摘要
目的:分析江苏省邳州市乡镇农民胰岛素原水平与文化程度之间相关性及该种相关性的特点。方法:于2002-10/12按简单随机抽样原则在江苏省邳州市随机抽取4个乡镇,每个乡镇随机抽取1个村庄,每个村庄随机抽取350名35～59岁的常住居民,共1400人。均知情同意参加调查。实际调查人数1265人。调查采用统一自行设计调查表(内容包括文化程度、性别、年龄、体质量指数、血压、血脂、腰围)。采用全自动生化分析仪测定空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇。低密度脂蛋白胆固醇按Friedewald等公式计算求得。胰岛素原的测定采用酶联免疫吸附反应方法。空腹血糖、血脂与胰岛素原资料呈偏态分布,以中位数(四分位间距)表示,对数转换后进行统计分析;分别应用成组资料的t检验、单因素方差分析比较胰岛素原的水平在不同的性别、文化程度组别间的分布差异。胰岛素原水平与文化程度及其他变量的关系分析采用Spear-man相关,相关分析及多元逐步相关分析。结果:①纳入对象中71人未按要求填写为无效样本,有效样本量为1194人,男531人(44.57%),女663人(55.43%),平均年龄(47±13)岁。接受教育水平未上学485人、小学259人、初中326人、高中以上124人。②胰岛素原的水平在男女性别间的分布无明显差异;总体观察显示胰岛素原的水平在不同的文化程度中的分布存在明显差异,文化程度越高,胰岛素原的水平越高(P=0.013)。分层后分析结果显示,胰岛素原的水平在男女性别间的分布均随文化程度的升高而升高,但在女性中,上述差异不明显。③Spearman相关及调整了年龄与性别变量的偏相关分析结果显示,胰岛素原的水平与文化程度、体质量指数、腰围、收缩压、舒张压、空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇的水平呈正相关(r=0.073～0.3692,P<0.05～0.01),与高密度脂蛋白胆固醇水平呈负相关(r=-0.130,-0.0643,P=0.000,0.027)。④经多元逐步线性回归分析结果显示,文化程度与胰岛素原的水平正相关,其标准化系数为0.106,P=0.001,即文化程度越高,胰岛素原的水平越高,且其相关关系独立于年龄、性别、体质量指数、腰围、收缩压、舒张压、空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇为自变量。结论:①胰岛素原水平随着文化程度增高而增高,且在男性中此种变化较女性明显。②文化程度是独立于年龄、性别、体质量指数、腰围、收缩压、舒张压、空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等因素,与胰岛素原水平呈独立正相关。
AIM： To analyze the association between the proinsulin level and educational level in farmers from Pizhou city of Jiangsu province. METHODS： From October to December 2002, a large cross-sectional, community-based epidemiological study was conducted in Pizhou city of Jiangsu province. A simple random sampling was used to select in 4 small towns, and one village was seleeted from every small town, each with a population of 350 subjects aged from 35 to 59 years, totally 1 400 people. They all knew the fact and agreed to he investigated. In fact, there were 1 265 people who took part in the investigation. The standard self-made questionnaire （including educational level, sex, age, body mass index, blood pressure, blood lipid, and waist circumference） was conducted. Fasting blood glucose, total cholesterol, triglyceride and.high-density lipoprotein cholesterol were determined with full-automatic biochemistry analyzer, and lowdensity lipoprotein cholesterol was assessed with the Friedwald method. The proinsulin was assessed with enzyme linked immunosorbent assay （ELISA）. Data of fasting blood glucose, lipid, proinsulin were skewed parameters and presented as median and quartile range, and were log transformed before analysis. The t-test and single factor analysis of variance in bundle data were used to determine the difference of proinsulin level among various groups of gender and educational level. Spearman correlation, partial correlation, and stepwise multiple linear regression were used to analyze the relationship between proinsulin level, educational level and other variables. RESULTS： ① The 71 included people, who did not fill out the questionnaire according to the requirement, were inefficiency samples and 1 194 people were efficient samples, including 531 males （44.57%） and 663 females （55.43%）, and their average age was 47±13. The Education level of subjects was as following： illiteracy 485, primary school 259, middle school 326, high school and more 124. ② The level of proinsulin displayed no significant difference between males and females. However, significant difference was found with proinsulin among suhjects with various educational levels, and the proinsulin level increased with the elevation of educational level （P=0.013）. After demixing the analysis result showed that the distribution of level of proinsulin between males and females increased with the higher of the edueational level, but the above-mentioned difference was insignificant in females. ③ The results of Spearman correlation and partial correlation controlling for age and gender showed that the levels of proinsulin positively significantly associated with educational level, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, blood glucose, total cholesterol, triglyceride, and low-density lipoprotein cholesterol （r=0.073-0.369 2, P 〈 0.05-0.01）, and negatively associated with high-density lipoprotein cholesterol （r=-0.130,-0.064 3, P=0.000, 0.027）. ④ The results of multiple stepwise linear regression indicated that the proinsulin was positively associated with the educational level, its standardized coefficient was 0.106,P=0.001, that was, the higher the educational level, the higher the proinsulin level, besides, independently of traditional cardiovascular risk factors, including age, sex, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol as independent vari-able. CONCLUSION： ① The concentration of proinsulin increased with the elevation of educational level, and this change is significant in males as compared with the females. ② The educational level is independent of age, sex, body mass index, waist circunfference, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol, and shows positive correlation dependently with proinsulin level.
出处
《中国临床康复》
CSCD
北大核心
2005年第36期35-37,共3页
Chinese Journal of Clinical Rehabilitation
基金
国家自然科学基金资助项目(30400173)~~
