体质指数正常人群多代谢异常与代谢综合征

Multi-metabolic disorders and metabolic syndrome in people with normal body mass index

目的了解体质指数（BMI）正常人群多代谢异常与代谢综合征（MS）的患病情况。方法以江苏省多代谢异常和代谢综合征防治队列研究的调查人群为研究对象,符合纳入标准的对象共4251名（男2003名,女2248名）。采用美国国家胆固醇教育计划成人治疗组第3次会议报告（NCEP-ATPⅢ）亚裔标准诊断MS,依据BMI将研究对象分为4组后,分性别计算各组MS患病率及OR值。结果4 251名对象的MS患病率为12.66%（男性7.69%,女性17.08%,P〈0.001）。男性随BMI升高MS患病率由2.58%增至12.54%,女性MS患病率由6.33%增至30.50%,趋势检验P〈0.001。Logistic回归分析显示,BMI为20.71~24.99 kg/m^2相对于BMI为18.50~20.70kg/m^2的男性患MS的OR值（BMI）分别为2.23（20.71~22.16 kg/m^2）,3.30（22.17~23.49 kg/m^2）,6.19（23.50~24.99 kg/m^2）;女性OR值分别为1.93,3.97,7.77。去除腰围重新定义MS进入模型计算OR值,得出男性为2.27,3.46,5.17;女性为1.39，2.36，2.59，所有OR值都调整了年龄、吸烟、饮酒、居住地、文化水平、婚姻状况、人均。收入变平和总胆固醇，趋势检验P〈0.001。结论体质指数正常人群中多代谢异常和代谢综合征的患病率同样较高；腰围与代谢综合征的关联可能比体质指数更密切。

Objective To study the prevalence of multi - metabolic disorders and metabolic syndrome in people with normal body mass index（BMI）. Methods Subjects were recruited from the project of the multiple metabolic disorders and metabolic syndrome prevention cohort study in Jiangsu province, in which 4 251 （male 2 003, female 2 248） were selected into this study according to the including criteria. The National Cholesterol Education Program Adult Treatment Panel In Asian criteria was used to define the metabolic syndrome, and the subjects were divided into 4 groups to compute the prevalence and OR of metabolic syndrome with BMI. Results The total prevalence of metabolic syndrome was 12.66 % （male 7.69 %, female 17.08% ） in 4 251 subjects. With the BMI raised, the prevalence in male increased from 2.58% to 12.54%, and from 6.33 % to 30.50 % in female, P 〈 0. 001 in trend test. The Logistic regression analysis, after controlling the factors of age, smoke, alcohol, habitation, education, marriage, income and total cholesterol, showed the OR for the metabolic syndrome was 2.23 in men with BMI 20.71-22.16 kg/m^2, 3.30 for men with BMI 22.17-23.49 kg/m^2 and 6.19 for men with BMI 23.50-24.99 kg/m^2 respectively, compared with men with BMI 18.50- 20.70 kg/m^2. The corresponding ORs in women were 1.93, 3.97 and 7.77. Do the same after Removing WC. The ORs for men was 2.27, 3.46 and 5.17, the ORs for women was 1.39, 2.36 and 2.59, P value for trend test was P 〈 0. 001. Conclusion There was also a high prevalence of multi - metabolic disorders and metabolic syndrome in people with normal body mass index, WC may has a stronger relationship with metabolic syndrome than BMI.