社区中老年人群代谢综合征影响因素的研究

Studying the influence factors for metabolic syndrome of elderly adults in the communities

目的通过对社区中老年人群开展代谢综合征(metabolic syndrome,MS)影响因素研究,为该人群有针对性地制定MS防治措施提供科学依据。方法采用成组病例对照研究方法,于2009-2010年从天津市南开区社区医院进行体检的中老年人群中随机选取MS患者150例,对照组168例。应用问卷调查、实验室检查及体格检查相结合的方式对病例组和对照组进行调查。采用经因子分析后的多因素非条件logistic回归分析MS的影响因素。结果人际关系差、家庭关系差、环境适应能力差因子,人均月饮食支出高、不定时吃饭因子,丧偶、文化程度低因子,吸烟、每日水果量少因子,睡眠障碍因子是MS的危险因素,其比值比(OR)和95%可信区间(95%CI)分别为2.084(1.334～3.375)、1.544(1.081～2.205)、1.389(1.018～3.830)、2.712(1.708～4.306)、4.213(2.437～5.942);有体育锻炼、重体力活动因子,正常体质指数(BMI)和腰臀比(WHR)因子是MS的保护因素,其OR值(95%CI)分别为0.645(0.477～0.870)、0.434(0.303～0.665)。结论中老年人群的社会经济地位、生活行为方式及心理因素共同影响其MS的发病风险,睡眠障碍是MS的一个独立危险因素。关注中老年人特别是丧偶者的心理健康和睡眠质量,树立并培养正确的健康观和饮食观,将有助于MS的防治。

Objective To explore the influence factors of metabolic syndrome （MS） for elderly adults in the communities and to provide the scientific basis for prevention and control measures of MS. Methods A case-control study （ 150 MS cases and 168 controls） was performed, the subjects were from Nankai District of Tianjin during 2009 to 2010. The questionnaires, laboratory examinations and medical examinations were used in present case-control investigation. The influence factors for metabolic syndrome were analyzed with multivariate unconditional logistic regression modified by the factor analysis. Results The poor interpersonal relationships, poor family relationships, poor adaptability, higher per capita expenditure on food, irregular meals, bereft of one＇ s spouse, low educational level, smoking, less amotmt of fruits per day and sleep-disorder were risk factors for MS, their OR and 95%CI were 2.084 （1.334-3.375）, 1.544 （1.081-2.205）, 1.389 （1.018-3.830）, 2.712 （1.708-4.306） and 4.213 （2.437-5.942）, respectively. The physical exercise, heavy physical activity and normal body mass index（ BMI ）, waist-to-hip ratio （WHR） were the protective factors for MS, their OR and 95%CI were 0.645 （0.477-0.870） and 0.434 （0.303-0.665）, respectively. Conclusion The social economic status, life behavior style and psychological factors are risk factors for MS of middle-aged and elderly people, the sleep-disorder is an independent risk factor for MS. Concerning mental health and sleep quality of elderly adults in the communities, especially the bereft of one＇ s spouse people, establishing and cultivating correct health concept and diet view will be helpful to prevent and treat the metabolic syndrome.