The levels of serum lipids and glucose in the control group
From 2012 to 2019, 5043 people have taken part in the health examination for 8 consecutive years. In the same period, 136,994 participants (the control group) had a health examination only 1 time. The number of participants in each age group was shown in Table 1. The age of all the participants ranged from 18 to 100.
Table 1
Numbers of participants in the control group, the 1st and 8th year of the follow-up group
Age group
|
≤30y
|
31-40y
|
41-50y
|
51-60y
|
61-70y
|
≥71y
|
Total
|
The control group
|
|
|
|
|
|
|
|
2012
|
Male
|
1901
|
2090
|
1868
|
1759
|
682
|
510
|
8810
|
|
Female
|
2446
|
2067
|
2490
|
1911
|
789
|
598
|
10,301
|
2013
|
Male
|
1870
|
2365
|
1801
|
1687
|
774
|
598
|
9095
|
|
Female
|
2731
|
2508
|
2078
|
1757
|
800
|
600
|
10,474
|
2014
|
Male
|
1473
|
2138
|
1571
|
1605
|
773
|
563
|
8123
|
|
Female
|
2132
|
2444
|
1965
|
1769
|
831
|
602
|
9743
|
2015
|
Male
|
1044
|
1751
|
1431
|
1603
|
799
|
509
|
7137
|
|
Female
|
1859
|
2383
|
1850
|
1723
|
933
|
606
|
9354
|
2016
|
Male
|
1207
|
1946
|
1428
|
1629
|
888
|
551
|
7649
|
|
Female
|
1885
|
2437
|
1836
|
1710
|
1050
|
644
|
9562
|
2017
|
Male
|
1121
|
1714
|
1278
|
1276
|
786
|
408
|
6583
|
|
Female
|
1613
|
2236
|
1752
|
1419
|
958
|
570
|
8548
|
2018
|
Male
|
1248
|
1850
|
1283
|
1236
|
832
|
424
|
6873
|
|
Female
|
1852
|
2435
|
1820
|
1465
|
1082
|
550
|
9204
|
2019
|
Male
|
980
|
1846
|
1413
|
1263
|
815
|
371
|
6688
|
|
Female
|
1508
|
2689
|
1793
|
1297
|
1034
|
529
|
8850
|
The follow-up group
|
|
|
|
|
|
|
|
1st
|
Male
|
197
|
403
|
418
|
417
|
205
|
115
|
1755
|
|
Female
|
521
|
830
|
794
|
673
|
279
|
191
|
3288
|
8th
|
Male
|
28
|
300
|
398
|
404
|
403
|
222
|
1755
|
|
Female
|
73
|
700
|
818
|
713
|
625
|
359
|
3288
|
The levels of serum lipids and glucose based on the data of control group from 2012 to 2019 were shown in Table 2. Serum TG increased with aging in both genders. For the male, serum TG was 1.05 mmol/L in ≤30 year group and a 1.42-fold increase was found in 41-50 year group (p < 0.001). After the age of 50, serum TG began to decrease slightly. Unlike the male, serum TG of female was 0.67 mmol/L in ≤30 year group and increased continuously after menopausal period. In 61-70 year group, it had a maximum value (1.30 mmol/L) and almost doubled (p < 0.001).
