社区中老年人群腹型肥胖与代谢综合征的关系及综合干预前后的对比分析

Relation on the abdominal obesity and Metabolic syndrome and the Comparative analysis between pre-and post-intervention in middle-aged and older people in a community

目的了解贵阳市社区中老年人群腹型(中心性)肥胖与代谢综合征(Metabolic syndrome,MS)患病率及相关代谢异常之间的关系,并且对社区中老年人群进行综合干预,分析干预前后肥胖的相关指标,评价干预效果。方法于2001年对贵阳市黔灵镇社区心脑血管病综合防治示范点中老年人群(大于35岁)进行调查,按照腰围(waistline,WL)进行分层,分析不同腰围人群MS的患病率及有关代谢指标的异常情况。抽样方法采用三阶段固定样本随机抽取1524人。经过五年综合干预后,2006年按上述方法再次三阶段固定样本随机抽取1141人进行复查。结果干预后MS、腹型肥胖、高血压、血糖异常和高甘油三酯血症的患病率分别从干预前的12.0%、42.6%、23.1%、29.0%和34.3%下降到9.6%、30.6%、19.1%、21.3%和27.4%(P均<0.05或0.01);当WL≥90 cm时,人群MS的患病率随WL的增加而上升;人群中肥胖相关指标腰围、腰臀围比与干预前相比,显著下降(P<0.01)。结论贵阳市社区中老年人群中腹型肥胖和MS患病率高。其MS的患病率随着WL的增加而升高。通过综合干预可以降低中老人群腹型肥胖及其MS的患病率。

Objective To analyze the relation between abdominal obesity and the prevalence rate of MS and its related-abnormalities in middle aged and older people in a community of Guiyang City. To analyze the obesity-related indicators before and after that and evaluate the intervention effects by carrying on the comprehensive interventions for the crowd. Methods 1524 community inhabitants in 2001,35 years old and above,were chosen by three stages stationary sample and stratified according to waistline. We made a analysis of the prevalence rate of metabolic syndrome and its related indicators in different waistline people. Then rechecked 1141 people in 2006 after five year intervention. Results The prevalence rate of MS, abdominal obesity, hypertension,abnormal glucose and hypertriglyceridemia in middle-aged and older people have been decreased from 12. 0% to 9.6% ,42.6% to 30.6% ,23.1% to 19.1% ,29. 0%to 21.3% and 34.3% to 27.4% respectively. There is a significant difference （ P 〈0.05or 0.01） between pre-and post-intervention. The prevalence rate of MS rises along with WL increasing if WL is above 90 era. Obesity related index such as waistline and waist--hip ratio were significantly decreased after intervention（ P 〈0.01）. Conclusion The prevalence rate of MS rises along with WL increasing. The prevalence rate of MS and abdominal obesity are high in middle-aged and older people in a community of Guiyang City and they could be significantly decreased by comprehensive interventions.