新疆哈萨克族与汉族代谢综合征流行特点比较与分析

Comparative analysis of epidemic characteristic of metabolic syndrome of Kazakh and Hans in Xinjiang

目的掌握新疆哈萨克族和汉族代谢综合征(MS)的流行特点。方法 采取分层整群随机抽样的方法,抽取新疆石河子市、沙湾县、新源县、玛纳斯县及博州25岁及以上人群,进行问卷调查、体格检查和血生化指标检测,其中哈萨克族2760人,汉族3001人,按照国际糖尿病联盟(IDF)标准比较两民族MS患病率。结果 哈萨克族和汉族MS粗患病率分别为26.6%和23.0%,年龄标化患病率分别为24.4%和20.3%,哈萨克族高于汉族(P<0.05),按性别分层后结果相同。两民族女性患病率均高于男性,MS患病率均随年龄增加而升高。哈萨克族MS组分检出率最高的是肥胖,其次是血压偏高和高密度脂蛋白胆固醇(HDL-C)低(51.8%、48.9%和41.1%),而汉族依次是血压偏高、肥胖和三酰甘油高(48.8%、42.6%和33.9%)。其中肥胖、HDL-C低、高血糖检出率哈萨克族高于汉族,而三酰甘油高检出率哈萨克族低于汉族。哈萨克族MS相关因素有:女性(男性为对照,OR=1.552)、年龄增加(25～<35、35～<45、45～<55、55～<65、≥65年龄段的OR值分别为1.843、4.246、6.489、8.154、10.904),离婚、丧偶或分居的OR值为2.084,单身OR值为1.335,非农牧民(OR=0.680),饮酒(OR=1.417),蔬菜摄入多(每天都吃OR=0.654,每周1～3次OR=0.609)。汉族MS相关因素:女性(男性为对照,OR=1.606),年龄(25～<35、35～<45、45～<55、55～<65、≥65年龄段的OR值分别为1.422、0.952、2.364、3.094、3.795)。结论 哈萨克族和汉族MS患病率高于全国平均水平,哈萨克族高于汉族,防治的重点是控制中心性肥胖,重点人群是中老年女性。

Objective To investigate the epidemic characteristics of the metabolic syndrome（MS） of Kazakh and Hans in Xinjiang. Methods A questionnaire-based survey, physical examination and blood testing of over 25 year olds were conducted according to cluster random samplings in Kazakhs and Hans residents in Shihezi city, Shawan county, Xinyuan county, Manasi county and Bole city in Xinjiang. Among them 2760 samples of Kazakbs and 3001 samples of Hans were collected to compare the prevalence rate of MS based on International Diabetes Federation （IDF） standard. Results The prevalence rate of MS in Kazakhs was 26.6%, and in Hans was 23.0% , 24.4% and 20.3% after age standardization, the prevalence rate of Kazakhs was higher than Hans＇（P〈0.05）. It was same after gender stratification. The prevalence rate of females in Kazakhs and Hans was higber than males＇ in both races. The prevalence rate of MS in these two races rose by the increase with age. Among all the main components of MS in Kazakhs the incidence of overweight and obesity was the highest one and then was the blood pressure which was a little higher than normal and the low high-density lipoprotein cholesterol（HDI.-C） （51.8%, 48.9%, and 41.1%）. Among all the main components of MS in Hans the first was the blood pressure which was a little higher than normal and then was the obesity and the high triglycerides（TG） （48.8%, 42.6% and 33.9%）. The incidence of obesity, low HDL-C and the hyperglycemia in Kazakhs were higher than in Hans while the incidence of high TG in Kazakhs was lower than in Hans. The related factors of MS in Kazakhs were female （contrast to males, 0R：1.552）, increase in age（the OR value of age 25-35, 〉35-45,〉45-55, 〉55 -65, ≥65 was 1. 843. 4. 246. 6. 489. 8. 154. 10. 904 respectively）, the OR value of the divorced and the widowed or the separated （OR=2. 084 respectively）, the OR value of bachelordom （1. 335）, non-herder（OR=0. 680）, drinking（OR= 1. 417） and the intake of vegetables （eating everyday OR=O. 654, 1-3 times one week OR=0. 609）. The related factors of MS in Hans were： female（contrast to males, OR=0. 6061, age （the OR value of age 25-〈35, 35-〈45, 45- 〈55, 55-〈65, ≥65 was 1.422,0.952,2.364,3.094,3.795 respectively）. Conclusion The prevalence rate of MS among Kazakhs and Hans was higher than the national average in China, and the rate in Kazakhs was higher than in Hans. The key prevention method was to control abdominal adiposity, especially the middle-aged and elderly female.