Table 2
The levels of serum lipids and glucose in the control group
Age group
|
TG
|
TC
|
LDL-C
|
HDL-C
|
GLU
|
Male
|
Female
|
Male
|
Female
|
Male
|
Female
|
Male
|
Female
|
Male
|
Female
|
≤30y
|
1.05
(0.72-1.60)
|
0.67
(0.51-0.92)#
|
4.47
(3.95-5.06)
|
4.31
(3.86-4.80)#
|
2.78
(2.31-3.30)
|
2.45
(2.06-2.87)#
|
1.20
(1.01-1.42)
|
1.56
(1.33-1.80)#
|
4.96
(4.69-5.24)
|
4.84
(4.59-5.10)#
|
31-40y
|
1.38
(0.93-2.09)***
|
0.78
(0.57-1.10)***,#
|
4.79
(4.26-5.36)***
|
4.51
(4.03-5.05)***,#
|
3.04
(2.56-3.55)***
|
2.62
(2.21-3.10)***,#
|
1.13
(0.96-1.34)***
|
1.52
(1.28-1.78)***,#
|
5.10
(4.82-5.43)***
|
4.95
(4.69-5.24)***,#
|
41-50y
|
1.49
(1.00-2.22)***
|
0.95
(0.68-1.39)***,#
|
4.94
(4.39-5.54)***
|
4.86
(4.32-5.43)***,#
|
3.13
(2.63-3.67)***
|
2.94
(2.49-3.46)***,#
|
1.15
(0.97-1.37)***
|
1.49
(1.24-1.76)***,#
|
5.31
(4.97-5.77)***
|
5.11
(4.82-5.44)***,#
|
51-60y
|
1.44
(0.99-2.15)***
|
1.23
(0.86-1.75)***,#
|
4.95
(4.34-5.56)***
|
5.34
(4.73-5.98)***,#
|
3.14
(2.58-3.68)***
|
3.35
(2.80-3.92)***,#
|
1.18
(0.99-1.40)***
|
1.47
(1.23-1.75)***,#
|
5.54
(5.12-6.20)***
|
5.31
(4.99-5.76)***,#
|
61-70y
|
1.28
(0.91-1.85)***
|
1.30
(0.93-1.83)***
|
4.77
(4.13-5.40)***
|
5.27
(4.66-5.91)***,#
|
2.99
(2.42-3.55)***
|
3.24
(2.68-3.82)***,#
|
1.20
(1.00-1.44)
|
1.45
(1.21-1.73)***,#
|
5.61
(5.17-6.37)***
|
5.46
(5.10-6.00)***,#
|
≥71y
|
1.15
(0.82-1.62)***
|
1.25
(0.91-1.72)***,#
|
4.48
(3.88-5.16)
|
5.00
(4.34-5.69)***,#
|
2.76
(2.19-3.36)*
|
2.99
(2.38-3.62)***,#
|
1.21
(1.01-1.47)***
|
1.46
(1.21-1.76)***,#
|
5.77
(5.28-6.65)***
|
5.66
(5.19-6.45)***,#
|
*: p < 0.05 compared with sex-matched ≤30 year group; ***: p < 0.001 compared with sex-matched ≤30 year group
#: p < 0.001 compared with age-matched male
|
In consistence with serum TG, serum TC of male showed an obvious age-dependent increase and reached the highest level (4.95 mmol/L) in 51-60 year group. After that, it dropped slowly. In ≥71 year group, serum TC returned to the same value with the ≤30 year group. For the female, under the age of menopause, serum TC was lower compared with that of the age-matched male (p < 0.001). In 51-60 year group, it had a maximum value (5.34 mmol/L), even higher than the age-matched male. Despite serum TC of female decreased after menopausal period, it still exceeded the level of ≤30 year group far away (p < 0.001).
The change patterns of serum LDL-C in both genders were similar to the level of serum TC. Serum LDL-C peaked in 51-60 year group of both genders. After menopausal period, serum LDL-C of female decreased but it was always higher than the age-matched male (p < 0.001). On the contrary, serum HDL-C decreased at first and then increased with aging, which was significantly different with TG, TC and LDL-C. In addition, serum HDL-C of male was always lower than that of the age-matched female.
Serum GLU exhibited an age-dependent increase markedly in both genders. 1.16- and 1.17-fold higher levels for male and female were found in ≥71 year group compared with the ≤30 year group (both p < 0.001), respectively. Furthermore, during the whole life-span, serum GLU of female was always lower than that of the age-matched male, even after the age of menopause.
Effect of annual health examination on the levels of serum TG, TC and GLU in the follow-up group
Because the number of participants of ≤30 year group in the 8th year of the follow-up group was small (Table 1), to avoid introducing bias in calculating the levels and the incidence rate, we merged ≤30 year group and 31-40 year group to be ≤40 year group.
