北京市老年人代谢综合征与心脑血管病的关系及其性别差异和随龄变化

Association between metabolic syndrome and cardio-cerebral vascular diseases in the elderly Beijing residents and its sex-and age-dependent variances

目的分析北京市老年人代谢综合征与心脑血管病的关系及性别差异和随龄变化。方法于2000年对一个流行病学队列研究人群1827名老年人进行身高、体重测量及血压和多项血液代谢指标的检查,应用中国标准诊断代谢综合征,同时进行人口学因素及心脑血管病的调查。结果1827名老年人平均年龄(71±7)岁,患代谢综合征372人,占20.4%。女性高于男性。随着年龄增大,代谢综合征患病率下降显著。代谢综合征诸成分中,高血压患病率63.2%,空腹血糖异常患病率23.5%,超重及肥胖患病率34.2%,高甘油三酯血症患病率29.8%,低高密度脂蛋白胆固醇(HDL-C)血症患病率3.7%,均为女性高于男性,糖尿病患病率13.7%,男女性别之间无统计学差异。随着年龄增长,收缩压水平、HDL-C水平逐渐增高,而舒张压、体重指数、空腹血糖、甘油三酯水平逐渐降低。代谢综合征老年人冠心病和脑卒中患病率均显著高于非代谢综合征老年人。这种趋势在低龄老年人中存在,而80岁及以上老年人中则无明显差别。男性代谢综合征冠心病患病和女性代谢综合征脑卒中患病均显著高于非代谢综合征老年人。结论老年人中代谢综合征患病率高,患代谢综合征的老年人心脑血管病患病率增高,在不同性别及年龄之间存在差异。

Objective To investigate the association between metabolic syndrome （MS） and cardio-cerebral vascular diseases in the elderly Beijing residents and its sex-and age-dependent variances. Methods A cohort of 1827 elderly Beijing residents were selected. The physical examination,including height,body weight,blood pressure,several serum metabolic indices,was performed. Metabolic syndrome was diagnosed with China criteria. Demographic data and prevalence of cardio-cerebral vascular diseases in the subjects were investigated. Results The mean age of the subjects was （71±7） years. Among 1827 subjects,there were 372 MS cases,accounting for 20.4%,with higher proportion of women than men. The prevalence of MS remarkably decreased with aging. The prevalence of hypertension was 63.2%,impaired fasting glycaemia 23.5%,overweight and obesity 34.2%,hypertriglyceride 29.8%,and low HDL-C 3.7% respectively,and all were higher in women than in men. Prevalence of diabetes mellitus was 13.7%,and there was no sex-related difference for it. Systolic blood pressure and HDL-C levels increased with aging; while diastolic blood pressure,body mass index,fasting glycaemia and triglyceride levels decreased with aging. The prevalence of coronary heart disease and stroke were higher in the elderly with MS than in those without MS. But,the difference was only seen in the elderly 80 years rather than≥80 years. The prevalence of coronary heart disease in elderly men with MS and prevalence of stroke in elderly women with MS were higher than that in the elderly without MS. Conclusion The prevalence of MS is high in the elderly. Those with MS have a high prevalence of cardio-cerebral vascular diseases,and there exists the sex-and age-related difference.