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目的前瞻性对南宁市社区人群中代谢综合征组分异常进行干预,随访3年。研究探讨社区人群中应对代谢综合征的方法和有效性。方法广西南宁市部分事业单位居民社区横断面随机调查7917人,纳入1215人,完成1072例。对其中含有一项或以上血脂异常的研究对象,随机分为干预治疗组和对照组,采取饮食、运动、药物和宣教等措施,随访3年,观察血脂衍变情况。结果①干预人群与对照组人群两组合并MS组,T-Ch,TG,HDL异常比例较无MS组增高,尤以TG升高明显,其次依次为T-Ch,HDL。无MS组,LDL异常比例略为增多。②按照性别分组,血脂组分异常占同组、同性别比例,各组相当。以T-Ch升高比例为最多,HDL异常比例较小,TG,LDL居中,二者比例接近。③T-Ch,LDL基线时,对照组与干预治疗组无差异,T-Ch、LDL干预组3年时略有升高;TG干预组3年似有升高,但无统计学意义;HDL基线干预组稍高,3年后也稍高,亦无统计学意义。④本组血脂异常患者干预后相关代谢指标FBG,PBG,Fins,HOMAIR较干预前有明显降低,干预组血压干预后较干预前有降低,但无统计学意义,而对照组血压干预后较干预前稍高;两组UA和Waist指标干预后较干预前稍高。结论①MS合并血脂异常比例较无MS人群比例增高,提示MS发病机制是引发血脂异常根源;性别在本组对MS影响不明显。在本组血脂异常中,以T-Ch升高比例为最多,HDL异常比例较小,TG,LDL居中,二者比例接近。②经过3年干预治疗,本组相关代谢指标较干预前有明显降低,提示生活方式干预及药物治疗可改善MS。③经过3年干预治疗,本组血脂改善不明显,提示血脂调整可能需长期坚持努力才可获得,如不注意健康生活方式,随着时间延长,血脂正常难以维持。
Objective To prospectively investigate the abnormalities of metabolic syndrome components in the community of Nanning City for three years. Study to explore ways and effectiveness of community-based coping with metabolic syndrome. Methods A total of 7917 people were randomly selected from community cross-sectional survey in some institutions in Nanning, Guangxi, with a total of 1215 residents and 1,072 completed cases. Subjects with one or more dyslipidemia were randomly divided into intervention group and control group. The patients were followed up for 3 years with diet, exercise, medicine and missionary education to observe the changes of blood lipid. Results ①The abnormal proportion of T-Ch, TG and HDL was higher in MS group and MS group than in MS group, especially TG, followed by T-Ch and HDL. No MS group, a slight increase in the proportion of LDL abnormalities. ②According to sex grouping, dyslipidemia accounted for the same group, the same sex ratio, each group is quite. T-Ch increased the highest proportion of HDL abnormalities smaller proportion of TG, LDL center, the ratio of the two approaches. There was no difference between the control group and the intervention group at the baseline of T-Ch and LDL. The level of T-Ch and LDL in the intervention group increased slightly at the third year, while the TG intervention group appeared to increase at the third year, but there was no statistical significance. Intervention group slightly higher, slightly higher after 3 years, nor statistical significance. ④In this group, FBG, PBG, Fins and HOMAIR were significantly lower than those before intervention in the patients with dyslipidemia, the intervention group had lower blood pressure after intervention than before intervention, but no significant difference Before slightly higher; two groups of UA and Waist indicators after intervention slightly higher than before intervention. Conclusions ① The proportion of MS with dyslipidemia is higher than that without MS, suggesting that the pathogenesis of MS is the root cause of dyslipidemia. Sex in this group has no obvious effect on MS. In this group of dyslipidemia, the highest proportion of T-Ch increased, a small proportion of HDL abnormalities, TG, LDL center, the ratio of the two approaches. ② After 3 years of intervention, the relevant metabolic parameters in this group were significantly lower than those before intervention, suggesting that lifestyle interventions and medication could improve MS. ③ after 3 years of intervention, this group of blood lipids did not improve significantly, suggesting that lipid regulation may need long-term adherence to be obtained, such as not paying attention to a healthy lifestyle, as time goes by, dyslipidemia is difficult to maintain.