The levels of serum TG, TC and GLU in 2019 of the control group, the 1st and 8th health examination year of the follow-up group were listed in Table 3. Firstly, we performed a cross-sectional comparison, comparing the levels of serum TG, TC and GLU between the 8th year of the follow-up group and 2019 of the control group. Our results established that compared with 2019 of the control group, serum TC and GLU in the 8th year of the follow-up group increased obviously in the ≤40 year group (all p < 0.001), which was present in both genders. Additionally, serum TC and GLU in the 8th year of the follow-up group were much higher than 2019 of the control group in the 41-50 year group (both p < 0.001), which was present only in female. Surprisingly, in the 61-70 year groups, serum GLU of female in the 8th year of the follow-up group was also higher than 2019 of the control group (p < 0.001). In the other age groups, there were no significant differences of serum TG, TC and GLU levels between the 8th year of the follow-up and the control group in 2019 (all p > 0.05).
Table 3
Levels of serum TG, TC and GLU in 2019 of the control group, the 1st and 8th year of the follow-up group
Age group
|
≤40y
|
41-50y
|
51-60y
|
61-70y
|
≥71y
|
|
|
Male
|
Female
|
Male
|
Female
|
Male
|
Female
|
Male
|
Female
|
Male
|
Female
|
TG
|
2019
|
1.25
(0.83-1.94)
|
0.74
(0.55-1.04)
|
1.41
(0.97-2.12)
|
0.95
(0.70-1.35)
|
1.46
(1.02-2.15)
|
1.22
(0.87-1.76)
|
1.26
(0.89-1.81)
|
1.33
(0.93-1.86)
|
1.21
(0.81-1.67)
|
1.27
(0.92-1.76)
|
|
1st
|
1.15
(0.79-1.76)
|
0.71
(0.53-0.99)
|
1.44
(1.00-2.11)
|
0.97
(0.70-1.39)
|
1.44
(1.04-2.05)
|
1.20
(0.85-1.64)
|
1.37
(0.93-2.12)
|
1.29
(0.93-1.86)
|
1.21
(0.85-1.54)
|
1.27
(0.93-1.74)
|
|
8th
|
1.29
(0.93-2.04)#
|
0.77
(0.58-1.10)*,#
|
1.42
(0.96-2.10)
|
0.95
(0.70-1.37)
|
1.47
(1.03-2.06)
|
1.23
(0.87-1.69)
|
1.27
(0.94-1.82)
|
1.27
(0.92-1.81)
|
1.26
(0.83-1.72)
|
1.24
(0.92-1.67)
|
TC
|
2019
|
4.78
(4.23-5.43)
|
4.56
(4.08-5.10)
|
5.06
(4.45-5.63)
|
4.99
(4.42-5.54)
|
4.98
(4.36-5.63)
|
5.45
(4.85-6.10)
|
4.87
(4.12-5.50)
|
5.36
(4.78-6.02)
|
4.40
(3.78-5.08)
|
4.98
(4.21-5.60)
|
|
1st
|
4.57
(4.04-5.14)
|
4.35
(3.89-4.92)
|
4.86
(4.41-5.44)
|
4.84
(4.27-5.41)
|
4.93
(4.34-5.51)
|
5.20
(4.67-5.85)
|
4.78
(4.16-5.30)
|
5.17
(4.62-5.77)
|
4.42
(3.74-5.16)
|
5.04
(4.37-5.62)
|
|
8th
|
5.04
(4.48-5.60)*,#
|
4.71
(4.23-5.29)*,#
|
5.00
(4.44-5.59)
|
5.05
(4.49-5.64)*,#
|
4.98
(4.37-5.58)
|
5.49
(4.86-6.10)#
|
4.90
(4.17-5.49)
|
5.31
(4.74-5.97)#
|
4.35
(3.80-5.03)
|
5.01
(4.26-5.63)
|
GLU
|
2019
|
5.02
(4.75-5.32)
|
4.89
(4.63-5.14)
|
5.27
(4.94-5.73)
|
5.06
(4.80-5.39)
|
5.49
(5.08-6.18)
|
5.27
(4.95-5.74)
|
5.70
(5.23-6.55)
|
5.42
(5.08-5.97)
|
5.78
(5.28-.66)
|
5.62
(5.14-6.45)
|
|
1st
|
5.12
(4.81-5.42)
|
5.04
(4.78-5.35)
|
5.28
(4.97-5.78)
|
5.17
(4.88-5.51)
|
5.50
(5.11-6.10)
|
5.34
(5.02-5.75)
|
5.71
(5.27-6.37)
|
5.52
(5.15-6.00)
|
5.74
(5.28-6.52)
|
5.71
(5.20-6.41)
|
|
8th
|
5.16
(4.87-5.48)*
|
5.08
(4.81-5.40)*
|
5.41
(5.03-5.78)
|
5.20
(4.92-5.53)*
|
5.54
(5.16-6.12)
|
5.46
(5.10-5.88)#
|
5.75
(5.25-6.62)
|
5.57
(5.18-6.14)*
|
5.86
(5.36-6.83)
|
