社区体检人群代谢综合征的患病现状及影响因素分析

发布时间：2018-05-15 06:01

本文选题：代谢综合征 + 患病率　；参考：《皖南医学院》2017年硕士论文

【摘要】：目的了解某社区体检人群代谢综合征(metabolic syndrome,MS)的患病率及其影响因素,为本地区代谢综合征的综合防治提供科学依据。方法采用整群抽样的方法,以某社区参加健康体检的18岁以上成人作为研究对象进行问卷调查、体格检查和实验室检查,采用非条件Logistic回归分析MS的相关影响因素。结果1.收集信息完整的研究对象610名,其中男性334人(54.8%),女性276人(45.2%)。按照CDS诊断标准,有82人被检出患有MS,患病率为13.4%,男女患病率分别为15.6%(52/334)和10.9%(30/276),差异无统计学意义。2.年龄大、文化程度低、具有高血压或糖尿病家族史、疏于锻炼或盐摄入过多的研究对象MS患病率均高于对照组。MS患病率随年龄的增长而上升(18~44岁、45~59岁和60岁以上者患病率分别7.5%(19/252)、16.5%(33/200)和19.0%(30/158);小学及以下、中学/中专和大专及以上患病率分别为19.4%(28/144)、13.3%(26/195)和10.3%(28/271);有无食盐摄入过多的患病率分别为11.5%(54/469)和19.9%(28/141);有无每周锻炼2次以上的生活习惯的患病率分别为17.2%(55/319)、9.3%(27/291);有无高血压家族史的患病率分别为9.8%(49/499)和29.7%(33/111);有无糖尿病家族史的患病率分别为11.2%(61/545)和32.3%(21/65),差异均具有统计学意义(P0.05)。而病例与对照两组患病率在职业、经济收入、有无吸烟史、有无红肉摄入过多的分布上差异无统计学意义。3.MS各组分按患病率高低依次为肥胖30.3%(185/610)、高血压22.6%(138/610)、高血糖16.6%(101/610)、高TG25.4%(155/610)、低HDL-C8.7%(53/610)。MS中肥胖+高血压+血脂异常是最常见的组合(占34.1%)。除了低HDL-C检出率女性高于男性,肥胖、高TG血症、高血压、高血糖检出率均为男性高于女性。4.除了HDL-C水平低于对照组,MS患者的BMI、WC等体检及实验室检测指标均高于对照组。5.MS患者的RDW-CV明显高于对照组(P0.05)。MS各组分中高血糖组和低HDL-C组的RDW-CV检测值高于对照组,差异有统计学意义,但是RDW-CV在其他组分中的分布未见明显差异。6.多因素Logistic回归分析结果显示年龄增大[OR=1.049(1.003-1.098)]、具有糖尿病家族史[OR=0.356(0.132-0.784)]、体质指数高[OR=1.241(1.088-1.426)]、腰围粗[OR=1.048(1.001-1.097)]、高血压[OR=1.040(1.017-1.063)]、高甘油三酯[OR=2.504(1.881-3.335)]和低HDL-C[OR=0.323(0.138-0.755)]是MS的危险因素。结论社区体检人群具有相当比例的个体患有MS,应针对相关危险因素及早采取综合防治措施,提高自我健康管理意识,增强运动,预防超重和肥胖,合理膳食(减少食盐和红肉摄入量)对于预防与控制MS的发生和发展,降低心脑血管疾病的发病和死亡风险,具有重要意义。目的代谢综合征(MS)增加了心血管疾病、2型糖尿病(DM)和其他慢性疾病的患病风险。为了更好地控制代谢综合征,全面了解代谢综合征的流行现状是必要的。但是,在研究中对于不同的中国人群,代谢综合征患病率各不相同。本研究的目的是系统地评估中国代谢综合征的患病率。方法通过Pub Med、Springer和Elsevier等数据库检索,收集发表于2011年1月至2015年12月的相关英文文献。根据不同的诊断标准,利用Meta分析估计代谢综合征患病率。采用固定效应模型或随机效应模型进行合并亚组分析,并进行发表偏倚的检查和敏感性分析。结果共纳入文献37篇,包括23个乡村或城市的研究和14个省为基础的研究。不同的诊断标准,合并代谢综合征发病率不同,以乡村或城市为基础的研究,NCEP-ATPIII为30.6%(23.6-37.7),IDF为27.5%(23.4-31.6),JIS为36.5%(29.0-44.1);以省为基础的研究,NCEP-ATPIII为24.9%(22.0-27.8),IDF为22.7%(13.5-31.9),JIS为24.4%(20.5-28.8)。基于三个标准,亚组分析显示女性代谢综合征的患病率高于男性。根据NCEP-ATPⅢ和IDF,在城市居民代谢综合征患病率高于农村。然而,基于JIS得到相反的结果。敏感性分析表明,合并的患病率保持稳定。结论这项mata分析显示,依据不同的诊断标准,中国成人代谢综合征患病率处于上升趋势,接近欧美国家水平。我们应该制定有效的公共卫生策略,预防代谢综合征,以减少中国的医疗负担。
[Abstract]:Objective to understand the prevalence and influencing factors of metabolic syndrome (MS) in a community physical examination population, and to provide a scientific basis for the comprehensive prevention and treatment of metabolic syndrome in the local area. The correlation factors of MS were analyzed by unconditional Logistic regression. Results 1. of the 610 subjects were collected, including 334 men (54.8%) and 276 women (45.2%). According to the CDS diagnostic criteria, 82 people were detected with MS, the prevalence rate was 13.4%, and the prevalence rates of men and women were 15.6% (52/334) and 10.9% (30/276), and the difference was not Statistical significance was.2. age, low education level, family history of hypertension or diabetes, and the prevalence rate of MS was higher than that of the control group. The prevalence rate of.MS was higher than that in the control group (18~44 years, 45~59 years and above 60 years old, respectively, 7.5% (19/252), 16.5% (33/200) and 19% (30/158), and primary school and the same. The prevalence rates were 19.4% (28/144), 13.3% (26/195) and 10.3% (28/271), respectively, and 11.5% (54/469) and 19.9% (28/141) for excessive intake of salt, and 17.2% (55/319), 9.3% (27/291), and the prevalence rate of family history of hypertension. 