四种肥胖指标对代谢综合征筛查效果分析

发布时间：2018-03-11 06:36

本文选题：代谢综合征　切入点：腰围　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:了解吉林省成年居民肥胖和代谢综合征的流行现况,分析吉林省成年居民代谢综合征的流行特征,探讨不同肥胖指标对代谢综合征筛查的效果,并确定出最适指标及最优切点值,为肥胖干预的实施提供依据。方法:采用多阶段分层随机整群抽样的方法,于2012年抽取吉林省9个市(州)共32个区/市/县18~79岁16412名常驻居民进行面对面的问卷调查、体格检查和实验室检查。调查采用项目组统一制定的《个人健康调查表》,调查表主要包括性别、年龄等基本的人口学信息,体格检查包括身高、体重、腰围、臀围和血压的测量,实验室检查包括血脂四项指标(高密度脂蛋白、低密度脂蛋白、胆固醇和甘油三酯)以及血糖的检测。定量资料采用t检验,定性资料采用χ2检验,应用LMS方法拟合男女性不同肥胖指标随年龄变化的百分位数曲线图,限制性立方样条检验不同肥胖指标与代谢综合征的剂量-反应关系,ROC曲线寻找不同肥胖指标最优切点,logistic回归评估其不同切点下不同肥胖指标的预测效果。结果:1.男性平均BMI为(24.34±3.62)kg/m2、平均WC为(84.67±10.44)cm、WHR平均为(0.88±0.07)、WHt R平均为(0.50±0.06),女性平均BMI为(24.18±3.66)kg/m2、平均WC为(80.31±10.14)cm、WHR平均为(0.85±0.07)、WHt R平均为(0.51±0.07),这些指标在性别间差异有统计学意义(P0.05),除WHt R外,男性均高于女性。2.通过对肥胖与年龄在不同分位数水平上分析发现,男性18~40岁体重增长变化最大,41~60岁期间趋于稳定,61~79岁呈下降趋势;而女性在65岁以前均处于增长阶段,在65岁以后体重趋于稳定且稍有下降趋势。3.随着肥胖指标数值的增加患代谢综合征的风险在增大,但青年人群相对于中年人群和老年人群更具有耐受性,其OR值增长相对于缓慢,尤其是青年女性人群最具有耐受性。就总体而言,在任何年龄段,女性人群相对于男性人群更具有耐受性,其OR值增长相对于缓慢。4.BMI的最优切点为24 kg/m2,男性WC最优切点为85cm、女性WC最优切点为80cm,男性WHR最优切点为0.88、女性WHR最优切点为0.85,WHt R最优切点为0.50。5.不同切点下,男性BMI、WC、WHR、WHt R对代谢综合征的OR值分别为9.01(95%CI:8.00~10.15)、16.15(95%CI:14.21~18.35)、8.97(95%CI:7.93~10.15)、11.49(95%CI:10.16~16.13);AUROC值分别为0.74(95%CI:0.73~0.75)、0.79(95%CI:0.78~0.80)、0.73(95%CI:0.72~0.75)、0.76(95%CI:0.75~0.77);女性中BMI、WC、WHR、WHt R对代谢综合征的OR值分别为6.28(95%CI:5.63~7.00)、11.41(95%CI:10.09~12.90)、5.37(95%CI:4.81~6.00)、10.68(95%CI:9.33~12.23);AUROC值分别为0.72(95%CI:0.71~0.73)、0.78(95%CI:0.77~0.79)、0.72(95%CI:0.71~0.73)、0.76(95%CI:0.75~0.77)。6.男性中,WHt R对高血压预测效果和筛查能力最好,WC对血脂异常、糖尿病和代谢综合征的预测效果和筛查能力最好;女性中,WHt R对血脂异常的预测效果和筛查能力最好,WC对高血压、糖尿病和代谢综合征的预测效果和筛查能力最好。总体而言,WC相对于其他指标,有更好的预测效果和筛查能力。结论:1.吉林省成年男性居民的代谢综合征及其危险因素(高血压、糖尿病、血脂异常)患病率均高于女性居民。2.男性体重变化呈现增长-稳定-下降趋势,而女性在青年和中年时期均呈现增长趋势,仅在老年时期有稳定、下降趋势。整体而言,男女性在青年时期体重增长变化最大,中年时期体重增长趋势放缓,老年时期略有下降趋势,建议体重控制从年轻开始。3.青年人群相比中老年人群对肥胖具有更高的耐受性,同时,成年女性居民相比男性居民对肥胖具有更高的耐受性。4.WC相比于其他指标对代谢综合征及其危险因素(高血压、糖尿病、血脂异常)有更好的筛查能力和预测效果,其次是WHt R,最差的是WHR。5.中心型肥胖相比其他类型的肥胖对代谢综合征及其危险因素(高血压、糖尿病、血脂异常)影响更大,且混合型肥胖对代谢综合征及其危险因素(高血压、糖尿病、血脂异常)的影响最大。
[Abstract]:Objective: To investigate the epidemic of adult residents in Jilin Province, obesity and metabolic syndrome, analysis of the epidemiological characteristics of metabolic syndrome in residents of adult Jilin Province, explore the screening of different obesity indices on metabolic syndrome effect, and determine the optimal index and the optimal cut-off value, provide the basis for the implementation of obesity intervention. Methods: a multi a stratified random cluster sampling method, 9 in 2012 from Jilin province (state) a total of 32 district / city / county 18~79 year old 16412 permanent residents were investigated face-to-face questionnaire, physical examination and laboratory examination. The survey project team to develop a unified "personal health questionnaire >, questionnaire including gender. Age and other basic demographic information, physical examination including height, weight, waist circumference, hip circumference and blood pressure measurement, laboratory tests including four indexes of blood lipid (high density lipoprotein, low density lipoprotein cholesterol, and Triglycerides) and blood glucose detection. The quantitative data using t test, qualitative data using 2 test, using LMS method to fit the men and women of different obesity indices change with age percentile curves, restricted cubic spline test different indicators of obesity and metabolic syndrome in the dose - response relationship, ROC curve for different obesity the optimal cut-off point, logistic regression prediction and evaluation index of the effect of different obesity under different