5.78
(5.21-6.67)
|
*: p < 0.001 compared with age-matched group in 2019 of the control group
#: p < 0.001 compared with age-matched group in the 1st year of the follow-up group
|
Secondly, we compared the levels of serum TG, TC and GLU between the 1st and the 8th year of the follow-up group longitudinally. Our results showed that in the ≤40 year group, serum TG and TC of both genders in the 8th year significantly increased compared with those in the 1st year (all p < 0.001). Additionally, in the 41-50, 51-60 and 61-70 year groups, serum TC of female in the 8th year increased markedly compared with those in the 1st year (all p < 0.001). These results suggested that serum TC of female demonstrated a more obvious increase compared with the age-matched male from 2012 to 2019. On the whole, there were no significant differences of serum GLU levels between the 1st and the 8th year of the follow-up (all p > 0.05).
The prevalence of hyperlipidemia and hyperglycemia in the control group
According to the diagnostic criteria, the incidence rates of hyperlipidemia in the control group from 2012 to 2019 were listed in Table 4.
Table 4
Percentages of hyperlipidemia in the control group from 2012 to 2019
Age group
|
≤40y
|
41-50y
|
51-60y
|
61-70y
|
≥71y
|
Total
|
2012
|
Male
|
19.22
|
29.41
|
26.83
|
17.45
|
12.35
|
22.58
|
|
Female
|
3.99
|
11.73
|
22.50
|
25.22
|
21.07
|
11.91
|
2013
|
Male
|
20.07
|
29.15
|
28.33
|
19.25
|
12.21
|
22.81
|
|
Female
|
4.62
|
11.93
|
25.95
|
27.50
|
23.67
|
12.49
|
2014
|
Male
|
19.44
|
28.26
|
27.73
|
21.73
|
12.61
|
22.53
|
|
Female
|
5.03
|
11.15
|
24.87
|
25.27
|
19.77
|
12.50
|
2015
|
Male
|
19.18
|
26.83
|
26.45
|
17.52
|
14.15
|
21.80
|
|
Female
|
5.02
|
10.16
|
25.42
|
23.69
|
20.63
|
12.67
|
2016
|
Male
|
19.98
|
29.69
|
27.44
|
19.71
|
14.34
|
22.94
|
|
Female
|
6.78
|
12.69
|
29.24
|
28.86
|
24.84
|
15.57
|
2017
|
Male
|
20.11
|
28.40
|
28.13
|
19.97
|
12.75
|
22.80
|
|
Female
|
6.65
|
14.21
|
28.05
|
29.44
|
20.35
|
15.22
|
2018
|
Male
|
18.88
|
24.63
|
24.43
|
18.63
|
13.44
|
20.60
|
|
Female
|
5.95
|
11.37
|
27.37
|
28.19
|
17.45
|
13.73
|
2019
|
Male
|
21.60
|
27.67
|
27.79
|
19.39
|
12.94
|
23.24
|
|
Female
|
6.79
|
14.39
|
30.61
|
29.59
|
20.98
|
15.33
|
Firstly, we investigated the relationship between the percentage of hyperlipidemia and age. The results showed that the prevalence of hyperlipidemia increased steadily with aging, no matter with the gender. For the male, the percentages of hyperlipidemia peaked in the 41-50y group. However, it had a maximum value for the female in the 61-70y group, which was consistent with the levels of serum TG. Secondly, we investigated whether the percentage of hyperlipidemia increased from 2012 to 2019 in each age group. Through the Trend chi-square test, we found that the percentages of hyperlipidemia of male didn’t exhibit a linear increase in all the age groups during the 8 years. However, the percentages of hyperlipidemia of female in the ≤40, 41-50, 51-60 and 61-70 year groups increased steadily from 2012 to 2019 (Trend chi-squares 54.55, 7.45, 29.55 and 7.61, respectively, all p < 0.05).
