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Lipid screening in an elderly population: difficulty in interpretation and in detection of occult metabolic disease.

机译:老年人血脂筛查:难以解释和发现隐性代谢疾病。

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摘要

AIMS: To determine lipid profiles and associations with other metabolic disease in a representative British elderly population. METHODS: Part of a prevalence survey of dementia in all 75+ year olds conducted from the large general practice serving the town and surrounding area of Melton Mowbray, Leicestershire (the M-old study). Patients (n = 224) aged from 75 to 98 years, and representative of the overall population, also provided pre-prandial blood samples on which various age and nutrition related analytes were determined. These included documented medical history, thyroid stimulating hormone (TSH), glucose, immunoglobulins, and lipid profile in plasma. RESULTS: Cholesterol and lipid variables showed wide scatter, with some negative trends but no significant associations with age for total cholesterol, high density lipoprotein (HDL) cholesterol, the ratio of total to HDL cholesterol or triglycerides. Women had significantly higher concentrations of total and HDL cholesterol at all ages. Serum TSH was above 6.0 mU/1 in 10/205 patients, random glucose was above 11.2 mmol/l in nine of 207 patients, borderline dysglobulinaemia was present in four of 210 patients, all without correlation with cholesterol concentrations. CONCLUSION: This British data is consistent with an inverse correlation between survival and cholesterol, but wide scatter restricts reliance on single result lipid data in individual patient management. Random lipid screening is also unhelpful, inefficient and without added value in revealing other age related and unrecognised occult metabolic disease.
机译:目的:确定具有代表性的英国老年人群的血脂谱以及与其他代谢疾病的关系。方法:从为莱斯特郡梅尔顿莫布雷(Melton Mowbray)镇及周边地区提供服务的大型普通诊所进行的所有75岁以上老年人痴呆症患病率调查的一部分(M项研究)。患者(n = 224)的年龄在75至98岁之间,并且代表了总体人群,他们还提供了餐前血液样本,可以在这些样本上确定各种年龄和营养相关的分析物。这些包括记录的病史,甲状腺刺激激素(TSH),葡萄糖,免疫球蛋白和血浆中的脂质分布。结果:胆固醇和脂质变量显示出较大的分散性,有一些负面趋势,但与总胆固醇,高密度脂蛋白(HDL)胆固醇,总胆固醇与高密度脂蛋白胆固醇或甘油三酸酯之比的年龄没有显着相关性。在所有年龄段,妇女的总胆固醇和高密度脂蛋白胆固醇含量都明显较高。 10/205名患者的血清TSH高于6.0 mU / 1,207名患者中的9名患者的随机葡萄糖高于11.2 mmol / l,210名患者中有4名存在边缘性血球蛋白异常,均与胆固醇浓度无关。结论:该英国数据与生存率和胆固醇之间呈负相关,但分散范围广,限制了单个患者管理中对单一结果脂质数据的依赖。随机脂质筛查对于揭示其他与年龄相关和未被认识的隐匿性代谢疾病也无济于事,效率低下并且没有附加价值。

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