一组随访13年的老年人死亡原因与代谢综合征关系分析

Relation between death causes and metabolic syndrome in senile patients observed during a 13- year follow-up period

目的一组随访13年的老年人死亡原因与代谢综合征之间关系的分析。方法回顾性分析1996年-2009年老年人群查体和病历资料,比较不同代谢性疾病对人群死亡率的影响。结果本组2 160例老年人在13年的随访中共死亡576例,总死亡率26.67%;死亡原因排位前三名的是恶性肿瘤、呼吸系统疾病及心血管疾病,分别占总死亡人数的36.98%、31.42%和18.23%;多因素回归分析显示年龄（OR=1.17,95%CI=1.144-1.193）和高血压（OR=1.39,95%CI=1.078-1.779）为死亡的独立危险因素。单个代谢疾病死亡率比较,仅高血压组死亡率（29.31%）高于非高血压组（19.80%,P〈0.01）,肥胖、糖、脂代谢异常组与对应非肥胖、非糖尿病、非高血压组死亡率相似。随着代谢综合征组分叠加,心、脑血管患病率显著增加,但死亡原因仍以恶性肿瘤及呼吸系统疾病为主。结论本组老年人群恶性肿瘤、呼吸系统疾病及心血管疾病为主要死亡原因,增龄及高血压增加老年人群死亡风险,代谢综合征组分叠加未增加死亡率。

Objective To analyze the relation between metabolic syndrome and causes of death in 2 160 senile patients who were followed up for 13 years. Methods Data on the prevalence of metabolic syndrome, mortality, distribution of death causes in senile patients who received medical examination every year during 1996-2009 were retrospectively analyzed and the effects of metabolic syndrome on mortality were compared. Results Five hundred and seventy-six （26.67%） out of the 2 160 patients died during the 13 years. The major death causes were malignant tumor, respiratory system and cardiovascular system diseases, leading to 36.98%, 31.42%, and 18.23% of deaths, of the total mortality. Multi-factor analysis showed that age （OR=1.17, 95%, CI=1.144-1.193） and hypertension （OR=1.39, 95%CI=1.078-1.779） were the independent risk factors for death. The mortality of hypertension patients （29.31%） was higher than that of those without hypertension. The mortality of patients with obesity, glucose and lipid metabolic disorder was similar to that of those without obesity, glucose and lipid metabolic disorder. The prevalence of cardiocerebral vascular diseases increased with the aggravation of metabolic syndrome, while the major causes of death were still malignant tumor, and respiratory system diseases. Conclusion The major death causes of senile patients are malignant tumor, respiratory system and cardiovascular system diseases. Aging and hypertension but not aggravated metabolic syndrome increases their death risk.