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目的探讨代谢综合征及其不同组分与自由脂肪酸(freefattyacid,FFA)的关系。方法1999年9月至10月,在北京市自然人群中采用分层随机抽样方法进行危险因素的横断面调查。分析了997名35~64岁男女两性的血浆FFA浓度与代谢综合征及其组分的关系。结果(1)代谢综合征的患病率随着FFA的升高而升高。(2)采用多因素logistic回归调整了年龄、性别、吸烟、饮酒、体重指数(BMI)和胰岛素抵抗后,FFA四分位分层的第二、三、四层的OR值分别为3·1、3·1和4·1,均有统计学意义(P<0·01)。(3)在相关分析中,FFA与甘油三酯(TG)、血糖、收缩压、舒张压和腰围的相关均有统计学意义(P<0·01),其中与TG的相关性最强,与血糖的相关性其次。FFA与高密度脂蛋白胆固醇(HDL-C)的相关无统计学意义。(4)用多因素logistic分析调整了BMI和胰岛素抵抗等因素后,FFA仍与代谢综合征5个组分中的腹部肥胖、高TG血症、高血压、高血糖4个组分相关,与低HDL-C血症的关系无统计学意义。(5)调整了FFA和BMI等因素的作用后,胰岛素抵抗也与代谢综合征及其5个组分中的腹部肥胖、高TG血症、高血糖和低HDL-C血症相关,而与高血压的关系无统计学意义。结论FFA与代谢综合征和代谢综合征5个组分中的腹部肥胖、高TG血症、高血压、高血糖4个组分均相关,提示FFA是代谢综合征的发病基础或危险因素之一。FFA和胰岛素抵抗可能通过不同的机制共同导致代谢综合征。
Objective To investigate the relationship between metabolic syndrome and its different components and free fatty acids (free fatty acids, FFA). Methods From September to October 1999, a stratified random sampling method was used to investigate the cross-sectional investigation of risk factors among the natural population in Beijing. The relationship between plasma FFA concentration and metabolic syndrome and its components in 997 men and women aged 35-64 years was analyzed. Results (1) The prevalence of metabolic syndrome increased with the increase of FFA. (2) After adjusted for age, sex, smoking, alcohol consumption, body mass index (BMI) and insulin resistance by multivariate logistic regression, OR of the second, third and fourth strata of FFA quartiles were 3.1 , 3.1 and 4.1, respectively, were statistically significant (P <0.01). (3) In the correlation analysis, the correlation between FFA and triglyceride (TG), blood glucose, systolic blood pressure, diastolic blood pressure and waist circumference were statistically significant (P <0.01) Related to blood sugar secondly. The correlation between FFA and high-density lipoprotein cholesterol (HDL-C) was not statistically significant. (4) After adjustment for BMI and insulin resistance by multivariate logistic analysis, FFA was still related to the four components of abdominal obesity, hypercholesteremia, hypertension and hyperglycemia in the five components of metabolic syndrome, The relationship between low HDL-C hyperlipidemia was not statistically significant. (5) After adjusting for the effects of factors such as FFA and BMI, insulin resistance is also associated with metabolic syndrome and its five components, abdominal obesity, hypercholesterolemia, hyperglycemia and hypo HDL-C, The relationship between hypertension was not statistically significant. Conclusion FFA is associated with four components of abdominal obesity, hypercholesteremia, hypertension and hyperglycemia in five components of metabolic syndrome and metabolic syndrome, suggesting that FFA is the basis or risk factor of metabolic syndrome . FFA and insulin resistance may lead to metabolic syndrome through different mechanisms.