广西40岁以上人群代谢综合征及其危险因素调查

The prevalence and risk factors of metabolic syndrome in middle-aged and elderly people in Guangxi

目的：了解广西地区40岁以上人群中的代谢综合征（metabolic syndrome,MS）流行病学现况及民族差异,研究其相关危险因素,以期为该人群的MS防治提供依据。方法：采用整群抽样方式选取2011年广西地区40岁以上的9 016名常住居民,进行生活方式问卷调查、体格检查及血液生化检测。根据2009年国际糖尿病联盟（International Diabetes Federation,IDF）及2013年中国糖尿病协会（China Diabetes Society,CDS）标准诊断MS,采用多因素非条件Logistic回归分析探讨人群的MS危险因素。结果：1广西地区9 016名40岁以上常住居民,根据2010年全国普查广西人口、性别、民族标化,按IDF的诊断标准,标化后的MS总患病率为31.02%,其中男性标化患病率为20.13%,女性标化患病率为40.29%;汉族标化患病率为30.38%,壮族标化患病率为24.35%。按CDS的诊断标准,标化后的MS总患病率为22.87%,男性标化患病率为19.12%,女性标化患病率为25.06%;汉族标化患病率为22.25%,壮族标化患病率为18.10%。该人群中汉族的MS粗患病率和标化率均显著高于壮族（P〈0.005）。2MS的男性患病率、女性患病率和总患病率均随年龄增长呈升高趋势。3按IDF的诊断标准,MS各组分的粗患病率前3项为高血糖、肥胖、低高密度脂蛋白胆固醇;按CDS的诊断标准,MS各组分的粗患病率前3项为高血糖、高血压、肥胖。4男性、教育程度高等为MS的保护因素[OR值分别为0.647（95%CI为0.549~0.764）、0.832（95%CI为0.771~0.899）,P〈0.05];而高龄、少运动、久坐等均为其危险因素[OR值分别为1.328（95%CI为1.180~1.496）、1.464（95%CI为1.100~1.949）、1.660（95%CI为1.066~2.585）,P〈0.05]。结论：广西地区40岁以上人群的MS发病有自身特点,对其开展MS防治时,重点应以控制高血糖、肥胖为主,且要采取综合干预措施,尤其是对女性人群开展相应的宣教工作,加强对疾病的认识,以期进行早期干预。

Objective： To investigate the prevalence of metabolic syndrome （MS） and its risk factors among people aged 40 years and over in Guangxi Zhuang Autonomous Region, and to compare the difference in prevalence between Zhuang and Han populations. Methods： A total of 9 016 community-residents aged 40 years and over from Nanning and its surroundings were recruited in 2011. Questionnaire interview, anthropometric and blood biochemical measurements were conducted. The criteria of International Diabetes Federation （IDF） in 2009 and the China Diabetes Society （CDS） in 2013 were applied for MS diagnosis. The risk for MS was calculated using logistic regression models. Results： （1） The age- standardized prevalence rates of MS according to IDF definition were 31.02% in overall, 20.13% in male and 40.29% in female, respectively; 30.38% in Han Chinese and 24.35% in Zhuang Chinese, respectively. The age-standardized preva- lence rates of MS according to CDS definition were 22.87% in overall, 19.12% in male and 25.06% in female, respective- ly; 22.25% in Han Chinese and 18.1% in Zhuang Chinese, respectively. The crude prevalence rate and age-standardized prevalence rate of MS in Han Chinese were higher than those in Zhuang Chinese（P〈0.005）. The prevalences of MS in overall, male and female were increasing with increase of age. The top three MS components in crude prevalence rate according IDF definition were hyperglycemia, obesity, and low high density lipoprotein cholesterol, and the top three MS components in crude prevalence rate according to CDS definition were hyperglycemia, hypertension and obesity. Unconditioned multivariable logistic regression analysis showed that gender and education were the protective factors for MS （0R=0.647, 0.832, P〈0.05）. However, age, less exercise and sedentary were the risk factors for MS （0R=1.328, 1.464, 1.660, P〈0.05）. Conclusions： The MS of people aged 40 years and over in Guangxi has its own characteristics. The prevention and treatment of MS should be strengthened on the control of hyperglycemia and obesity. Moreover, comprehen- sive interventions should be taken, especially the health education for female population.