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目的代谢综合征(MS)包括多种组成成分,可导致心血管疾病和糖尿病。本研究目的是明确哪一种成分对MS的贡献最大。方法根据1999年WHO的MS工作定义对1994年全国糖尿病防治协作组调查的15 564例年龄≥25岁的中国成人资料进行分析;胰岛素抵抗定义为HOMA-IR指数超过本组糖耐量正常人群(年龄25 ~74岁)的第75百分位数。用logistic逐步回归方法分析MS各组分对MS贡献大小。结果(1)本人群MS患病率为64.35%,标化患病率为59.00%。(2)年龄、性别、收缩压(SBP)、舒张压(DBP)、腰臀围比值(WHR)(或腰围)、体重指数(BMI)与MS独立正相关,相关强度从高至低顺序依次为WHR(或腰围)、SBP、DBP、性别(女>男)、BMI、年龄,这些变量预测本人群MS的一致性达93.8%。WHR、BMI、SBP、DBP预测本人群MS的一致性为90.2%;若以腰围代替WHR,则一致性为86.2%;若去掉BMI,则一致性达86.1%。(3)在其它因素不变时, WHR每增加0.05、腰围每增加5 cm、SBP每增加10mm Hg(1 mm Hg=0.133 kPa)、DBP每增加5 mm Hg、BMI每增加5 kg/m2分别可增加本人群MS风险3.35倍、1.87倍、1.52倍、1.46倍、1.34倍。结论在临床实践中,联合测量腰臀围比值(或腰围)和血压可作为一项快速评估MS的简易指标。
Aims Metabolic syndrome (MS) consists of multiple components that can lead to cardiovascular disease and diabetes. The purpose of this study was to determine which component contributed the most to MS. Methods According to the WHO definition of MS in 1999, 15 564 Chinese adults aged 25 years and above who were surveyed by the National Collaborative Group on Diabetes Care in 1994 were analyzed. Insulin resistance was defined as the HOMA-IR index exceeding the normal glucose tolerance group (age 25 ~ 74 years old) the 75th percentile. Logistic stepwise regression was used to analyze the contribution of each component of MS to MS. Results (1) The prevalence of MS in my group was 64.35%, and the standardized prevalence was 59.00%. (2) Age, sex, SBP, DBP, WHR (or waist circumference), body mass index (BMI) were positively correlated with MS, and the correlation intensity was in descending order For the WHR (or waist circumference), SBP, DBP, gender (female> male), BMI, age, these variables predict the consistency of the MS population of 93.8%. The WHR, BMI, SBP and DBP predict the consistency of MS in our population was 90.2%. If waist circumference was used in place of WHR, the consistency was 86.2%. If BMI was removed, the consistency was 86.1%. (3) For every additional WHR, 0.05 for each increase in WHR and 5 cm / m2 for SBP, 10 mm Hg for SBP (1 mm Hg = 0.133 kPa), 5 mg / MS can increase their risk of 3.35 times, 1.87 times, 1.52 times, 1.46 times, 1.34 times. Conclusions In clinical practice, the combined measurement of waist-to-hip ratio (or waist circumference) and blood pressure can be used as a simple indicator for rapid assessment of MS.