成人血清铁蛋白与代谢综合征之间的关联性分析
发布时间：2018-08-03 14:40
【摘要】：目的本研究是基于大样本体检人群,进行的一项横断面和队列研究。旨在全面评估性别特异的血清铁蛋白水平与代谢综合征(metabolic syndrome,MS)之间的真实关联。方法本研究人群来源于天津人群慢性低度炎症与健康促进队列。主要包括2007-2015年间在天津医科大学总医院健康管理中心接受常规年度体检的人群。所有参与者自愿参加研究并签署知情同意书。通过相关纳入及排除标准,最终横断面研究共纳入23,952名研究对象。横断面基础上排除基线患有MS的人群、只有2015年体检的人群以及随访期间未完成随访的人群,最终队列研究共纳入7,545名研究对象,平均随访时间为2.58年(95%置信区间:2.54-2.62)。对研究对象进行体格检查、问卷调查以及血液生化指标测定。采用标准测量方法对各变量进行测量。MS的诊断标准使用中华医学会糖尿病学分会在2013年制定的我国最新的MS诊断标准。对于连续变量及分类变量,分别采用方差分析及Logistic回归分析比较MS和非MS人群的基本特征差异。采用方差分析及Logistic回归分析,比较不同铁蛋白五分位的人群特征差异。在横断面研究中,以是否患MS为因变量,性别特异的铁蛋白五分位水平作为自变量,运用多因素Logistic回归分析评估血清铁蛋白水平与MS患病率之间的关系。在队列研究中,以是否发生MS为因变量,基线性别特异的铁蛋白五分位水平作为自变量,使用Cox比例风险回归模型评估血清铁蛋白水平与MS发病率之间的关系。将每个五分位的中位数作为有序变量,进行五分位的趋势性检验。结果横断面研究结果发现,本研究人群MS的患病率为34.0%,男性MS患病率为40.9%,高于女性患病率(23.1%)。调整潜在的混杂因素,如年龄、性别、体质指数、白细胞计数、吸烟情况、饮酒情况以及家族病史(心血管疾病、高血压、高脂血症和糖尿病)之后,最终的调整模型结果显示,在研究人群中,随着血清铁蛋白水平的升高,MS患病率逐渐升高(各五分位的比值比以及95%置信区间),分别为1.00,1.18(1.06,1.31),1.37(1.24,1.52),1.72(1.56,1.91)和2.28(2.06,2.52)(趋势性P0.0001)。男性和女性分别分析中也观察到类似的结果。在队列研究中发现,MS者与非MS者在基线上的年龄分布、体检、血生化指标以及生活习惯等方面的差别有统计学意义(P0.05)。根据血清铁蛋白五分位分组分析发现男性BMI、WC、TC、TG、FBG以及HDL-C与铁蛋白五分位数组呈现明显的线性关联(趋势性P0.05),女性人群中可以观察到类似关联。随访期间该人群男性MS发病率为125/1000人年,女性发病率为56/1000人年。研究人群中,经年龄、性别、体质指数、白细胞计数、吸烟情况、饮酒情况、家族病史(心血管疾病、高血压、高脂血症和糖尿病)、腰围、血压、血糖、高密度脂蛋白胆固醇以及甘油三酯进行调整后,在不同铁蛋白五分位组,MS的风险比(95%置信区间)为1.00,0.91(0.78,1.06),1.00(0.86,1.16),0.99(0.85,1.15)和1.07(0.93,1.24)(趋势性P=0.13)。血清铁蛋白水平与MS的发病没有统计学关联,在男性和女性分别分析中也观察到类似的结果。结论横断面研究结果显示,成年人群血清铁蛋白水平与MS患病率呈正相关,然而队列研究中经过混杂因素调整,尤其是基线甘油三酯水平调整后发现,血清铁蛋白水平与MS的发病未见统计学关联。血清铁蛋白尚不能预测成年人MS的发生情况。今后还需要更多的研究,去探索铁蛋白与代谢综合征的关联。
[Abstract]:Objective this study was based on a cross-sectional and cohort study based on a large sample of physical examination. The purpose of this study was to assess the true association between the sex specific serum ferritin level and the metabolic syndrome (MS). Methods the population of this study was derived from the chronic low degree of inflammation and health promotion in the Tianjin population, mainly including 20 People who received regular annual physical examination at the health management center of General Hospital Affiliated to Tianjin Medical University during 07-2015. All participants volunteered to participate in the study and signed informed consent. Through the relevant inclusion and exclusion criteria, a total of 23952 subjects were included in the cross-sectional study. A population of MS was excluded from the baseline on a cross-sectional basis, only 2015. A total of 7545 subjects were included in the final cohort study. The average follow-up time was 2.58 years (95% confidence interval: 2.54-2.62). A physical examination, a questionnaire, and a measurement of blood biochemical indexes were carried out on the subjects. The standard measurement method was used to measure the.MS. The standard uses the latest MS diagnostic criteria in China established by the Chinese Medical Association for diabetes in 2013. For continuous and classified variables, variance analysis and Logistic regression analysis were used to compare the basic characteristics differences between the MS and non MS groups. The variance analysis and Logistic regression analysis were used to compare the different five fraction of the ferritin. In the cross-sectional study, the relationship between serum ferritin level and the prevalence of MS was assessed in the cross-sectional study using the MS dependent variable and the gender specific ferritin five division level as the independent variable. In the cohort study, the baseline sex specific ferritin five was found if the MS was generated as the dependent variable. The Cox proportional risk regression model was used to evaluate the relationship between serum ferritin level and the incidence of MS. The median of each five Division was used