桂林市公务员代谢综合征的流行病学特点

Epidemiological analysis of metabolic syndrome among civil servants in Guilin

目的探讨桂林市公务员代谢综合征(MS)的流行病学特征。方法选取在桂林医学院附属医院进行健康体检的858例公务员为研究对象,调查其性别、年龄、民族、膳食、既往病史、吸烟史、饮酒史、运动情况等一般情况;测定身高、体质量、血压,检测空腹血糖(FPG)、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇(HDL-C)、尿酸(UA)、谷草转氨酶(AST)、谷丙转氨酶(ALT)等生化指标,彩超诊断其非酒精性脂肪肝(NAFLD)患病情况;根据2004年中华医学会糖尿病分会诊断标准判定体检者MS及相关疾病如超重和(或)肥胖、高血糖、高血压、血脂紊乱发生率,比较体检者MS和非MS代谢指标差异,采用多因素Logistic回归分析MS的危险因素。结果858例中,共检出MS患者115例,总患病率13.4%;其中男性患病率为19.1%,女性患病率为7.9%,两者差异有统计学意义(P<0.05)。随着年龄递增MS患病率呈上升趋势,年龄40岁以上体检者MS患病率高于40岁以下(P<0.05);男性40~49岁、女性50~59岁MS患病率增长较快,60~69岁为患病高峰;40~59岁男性MS患病率高于相同年龄女性(P<0.05)。超重或肥胖、高脂血症、高血压、高血糖发生率分别为40.1%、26.2%、22.1%、12.4%,不同年龄和性别体检人群MS相关疾病发生率差异有统计学意义(P均<0.05)。MS和非MS两者性别构成、年龄、NAFLD检出率、ALT、AST、BMI、TG、UA、FPG、血压比较差异有统计学意义(P均<0.05)。Logistic回归分析显示男性、年龄、NAFLD、尿酸为MS发生的危险因素(P均<0.05)。结论桂林市40~59岁男性公务员合并NAFLD或血尿酸异常升高者应特别重视MS的发生。

Objective To analyze the epidemiological features of metabolic syndrome(MS)among civil servants in Guilin.Methods Totally 858 civil servants in the physical examination center of the Affiliated Hospital of Guilin Medical College were selected as the subjects.We investigated the general situation of their sex,age,nationality,diet,past medical history,smoking history,drinking history,and sports,etc.The height,weight,blood pressure,fasting blood glucose(FPG),triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),uric acid(UA),aspartate aminotransferase(AST),alanine aminotransferase(ALT)and other biochemical indexes were measured.Non-alcoholic fatty liver disease(NAFLD)was diagnosed by ultrasonography.According to the diagnostic criteria of diabetes branch of Chinese Medical Association in 2004,we determined the incidence rates of MS and its related diseases such as over-weight or obesity,hyperglycemia,hypertension and dyslipidemia.The differences in metabolic indexes between MS patients and non-MS patients were compared.Multivariate logistic regression was used to analyze the risk factors for MS.Results Of 858 cases,115 were MS patients,with a overall prevalence of 13.4%,male prevalence of 19.1%,and female prevalence of 7.9%,and the difference was statistically significant(P<0.05).With the increase of age,the prevalence of MS increased.The prevalence of MS in people over 40 years old was higher than that under 40 years old(P<0.05).The prevalence of MS in men aged 40-49 years and women aged 50-59 years increased rapidly,and reached the peak at 60-69 years old.The prevalence of MS in men aged 40-59 years was higher than that in women of the same age(all P<0.05).The incidence rates of overweight or obesity,hyperlipidemia,hypertension and hyperglycemia were 40.1%,26.2%,22.1%and 12.4%,respectively,there was significant difference in the incidence rate of MS-related diseases among people with different age and gender(all P<0.05).During 858 cases,115 cases were diagnosed with MS and 743 were not;there were significant differences in sex composition,NAFLD detection rate,age,ALT,AST,BMI,TG,UA,FPG and blood pressure between the two groups(all P<0.05).Logistic regression analysis showed that male,age,NAFLD,and uric acid were risk factors for MS(all P<0.05).Conclusion The male civil servants aged 40-59 years with NAFLD or abnormal elevation of serum uric acid in Guilin should pay special attention to the occurrence of MS.