia was fluctuant and showed a decreasing trend;the detection rate of high TC and high LDL-C showed an increasing trend in general,but it fell slightly in 2023;the detection rate of high TG and low HDL-C fluctuated greatly:the detection rate of high TG gradually decreased from 2018 to 2022 and rebounded slightly in 2023.The results of subgroup analysis showed that,concerning age,the overall morbidity rate of dyslipidemia in children and adolescents and that of high TC showed an ascending tendency with the increasing of age(10%and 2%for those aged from 3 to 6,17%and 10%for those aged from 7 to 11,and 27%and 14%for those aged from 12 to18),the morbidity rate of lowered HDL-C was higher among 12-to-18-year olds(20%)than among 7-to-11-year olds(9%),and the morbidity rate of high TC among 3-to-6-year olds(9%)was higher than that among 7-to-11-year olds and 12-to-18-year-olds(4%and 3%)(P<0.05).Concerning region,the morbidity rates of low HDL-C were higher in the West(15%)than in the East(7%),and the morbidity rates of high TC and high LDL-C were higher in the East(7%and 6%)than in the West(3%and 2%)(P<0.05).Concerning BMI,the morbidity rates of dyslipidemia,high TG and high LDL-C were higher in obese children and adolescents(48%,18%,25%,and 7%)than in overweight(27%,6%,9%,and 4%)and normal children and adolescents(15%,4%,3%,and 3%)(P<0.05).Conclusion The morbidity rate of dyslipidemia in Chinese children and adolescents is relatively high and varied across the age,region and BMI of children and adolescents.Due to the limitation of the number and quality of included studies,more high-quality studies are needed to be conducted to further validate these findings.
基金项目
四川省科技厅项目(2022JDR0329)
四川省2021-2023年高等教育人才培养质量和教学改革项目(JG2021-791)
维普
万方数据