as an orderly variable and a trend test was conducted in the five Division. The results of the cross-sectional study found that the prevalence rate of MS in this study was 34%, and the prevalence rate of male MS was 40.9%, Higher than female prevalence (23.1%). Adjustment of potential confounding factors, such as age, sex, body mass index, leukocyte count, smoking, drinking, and family history (cardiovascular disease, hypertension, hyperlipidemia, and diabetes), the final adjustment model showed that in the study population, with the increase of serum ferritin level, MS The prevalence rate increased gradually (the ratio of five points and 95% confidence intervals), 1.00,1.18 (1.06,1.31), 1.37 (1.24,1.52), 1.72 (1.56,1.91) and 2.28 (2.06,2.52) (trend P0.0001). Similar results were observed in the analysis of men and women. The age distribution of MS and non MS in the cohort study was found in the cohort study. The differences in blood biochemical indexes and living habits were statistically significant (P0.05). According to the group analysis of serum ferritin five subdivision, male BMI, WC, TC, TG, FBG, and HDL-C had a significant linear association with the five subarray of ferritin (trend P0.05), and a similar association could be observed in female population. During the follow-up period, the population was followed up. The incidence of male MS was 125/1000 year, and the incidence of female was 56/1000 year. The study population was adjusted by age, sex, body mass index, white blood cell count, smoking, drinking, family history (cardiovascular disease, hypertension, hyperlipidemia and diabetes), waist circumference, blood pressure, blood glucose, high density lipoprotein cholesterol and triglyceride After that, the risk ratio of MS (95% confidence interval) was 1.00,0.91 (0.78,1.06), 1 (0.86,1.16), 0.99 (0.85,1.15) and 1.07 (0.93,1.24) (trend P=0.13). The level of serum ferritin was not statistically associated with the incidence of MS, and similar results were also observed in the analysis of male sex and women. Conclusion the cross-sectional study was concluded. The results showed that serum ferritin levels were positively correlated with the prevalence of MS in the adult population. However, in the cohort study, the serum ferritin level was not statistically associated with the incidence of MS after a mix adjustment, especially the baseline triglyceride level adjustment. Serum ferritin did not yet predict the occurrence of MS in adults. More studies are needed to explore the association between ferritin and metabolic syndrome.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R589
本文编号：2162066
[Abstract]:Objective this study was based on a cross-sectional and cohort study based on a large sample of physical examination. The purpose of this study was to assess the true association between the sex specific serum ferritin level and the metabolic syndrome (MS). Methods the population of this study was derived from the chronic low degree of inflammation and health promotion in the Tianjin population, mainly including 20 People who received regular annual physical examination at the health management center of General Hospital Affiliated to Tianjin Medical University during 07-2015. All participants volunteered to participate in the study and signed informed consent. Through the relevant inclusion and exclusion criteria, a total of 23952 subjects were included in the cross-sectional study. A population of MS was excluded from the baseline on a cross-sectional basis, only 2015. A total of 7545 subjects were included in the final cohort study. The average follow-up time was 2.58 years (95% confidence interval: 2.54-2.62). A physical examination, a questionnaire, and a measurement of blood biochemical indexes