·糖尿病与代谢综合征·

　　石家庄市中老年代谢综合征现状及其相关因素分析的调查研究

　　王伟超 张洁 梁屹 闫淑静 刘素波 任巧华 吴韬

　　【摘要】 目的 探讨石家庄市中老年人群代谢综合征(MS)的患病情况及其影响因素。 方法 分层随机抽样选择石家庄市9个社区，居住≥5年，年龄≥45岁的居民，进行流行病学调查和体格检查，检测FPG、HbA1c、血脂及OGTT等指标。 结果 最终纳入1447例，其中男509例，女938例，45～65岁1024例，≥65岁423例。MS患病率为21.2%，其中男性6.4%，女性14.8%;65岁以上患病率为24.8%及65岁以下为19.7%(P<0.05或P<0.01);65岁以下的男性患病率为5.7%，女性14.1%;65岁以上的男性患病率为8.3%，女性16.5%(P=0.01)，提示男性随年龄增加MS患病率升高。以HbA1c 6.5%为切点，MS患病率分别为59.7%和14.1%(P<0.01)。NGT、DM、IFG、IGT、IFG+IGT组间比较，MS患病率差异均有统计学意义。年龄、性别、糖尿病家族史、喜食甜食、BMI、WHR、TG、HDL-C、SBP、DBP、FPG、2 hPG、HbA1c为MS患病率的危险因素。 结论 石家庄市MS患病率较高，有性别及年龄差异。BMI、WHR，血脂、血压及HbA1c监控、糖代谢状态筛查，有助于MS的诊断及防控。

　　【关键词】代谢综合征;糖尿病;中老年;患病率;糖化血红蛋白

Epidemiological investigation on metabolic syndrome of middle-aged and old people in Shijiazhuang city and analysis on its influence factors WANG Wei-chao, ZHANG Jie, LIANG Yi, et al. Department of Endocrinology, the First Clinical Hospital of Shijiazhuang, Shijiazhuang 050011, China.

　　【Abstract】Objective To investigate the epidemiologic profile and influence factors of metabolic syndrome of middle-aged and old people in Shijiazhuang. Methods A cross-sectional epidemiological investigation was performed. The middle-aged and old people in the city of Shijiazhuang (age≥45 years) in nine communities were investigated. A total of 1447 subjects (509 males and 938 females) were included.After an overnight fasting, each participant underwent epidemiological surveys, physical examination，fasting plasma glucose and serum lipid tests，and oral glucose tolerance test (OGTT). The prevalence of MS and its attributing factors were analyzed by logistic regression model. Results The prevalence of metabolic syndrome was 21.2%% in Shijiazhuang (male 6.4%, female 14.8%, χ2=4.075, P=0.044; ≥65 years old 24.8%, <65 years old 19.7%, χ2=4.651, P=0.031). The prevalence of metabolic syndrome was 14.8% in female aged <65 years，while in male aged <65 years was 8.3% (χ2=14.67, P<0.01). The prevalence of metabolic syndrome was 8.5% in female aged ≥65 years，while in male aged ≥65 years was 16.5% (χ2=10.08, P=0.01). The prevalence of metabolic syndrome increased with age for male，while not for female. The prevalence of metabolic syndrome was different for different HbA1C profile (HbA1c≥6.5% vs HbA1c<6.5%, 59.7% vs 14.1%, χ2=237.732, P<0.01). The comparisons among the NGT, DM, IFG, IGT and IFG+IGT groups showed that the prevalence of metabolic syndrome was significantly different. The multivariable stepwise analysis extracted the age, sex, family history of diabetes, preference for sweet foods, body mass index, waist-to-hip ratio, plasma triglyceride, low-density lipoprotein cholesterol, systolic blood pressures, diastolic blood pressures, fasting plasma glucose, 2-h postprandial blood glucose, and hemoglobin A1c as the major risk factors for metabolic syndrome. Conclusion The prevalence of metabolic syndrome is high in Shijiazhuang. The prevalence of metabolic syndrome is different for different genders and ages. The observation on BMI, WHR, lipid levels, blood pressure levels, glycometabolic state, and HbA1c helps the diagnosis and prevention of metabolic syndrome.

　　【Key words】 Metabolic syndrome (MS); Hemoglobin A1c; Middle-aged and old people; Prevalence; Diabetes mellitus