The incidence rates of hyperglycemia in the control group from 2012 to 2019 were listed in Table 5. The percentages of hyperglycemia also exhibited an age-dependent increase markedly in both genders. Similar to the levels of serum GLU, the percentages of hyperglycemia of male were always higher than those of the age-matched female. It should be noticed that the percentages of hyperglycemia of female increased more rapidly with aging than that of male. Such as, in 2013, the percentage of hyperglycemia of male was 4.91 folds as that of female in the ≤40 year group; but, it was only 1.28 folds as that of female in the ≥71year group. Furthermore, through the Trend chi-square test, the prevalence of hyperglycemia of male increased steadily in the ≤40 and 61-70 year groups from 2012 to 2019 (Trend chi-square 27.21 and 14.10, respectively, both p < 0.05). And the percentages of hyperlipidemia of female didn’t show differences in all the age groups in the consecutive 8 years.
Table 5
Percentages of hyperglycemia in the control group from 2012 to 2019
Age group
|
≤40y
|
41-50y
|
51-60y
|
61-70y
|
≥71y
|
Total
|
2012
|
Male
|
1.80
|
8.46
|
14.10
|
16.28
|
20.20
|
7.84
|
|
Female
|
0.64
|
2.37
|
7.12
|
10.39
|
17.22
|
3.97
|
2013
|
Male
|
2.03
|
7.72
|
15.00
|
16.54
|
20.40
|
8.00
|
|
Female
|
0.46
|
2.94
|
7.11
|
10.75
|
15.17
|
3.69
|
2014
|
Male
|
1.94
|
7.77
|
13.71
|
16.04
|
18.83
|
7.89
|
|
Female
|
0.52
|
2.90
|
6.67
|
9.87
|
14.78
|
3.80
|
2015
|
Male
|
2.11
|
7.41
|
13.41
|
17.27
|
19.65
|
8.66
|
|
Female
|
0.47
|
2.76
|
6.79
|
10.93
|
17.49
|
4.23
|
2016
|
Male
|
2.16
|
7.63
|
14.24
|
14.08
|
18.69
|
8.33
|
|
Female
|
0.44
|
3.59
|
5.73
|
11.05
|
14.60
|
4.11
|
2017
|
Male
|
3.00
|
7.51
|
14.97
|
16.03
|
21.81
|
8.92
|
|
Female
|
0.57
|
2.68
|
6.06
|
9.29
|
17.37
|
4.01
|
2018
|
Male
|
2.58
|
8.81
|
15.05
|
19.71
|
23.35
|
9.34
|
|
Female
|
0.70
|
2.91
|
6.69
|
11.37
|
19.09
|
4.44
|
2019
|
Male
|
2.34
|
7.93
|
15.36
|
19.88
|
21.29
|
9.17
|
|
Female
|
0.33
|
2.51
|
6.78
|
21.57
|
16.64
|
5.18
|
Effect of annual health examination on the prevalence of hyperlipidemia and hyperglycemia
The incidence rates of hyperlipidemia in 2019 of the control group, the 1st and 8th year of the follow-up group were listed in Table 6. Compared with the non-consecutive group in 2019, there was only a significant difference of the percentages of hyperlipidemia of female in the 8th year of the follow-up group in the ≤40y group (p < 0.05). Compared with the 1st year, the incidence rates of hyperlipidemia of both genders in the 8th year increased steadily in the ≤40 year group (both p < 0.05). It should be noticed that, for the female under the age of 60, the percentages of hyperlipidemia in the 8th year were significantly higher than those in the 1st year of the follow-up group (all p < 0.05). These were in accordance with the change pattern of serum TC in female of the follow-up group completely. As a whole, the percentages of hyperlipidemia of female in the 8th year showed significant increase compared with the 1st year of the follow-up group and 2019 of the control group (all p < 0.05). For the male, there were no differences of the percentages of hyperlipidemia among these three groups.
