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目的本研究旨在了解我国南方人群代谢综合征(MS)及其组成成分的患病率,分析胰岛素抵抗与MS及其组成成分的相互关系,同时对照比较国际糖尿病联盟(IDF)和中华医学会糖尿病学分会建议的MS诊断标准。方法对广西和广东的城市社区居民进行随机分层抽样队列分析,共筛查7669例,收集空腹血及晨尿进行血糖、血脂、肾功能、胰岛素、超敏C反应蛋白、尿常规及尿微量白蛋白等检测,同时进行问卷调查和体格检查。结果在所有居民中,依照中华医学会糖尿病学分会建议诊断标准,MS的患病率为8.7%;而依照IDF诊断标准,MS患病率为19.8%。依照《中国高血压防治指南》高血压患病率为22.1%;依照《中国成人超重和肥胖症预防控制指南》腹型肥胖患病率为39.2%;依照美国糖尿病协会标准糖尿病患病率为6.7%;依照HOMA胰岛素抵抗指数计算结果,胰岛素抵抗患病率为5.0%。二分类Logistic回归分析发现,空腹血糖受损、糖尿病、肥胖、腹型肥胖、甘油三酯和超敏C反应蛋白增高是胰岛素抵抗的独立风险因素,而性别、高血压、低密度脂蛋白、胆固醇不是胰岛素抵抗的风险因素。结论采用国内诊断标准比国际诊断标准所统计的MS患病率要低,漏诊部分以腹型肥胖为主的MS;在MS组成成分中,高血压、腹型肥胖和高密度脂蛋白降低的发生率较高;胰岛素抵抗与MS的多数组分相关性良好,仍是主要发病因素之一。
Objectives The purpose of this study is to understand the prevalence of metabolic syndrome (MS) and its components in the southern population of China and to analyze the relationship between insulin resistance and MS and its components. At the same time, compare and contrast the International Diabetes Federation (IDF) and Chinese Medical Association Diabetes credits will recommend MS diagnostic criteria. Methods A randomized stratified sampling cohort analysis was conducted among urban community residents in Guangxi and Guangdong. A total of 7 669 cases were screened. Fasting blood and morning urine were collected for blood glucose, blood lipid, renal function, insulin, high-sensitivity C-reactive protein, Albumin and other tests, at the same time questionnaire and physical examination. Results Among all the residents, the prevalence of MS was 8.7% according to the diagnostic criteria recommended by the Diabetes Branch of Chinese Medical Association. According to IDF diagnostic criteria, the prevalence of MS was 19.8%. The prevalence of hypertension was 22.1% according to the Guide to Prevention and Treatment of Hypertension in China. The prevalence of abdominal obesity was 39.2% according to the Guidelines for the Prevention and Control of Overweight and Obesity in Adults in China. The prevalence of diabetes was 6.7 in accordance with the American Diabetes Association standard %; According to HOMA insulin resistance index calculation, the prevalence of insulin resistance was 5.0%. Logistic regression analysis showed that impaired fasting glucose, diabetes, obesity, abdominal obesity, triglycerides and hypersensitive C-reactive protein were independent risk factors of insulin resistance, but gender, hypertension, low density lipoprotein, cholesterol Not a risk factor for insulin resistance. Conclusions The prevalence of MS is lower than that of international diagnostic criteria by using domestic diagnostic criteria, and the main cause of missed diagnosis is abdominal obesity. Among the components of MS, high blood pressure, abdominal obesity and high density lipoprotein High rate; insulin resistance and the majority of components of MS correlation is good, is still one of the main risk factors.