cut-off points. Results: 1. the average male BMI (24.34 + 3.62) kg/m2, average WC (84.67 + 10.44) cm, WHR average (0.88 + 0.07) WHt, average R (0.50 + 0.06), the average woman BMI for (24.18 + 3.66) kg/m2, average WC (80.31 + 10.14) cm, WHR average (0.85 + 0.07) WHt, average R (0.51 + 0.07), there are significant differences in gender between these indicators (P0.05), in addition to WHt R, men are higher than women by obesity and.2. in different age The analysis found that the quantile level, male 18~40 years old weight gain the biggest change, 41~60 years period tends to be stable, 61~79 years showed a downward trend; while women before the age of 65 are in the growth stage, at the age of 65 after weight stabilized and decreased slightly with the.3. value of the indicators of obesity increases the risk of metabolic syndrome in the youth population increased, but relative to the middle-aged and elderly people have more tolerance, the OR value of growth relative to slow, especially young women with the most tolerance. On the whole, at any age, women to men with more tolerance, the optimal cutoff OR value growth relative to slow.4.BMI 24 kg/m2 male WC optimal cut-off value was 85CM, female WC optimal cut-off value was 80cm, the optimal cut-off point of 0.88 male WHR, female WHR optimal cut-off point of 0.85, WHt R 0.50.5. is not the same as the optimal cut-off point, male BMI, WC, WHR, WHt, R on the metabolic syndrome OR values were 9.01 (95%CI:8.00~10.15), 16.15 (95%CI:14.21~18.35), 8.97 (95%CI:7.93~10.15), 11.49 (95%CI:10.16~16.13); AUROC = 0.74 (95%CI:0.73~0.75), 0.79 (95%CI:0.78~0.80), 0.73 (95%CI:0.72~0.75), 0.76 (95%CI:0.75~0.77); women BMI, WC, WHR, WHt, R on the metabolic syndrome OR values were 6.28 (95%CI:5.63~7.00), 11.41 (95%CI:10.09~12.90), 5.37 (95%CI:4.81~6.00), 10.68 (95%CI:9.33~12.23); AUROC = 0.72 (95%CI:0.71~0.73), 0.78 (95%CI:0.77~0.79), 0.72 (95%CI:0.71~0.73), 0.76 (95%CI:0.75~0.77).6. in men. WHt R of hypertension prediction effect and screening the best of WC, dyslipidemia, diabetes and metabolic syndrome prediction and screening ability best; women, WHt R was the best for dyslipidemia prediction and screening of WC, hypertension, diabetes mellitus The metabolic syndrome and prediction and screening the best. Overall, WC relative to other indicators, has a better prediction and screening ability. Conclusion: the factors of Jilin province in 1. adult male residents and the risk of metabolic syndrome (hypertension, diabetes, dyslipidemia) prevalence rate was higher than that of female residents of.2. male body weight changes stable growth decreased, while women in youth and middle age showed a growth trend, only in old age with a stable downward trend. Overall, male and female youth middle age weight gain the biggest change, weight growth trend slowed down, old age showed a slight downward trend, suggestions for weight control from young to young people.3. compared with elderly people in tolerance, higher in obese, compared to adult female residents in male residents have a higher tolerance for obesity compared to other.4.WC Factors and risk of metabolic syndrome (hypertension, diabetes, dyslipidemia) have better screening ability and prediction effect, followed by WHt R, the worst is WHR.5. central obesity compared to other types of obesity on the metabolic syndrome and its risk factors (hypertension, diabetes, dyslipidemia) the greater the impact factors and mixed type of obesity on the metabolic syndrome and its risk (hypertension, diabetes, dyslipidemia) the greatest impact.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R589;R181.3

【相似文献】