9.8% (49/499) and 29.7% (33/111), respectively, the prevalence rates of family history of diabetes were 11.2% (61/545) and 32.3% (21/65), and the differences were statistically significant (P0.05). The two groups of cases and control cases were in occupational, economic income, smoking history, and the distribution of excessive intake of red meat was not statistically significant,.3.MS components were not statistically significant The prevalence rate was 30.3% (185/610), hypertension 22.6% (138/610), hyperglycemia 16.6% (101/610), high TG25.4% (155/610), low HDL-C8.7% (53/610).MS, obesity + hypertension + blood lipid abnormality (34.1%). In addition to low HDL-C detection rate, women were higher than men, obesity, high TG, hypertension, and high blood sugar were all male The sex of.4. was higher than that of the control group. The BMI, WC and other physical examination indexes of the patients with MS were higher than those of the control group. The RDW-CV of the.5.MS patients was higher than that of the control group (P0.05). The RDW-CV detection values in the hyperglycemic group and the low HDL-C group were higher than those in the control group. The difference was statistically significant, but the RDW-CV was in the other components. The distribution of.6. multiple factor Logistic regression analysis showed that age increased [OR=1.049 (1.003-1.098)], with family history of diabetes [OR=0.356 (0.132-0.784), high [OR=1.241 (1.088-1.426) of body mass index], low waistline [OR=1.048 (1.001-1.097)], high blood pressure [OR=1.040 (1.017-1.063)], high triglyceride] And low HDL-C[OR=0.323 (0.138-0.755)] is a risk factor for MS. Conclusion a considerable proportion of individuals with MS in community physical examination people should be taken early to adopt comprehensive prevention and control measures to improve self-health management awareness, enhance exercise, prevent overweight and obesity, reasonable diet (reducing salt and red meat intake) for prevention and treatment. It is of great significance to control the occurrence and development of MS and reduce the risk of death and death of cardiovascular and cerebrovascular diseases. Objective metabolic syndrome (MS) increases the risk of cardiovascular disease, type 2 diabetes (DM) and other chronic diseases. To better control the metabolic syndrome, it is necessary to understand the prevalence of metabolic syndrome in a full face. In the study, the prevalence rates of metabolic syndrome were different for different Chinese people. The purpose of this study was to systematically assess the prevalence of metabolic syndrome in China. Methods through Pub Med, Springer, and Elsevier databases, the relevant English literature published from January 2011 to December 2015 was collected. According to different diagnostic criteria, Meta analysis was used to estimate the prevalence of metabolic syndrome. The combined subgroup analysis was performed with a fixed effect model or a random effect model, and the bias examination and sensitivity analysis were conducted. The results were included in 37 literature, including 23 rural or urban studies and 14 provinces based research. Different diagnostic criteria, combined with metabolic syndrome. The incidence was different in rural or urban based studies, NCEP-ATPIII was 30.6% (23.6-37.7), IDF was 27.5% (23.4-31.6), JIS was 36.5% (29.0-44.1); NCEP-ATPIII was 24.9% (22.0-27.8), IDF was 22.7% (13.5-31.9), JIS was 24.4% (20.5-28.8). The subgroup analysis showed the prevalence of female metabolic syndrome based on three criteria. The prevalence rate of metabolic syndrome in urban residents was higher than that in the rural areas based on NCEP-ATP III and IDF. However, the adverse results based on JIS showed that the incidence of the combined disease remained stable. Conclusion this Mata analysis showed that the prevalence rate of metabolic syndrome in Chinese adults was on the rise, according to the different diagnostic criteria, and the prevalence rate of Chinese adult metabolic syndrome was on the rise. We should develop effective public health strategies to prevent metabolic syndrome, so as to reduce China's medical burden.

【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R589;R181.3

【参考文献】