Table 6
Percentages of hyperlipidemia in 2019 of the control group, the 1st and 8th year of the follow-up group
Age group
|
≤40y
|
41-50y
|
51-60y
|
61-70y
|
≥71y
|
Total
|
2019
|
Male
|
21.60
|
27.67
|
27.79
|
19.39
|
12.94
|
23.24
|
|
Female
|
6.79
|
14.39
|
30.61
|
29.59
|
20.98
|
15.33
|
1st
|
Male
|
18.17
|
24.88
|
26.62
|
19.02
|
13.04
|
21.25
|
|
female
|
4.89
|
10.94
|
20.36
|
27.24
|
18.85
|
12.23
|
8th
|
Male
|
22.39#
|
26.88
|
25.00
|
20.35
|
15.77
|
22.67
|
|
Female
|
8.70*,#
|
14.38#
|
24.03#
|
27.52
|
22.56
|
18.10*,#
|
*: p < 0.05 compared with age-matched group in 2019 of the control group
#: p < 0.05 compared with age-matched group in the 1st year of the follow-up group
|
The incidence rates of hyperglycemia in 2019 of the control group, the 1st and 8th year of the follow-up group were listed in Table 7. Compared with the control group in 2019, there were significant differences of the percentages of hyperglycemia of female in the 8th year in most of the age groups (all p < 0.05), consistent with serum GLU of female. Additionally, compared with the 1st year, the percentages of hyperglycemia in the 8th year increased significantly in the 61-70 and ≥71 year groups for the male and in the 41-50 and 61-70 year groups for the female, respectively (all p < 0.05). On the whole, the percentages of hyperglycemia in the 8th year showed significant increase compared with the 1st year of the follow-up group and 2019 of the control group (all p < 0.05), which was present in both genders.
Table 7
Percentages of hyperglycemia in 2019 of the control group, the 1st and 8th year of the follow-up group
Age group
|
≤40y
|
41-50y
|
51-60y
|
61-70y
|
≥71y
|
Total
|
2019
|
Male
|
2.34
|
7.93
|
15.36
|
19.88
|
21.29
|
9.17
|
|
Female
|
0.33
|
2.51
|
6.78
|
11.57
|
16.64
|
5.18
|
1st
|
Male
|
1.67
|
6.22
|
11.27
|
12.20
|
18.26
|
7.35
|
|
Female
|
0.52
|
2.26
|
6.98
|
10.04
|
16.75
|
4.01
|
8th
|
Male
|
2.75
|
8.04
|
13.37
|
21.59#
|
22.52#
|
13.28*,#
|
|
Female
|
0.65*
|
3.54*,#
|
6.87
|
13.92*,#
|
19.78*
|
7.33*,#
|
*: p < 0.001 compared with age-matched group in 2019 of the control group
#: p < 0.001 compared with age-matched group in the 1st year of the follow-up group
|
Among the total 5043 participants, 2285 (45.31%) had been diagnosed as hyperlipidemia from 2012 to 2019. Of them, 1107(1107/2285, 48.45%) had been hyperlipidemia 1 or 2 times and 1168 (1168/2285, 51.12%) had a bad hyperlipidemia control (over 3 times). Additionally, of the 5043 participants, 752 (14.91%) had been diagnosed as hyperglycemia. Of them, 318 (318/752, 42.29%) had been hyperglycemia 1 or 2 times and 434 (434/752, 57.71%) had a bad hyperglycemia control.