代谢综合征组分的因子分析

The components of metabolic syndrome analyzed by factor analysis

目的分析代谢综合征(MS)各组分的聚集特征。方法研究对象483人,无已知糖尿病(DM)史,通过葡萄糖耐量试验查出DM患者203例,对其胰岛素、血糖、血脂、血压、体质指数等指标进行因子分析。结果因子分析显示肥胖、胰岛素抵抗(IR)、高血糖、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、血脂异常(高甘油三酯和低高密度脂蛋白胆固醇)和高血压等5个因子的累计方差贡献率为72.24%,肥胖因子的方差贡献率最高,为29.75%,肥胖因子与血脂异常因子通过C反应蛋白联结,血脂异常因子与胰岛素抵抗、高血糖因子联结,高血压及TC、LDL-C独立于其他因子存在。结论肥胖是MS最重要的因子,MS的病理生理机制复杂,不能单独用IR解释,可能是肥胖、IR、炎症反应等因子综合作用的结果。

Objective To evaluate the clustered characteristics of the components of metabolic syndrome. Methods 483 subjects （242 men, 241 women, aged 53±12 years ） in Beijing area underwent a 75g oral glucose tolerance test （OGTT） for screening of diabetes. 203 subjects were diagnosed as diabetes through OGTT. Factor analysis was performed using the variables of insulin/blood glucose, total cholesterol （CHO）, LDL-C, HDL-C, triglycerides （TG）, systolic blood pressure, diastolic blood pressure, BMI, waist-to-hip ratio and waist circumference. Results Five factors, including obesity, insulin resistance/hyperglycemia, CHO/LDL-C, dyslipidemia （elevated TG and decreased HDL） and hypertension, could explain 72.20//00 of total variance. The most important component was obesity, which could explain 29.80//00 of total variance. The obesity factor was associated with dyslipidemia factor through C-reactive protein （CRP）. Dyslipidemia factor also associated with insulin resistance/hyperglycemia factor. Hypertension factor and CI-IO/LDL-C factor were isolated from other factors. Conclusions Obesity factor is the most important component of metabolic syndrome. The pathophysiologic mechanism of metabolic syndrome is complex. Insulin resistance alone could not explain all features of the metabolic syndrome. Its pathophysiology maybe include the factors of obesity, insulin resistance and inflammatory reaction.