清河县农村老年人群血浆醛固酮与代谢综合征组分的相关性分析

The Relationship of Plasma Aldosterone with the Components of Metabolic Syndrome in the Rural Chinese Elderly of Qinghe County

目的探讨血浆醛固酮与代谢综合征（MS）及各组分在老年人群中的关系,为进一步研究MS的发病机制提供依据。方法于2006年采用整群抽样方法,对河北省清河县1 969名70岁以上老年人[男976人,女993人,平均年龄（73.8±3.78）岁]进行问卷调查、体格检查和实验室检验,并用放射免疫分析法测量血浆醛固酮和胰岛素的浓度及肾素活性。结果该研究人群醛固酮水平的中位数是0.18 ng/ml,MS的患病率是30.9%。偏相关分析结果显示调整年龄和性别后,腰围（WC）、三酰甘油（TG）、空腹血糖（FPG）、舒张压（DBP）、总胆固醇（TC）/高密度脂蛋白胆固醇（HDL-C）的比值、体质指数（BMI）与醛固酮水平均呈显著正相关。按醛固酮三分位分组（切点值为0.15和0.22 ng/L）,MS的患病率分别是24.4%,31.8%,37.7%。调整年龄和性别后,WC、胰岛素抵抗指数（Homa IR）、TG、FPG、DBP、TC/HDL-C、BMI的均数均随醛固酮的水平升高而升高（P〈0.05）。MS的非条件Logistic回归分析结果显示,在控制了性别、年龄、颈股动脉脉搏波传导速度（cfPWV）、吸烟状况、饮酒状况、家族史后,随醛固酮分位数的升高,MS的危险增加（OR2分位=1.41,95%CI：1.07-1.86;OR3分位=1.87,95%CI：1.42-2.44）。结论本组老年人群中醛固酮与Homa IR和MS大部分组分相关。

Objective To study the relationship between plasma aldosterone（PA） and the metabolic syndrome（MS） and its components in the elderly population.Methods A total of 1 969 subjects aged over 70 yrs（976 males,993 females,age 73.8± 3.78 yrs） living in Qinghe county were selected with cluster sampling method,and surveyed by standard epidemiological investigation methods in 2006.PA and insulin were measured by radioimmunoassay.Results The Median of PA was 0.18 ng/ml,the prevalence of MS was 30.9%.Partial correlation analysis（controlling for age and sex） showed that PA was positively associated with triglyceride（TG）（r=0.102,P〈0.001）,blood glucose（FPG）（r=0.109,P〈0.001）,DBP（r=0.053,P=0.019）,waist circumference（WC）（r=0.092,P〈0.001）.The age-sex adjusted means of Homa IR,FPG,TG,WC,DBP,body mass index（BMI） and the prevalence of MS were elevated with PA tertile（1st to 3rd tertile） from low to top（P〈0.05）.Logistic regression analysis showed that： after adjusting for age,sex,carotid-femoral artery pulse wave velocity（cfPWV）,smoking,drinking and family history,the PA significantly increased MS risk（ORT2=1.41,95%CI：1.07-1.86;ORT3=1.87,95%CI： 1.42-2.44）.Conclusion PA was positively associated with insulin resistance and some components of MS in our studied rural elderly.The prevalence of MS was increased with aldosterone level increasing.Further research on mechanism of relationship between MS and aldosterone is needed.