| Objective To describe the distribution characteristics of unstable carotid plaque and related risk factors in low income rural area population.Methods Permanent residents aged 45 years old and above in Ji Count,Tian Jin,3946 subjects was included in this study.The demographic data and previous medical history was collected through face-to-face investigation.Physical examination was used to measure height,weight,blood pressure.Fasting blood glucose and blood lipid was determined by sampling blood.The carotid B-ultrasonography in carotid enlargement was examined to obtain the echo of carotid plaque.The plaques were divided into high,medium,low and mixed echo plaques according to the intensity of the plaque echoes.The high and middle echo plaques are defined as stable plaques,and the low and mixed echo plaques are defined as unstable plaques.The risk factors related to plaque stability were determined by univariate analysis and multivariate analysis.Results The results of multivariate analysis showed that: compared with the plaque-free group,women and drinking were the protective factors of unstable plaques,OR for women was 0.60(0.50-0.73;p<0.001),OR for drinking subjects was 0.65(0.51-0.83;p<0.001)respectively.Smoking,hypertension,low density lipoprotein cholesterol(LDL-C)were risk factors for unstable plaques,OR for drinking subjects was 1.40(1.12-1.75;p=0.003),OR for hypentension was 1.344(1.14-1.59;p=0.001),LDL-C was 1.24(0.99-1.55;p=0.057).And age was risk factors of unstable plaque group,55-64 age group,65-74 age group,? 75 age group comparing with reference group,OR were 2.26(1.85-2.76;p<0.001),2.65(2.11-3.33;p<0.001),4.92(3.67-6.60;p<0.001)respectively.Compared with the stable plaque group,the old age and obesity were the protective factors of carotid plaque stability,the age group of ?75 years,65-74 years compared with reference group,OR was 0.37(0.19-0.72;p=0.004),0.36(0.20-0.67;p<0.001)respectively.OR for obesity was 0.59(0.37-0.96;p=0.033).High triglyceride(TG)and high LDL-C were risk factors for carotid plaque stability,OR for TG was 1.35(1.04-1.81;p=0.025),OR for LDL-C was 1.46(1.00-2.14;p=0.053).Compared with the mixed plaque group,the old age was the protective factor of carotid plaque stability,compared with reference group,OR for age ? 75 group was 0.35(0.14-0.86;p=0.023).In male stratified multivariate analysis: Age,smoking,LDL-C and hypertension were the risk factors for unstable plaques compared with no plaque group.55-64 age group,65-74 age group and?75 age group compared with reference group,,OR were 2.36(1.73-3.23;p<0.001),2.89(2.03-4.00;p<0.001),6.80(4.36-10.59;p<0.001),OR for subjects with smoking,hypentensive and high LDL-C was 1.48(1.16-1.88;p=0.002),1.38(1.07-1.78;p=0.012),1.47(1.00-2.16;p=0.053).Compared with the stable plaque group,obesity was a protective factor for carotid plaque stability,OR was 0.46(0.22-0.80;p=0.043).TG was a risk factor for carotid plaque stability,OR for TG was 2.07(1.10-3.87;p=0.023).Multivariate analysis of female stratification showed: compared with plaque-free group,old age and hypertension were risk factors of unstable plaque,OR for 55-64 age group,65-74 age group,?75 age group were 2.18(1.68-2.83;p<0.001),OR=2.53(1.86-3.44;p<0.001),OR=3.61(2.41-5.42;p<0.001).OR for subjects with hypertensive were 1.32(1.05-1.64;p=0.017).Compared with the stable plaque group,the old age was the protective factor of carotid plaque stability,OR for ?75 age group and 65-74 age group were 0.27(0.10-0.70;p=0.007),0.29(0.13-0.67);p=0.004)respectively.Old age and elevated HDL-C were protective factors for carotid plaque stability,OR for age ?75 group was 0.17(0.03-0.93;p=0.041),OR for HDL-C was 0.36(0.14-0.90;p=0.029).Multivariate analysis of risk factors for age group stratification: in the 45-54 age group showed that compared with the free-plaque group drinking was the protective factor of unstable plaque,OR was 0.51(0.29-0.89;p=0.017),and compared with the stable plaque group,drinking was the protective factor of carotid plaque stability,OR was 0.10(0.02-0.63;p=0.014).In 55-64 age group: Compared with the plaque-free group,female was the protective factor of unstable plaque,OR for female was 0.68(0.51-0.91;p=0.009).Hypertension is risk factor for unstable plaques,OR was 1.30(1.02-1.66;p=0.036).In 65-74 age group: Compared with the plaque-free group,females were protective factors for unstable plaques,OR was 0.52(0.36-0.74;p<0.001).In ? 75 age group: Compared with plaque-free group,females are protective factors for unstable plaques,OR was 0.39(0.22-0.70;p=0.002).Smoking,hypertension were risk factors for unstable plaques,OR for smoking was 2.59(1.18-5.71;p=0.018),OR for hypertensive was 2.95(1.51-5.65;p<0.001).Conclusion: In Chinese rural low-income population,the risk of unstable plaque in the carotid artery is lower than that of 55 years in people older than 65 years old.Old age and obesity were protective factors for carotid plaque stability,and elevated TG and LDL-C were risk factors for plaque stability.In males,obesity is a protective factor for plaque stability,and high TG is a risk factor for plaque stability.In women,the old age was a protective factor for plaque stability.Among the 45-54-year-old population,drinking was a protective factor for plaque stability.In the control of stroke risk,special attention should be paid to young and middle-aged people. |
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