were carried out on the subjects. The standard measurement method was used to measure the.MS. The standard uses the latest MS diagnostic criteria in China established by the Chinese Medical Association for diabetes in 2013. For continuous and classified variables, variance analysis and Logistic regression analysis were used to compare the basic characteristics differences between the MS and non MS groups. The variance analysis and Logistic regression analysis were used to compare the different five fraction of the ferritin. In the cross-sectional study, the relationship between serum ferritin level and the prevalence of MS was assessed in the cross-sectional study using the MS dependent variable and the gender specific ferritin five division level as the independent variable. In the cohort study, the baseline sex specific ferritin five was found if the MS was generated as the dependent variable. The Cox proportional risk regression model was used to evaluate the relationship between serum ferritin level and the incidence of MS. The median of each five Division was used as an orderly variable and a trend test was conducted in the five Division. The results of the cross-sectional study found that the prevalence rate of MS in this study was 34%, and the prevalence rate of male MS was 40.9%, Higher than female prevalence (23.1%). Adjustment of potential confounding factors, such as age, sex, body mass index, leukocyte count, smoking, drinking, and family history (cardiovascular disease, hypertension, hyperlipidemia, and diabetes), the final adjustment model showed that in the study population, with the increase of serum ferritin level, MS The prevalence rate increased gradually (the ratio of five points and 95% confidence intervals), 1.00,1.18 (1.06,1.31), 1.37 (1.24,1.52), 1.72 (1.56,1.91) and 2.28 (2.06,2.52) (trend P0.0001). Similar results were observed in the analysis of men and women. The age distribution of MS and non MS in the cohort study was found in the cohort study. The differences in blood biochemical indexes and living habits were statistically significant (P0.05). According to the group analysis of serum ferritin five subdivision, male BMI, WC, TC, TG, FBG, and HDL-C had a significant linear association with the five subarray of ferritin (trend P0.05), and a similar association could be observed in female population. During the follow-up period, the population was followed up. The incidence of male MS was 125/1000 year, and the incidence of female was 56/1000 year. The study population was adjusted by age, sex, body mass index, white blood cell count, smoking, drinking, family history (cardiovascular disease, hypertension, hyperlipidemia and diabetes), waist circumference, blood pressure, blood glucose, high density lipoprotein cholesterol and triglyceride After that, the risk ratio of MS (95% confidence interval) was 1.00,0.91 (0.78,1.06), 1 (0.86,1.16), 0.99 (0.85,1.15) and 1.07 (0.93,1.24) (trend P=0.13). The level of serum ferritin was not statistically associated with the incidence of MS, and similar results were also observed in the analysis of male sex and women. Conclusion the cross-sectional study was concluded. The results showed that serum ferritin levels were positively correlated with the prevalence of MS in the adult population. However, in the cohort study, the serum ferritin level was not statistically associated with the incidence of MS after a mix adjustment, especially the baseline triglyceride level adjustment. Serum ferritin did not yet predict the occurrence of MS in adults. More studies are needed to explore the association between ferritin and metabolic syndrome.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R589
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