高海拔地区人群代谢综合征及其组分变化的纵向研究

Longitudinal study on metabolic syndrome and its components in high altitude population

目的:分析高海拔地区健康体检人群代谢综合征(MS)患病及其组分的纵向变化。方法:选取2017年和2020年均在某综合性三甲医院健康管理中心进行健康体检且长期居住于高海拔地区的受检者,通过问卷调查、体格检查和实验室检查等了解该人群代谢综合征的患病情况。纵向对比2017、2020两年间同一人群代谢综合征检出率及其组分的变化趋势,比较该人群中新发代谢综合征患者与对照组的代谢组分水平差异。采用多因素Logistic回归方程分析该高海拔地区人群代谢综合征发生的影响因素。结果:该人群2020年的MS患病率显著高于2017年(17.20%vs.10.18%,P<0.001)。2020年该人群的高血糖、高尿酸血症和患病率均高于2017年,差异有统计学意义(P值均<0.01),但吸烟者、饮酒者和腹型肥胖者所占比例均显著低于2017年(P值均<0.05)。多因素Logistic回归分析结果显示,高血糖、高尿酸、腰围增加和甘油三酯升高是该人群男性发生MS的独立危险因素(P值均<0.05),高尿酸、腰围增加和甘油三酯升高是该人群女性发生MS的独立危险因素(P值均<0.05)。结论:高海拔地区人群MS的患病率随时间推移呈上升趋势,其发病高危因素包括高尿酸、腰围增加、甘油三酯升高及高血糖等。应重视高海拔地区人群代谢组分的异常情况,积极开展相应的预防干预措施,减少MS的发生风险。

Objective:To analyze the longitudinal changes of metabolic syndrome and its components in health examined population in high altitude areas.Methods:The subjects who underwent physical examination in the health management center of a Grade Ⅲ Level A hospital in 2017 and 2020 and lived in high-altitude areas for a long time were selected to understand the prevalence of metabolic syndrome in this population through questionnaire survey,physical examination and laboratory examination,and the change trend of metabolic syndrome and its components in the same population between 2017 and 2020 were compared longitudinally,The differences of metabolic components at baseline between new cases and those without metabolic syndrome were compared.Multivariate logistic regression equation was used to explore the risk factors of MS in people at high altitude.Result:The prevalence of MS in this population in 2020 was higher than that in 2017(17.20%vs.10.18%,P<0.001).The proportion of hyperglycemia,hyperuricemia and decreasing of HDL-C in the same population in 2020 was higher than that in 2017,and the difference was statistically significant(P<0.01).The proportion of smoking,drinking and abdominal obesity in this population in 2020 was lower than that in 2017,and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that hyperglycemia,hyperuric acid,WC and TG were the risk factors for MS in men(all P<0.05).UA,WC and TG were the risk factors for MS in women(all P<0.05).Conclusion:The prevalence of MS in people at high altitude increased with time.UA,WC,TG and hyperglycemia were risk factors.We should focus on the abnormal metabolic components of people in high-altitude areas,and actively carry out prevention and intervention measures to reduce the risk of MS.