体质指数正常人群多代谢异常与代谢综合征

目的了解体质指数（BMI）正常人群多代谢异常与代谢综合征（MS）的患病情况。方法以江苏省多代谢异常和代谢综合征防治队列研究的调查人群为研究对象,符合纳入标准的对象共4251名（男2003名,女2248名）。采用美国国家胆固醇教育计划成人治疗组第3次会议报告（NCEP-ATPⅢ）亚裔标准诊断MS,依据BMI将研究对象分为4组后,分性别计算各组MS患病率及OR值。结果4 251名对象的MS患病率为12.66%（男性7.69%,女性17.08%,P〈0.001）。男性随BMI升高MS患病率由2.58%增至12.54%,女性MS患病率由6.33%增至30.50%,趋势检验P〈0.001。Logistic回归分析显示,BMI为20.71~24.99 kg/m^2相对于BMI为18.50~20.70kg/m^2的男性患MS的OR值（BMI）分别为2.23（20.71~22.16 kg/m^2）,3.30（22.17~23.49 kg/m^2）,6.19（23.50~24.99 kg/m^2）;女性OR值分别为1.93,3.97,7.77。去除腰围重新定义MS进入模型计算OR值,得出男性为2.27,3.46,5.17;女性为1.39，2.36，2.59，所有OR值都调整了年龄、吸烟、饮酒、居住地、文化水平、婚姻状况、人均。收入变平和总胆固醇，趋势检验P〈0.001。结论体质指数正常人群中多代谢异常和代谢综合征的患病率同样较高；腰围与代谢综合征的关联可能比体质指数更密切。     

健康体检者体质指数及体脂肪含量与代谢综合征各组分的关系

肥胖与全身脂肪分布异常是代谢综合征（MS）发病率增高的主要原因。使用体质指数（BMI）判断肥胖有一定片面性。利用生物电阻抗技术进行体脂肪含量（BF％）测定近来得到广泛应用。本研究通过BMI、BF％与血压、血糖、血脂及尿酸等MS组分关系的分析，探讨BMI和BF％对代谢异常危险因素的预测价值。     

代谢综合征与肥胖的关系

代谢综合征（MS）、高血糖、血脂紊乱、高血压、肥胖等是心脑血管疾病的独立危险因素，各组分相互作用，增加了心脑血管疾病的相对危险度。用于估计肥胖程度的指标是体质指数（BMI）、腰围（WC）。WC与腹部脂肪相关，用作腹型肥胖的指标，BMI代表总体脂。为了解人群MS与WC和BMI的关系，笔者于2002年对云南省玉溪市红塔区的成人进行了抽样调查。     

成人代谢综合征适宜体质指数切点的研究

目的:探讨成人诊断代谢综合征的适宜体质指数切点。方法:以2008-2009年南京地区参加健康体检成人27822人为研究对象,测量身高、体重、血压,采集空腹静脉血测定葡萄糖、血甘油三酯、高密度脂蛋白胆固醇,通过对体质指数和各代谢异常危险因素的分析,建立受试者工作特征曲线(ROC曲线),探讨适宜的体质指数诊断切点。结果:男性出现代谢异常危险因素的比例高于女性;根据ROC曲线分析,在男性BMI为24.32、女性BMI为23.06时,预测≥2项代谢异常危险因素的Youden指数最大。结论:南京地区成人代谢综合征的体质指数切点,以男性BMI=24,女性BMI=23比较合适。     

中国成年人体质指数和腰围与高血压关系的四年随访研究

目的探讨中国成年人体质指数(BMI)和腰围(WC)的增加与高血压发病危险的关系。方法利用“中国居民健康与营养调查”资料,以4552例18~60岁参加2000年调查、当时无高血压等慢性病并且2004年调查被随访到者为研究对象,考察基线BMI和WC对高血压的预测作用,以及BMI和WC4年间的变化与高血压发病之间的关系。结果男性和女性随访4年高血压发病率分别为20.01%和13.52%。随着基线肥胖程度的增加,高血压的发病危险增加。与BMI和WC均不肥胖者相比,BMI超重/肥胖并且WC肥胖者发生高血压的危险最高(男性,RR=2.840,95%CI:2.139~3.771;女性,RR=2.734,95%CI:2.050~3.647)。调整了其它协变量后,4年中BMI每增加一个单位,男性和女性患高血压的危险分别增加0.141和0.109倍;WC每增加1cm,男性和女性患高血压的危险分别增加0.038和0.035倍。结论体质指数和腰围的增加均能增加高血压发病的危险,体质指数和腰围联合使用可增强对高血压发病的预测作用。     

C反应蛋白水平与传统冠心病危险因素分析

目的了解江苏省人群C反应蛋白（CRP）的水平与传统冠心病（CHD）危险因素的关系。方法通过“江苏省多代谢异常和代谢综合征综合防治研究”资料，比较高敏C反应蛋白（hs—CRP）（hs—CRP：1～2．99mg／L和≥3mg／L）与传统CHD危险因素：体重指数（BMI）、吸烟、高血压、高血糖、高胆固醇、高三酰甘油、低高密度脂蛋白胆固醇、体力活动缺乏等的关系。结果高hs—CRP罹患率均随血压、血糖、胆固醇、三酰甘油、BMI、吸烟、体力活动（无、轻、中、重）增加而增高，但当hs-CRP（1-2．99mg／L）时，传统CHD危险因素中大部分未表现出显著联系；随着Framingham心脏积分（5个危险因素）合并数量增加，高hs-CRP呈明显的等级性变化趋势；logistic回归分析表明，hs—CRP（≥3mg／L）时，BMI、三酰甘油、高血压、高密度脂蛋白胆固醇、吸烟、血糖的OR值均有统计学意义，但hs—CRP（1～2．99mg／L）时，传统CHD危险因素的OR估计值大部分无统计学意义；男性中60．98％和女性中59．02％的高CRP可以归因于传统CHD危险因素。结论传统CHD危险因素与hs—CRP水平关系密切，目前在临床上、人群研究中根据CRP水平的高低判断CHD风险的实际意义值得进一步探讨。     

通州市农村人群代谢综合征的因子分析

目的探讨代谢综合征（MS）患病率的性别差异,分析不同性别代谢综合征各组分的聚集特征。方法有效样本20502名,男性6997人,女性13505人,分别对其代谢综合征的组分f血压、体质指数（BMI）、腰围（WC）、血清胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL—C）、空腹血糖（FPG）1进行因子分析。结果代谢综合征患者3434人,粗患病率为16．75％,其中男性为11．52％,女性为19．46％,女性粗患病率显著高于男性（P〈0．001）;标化率为10．74％,其中男性为10．35％,女性为11．16％。男性WC、收缩压（SBP）、舒张压（DBP）高于女性,女性BMI、TC、HDL—C、FPG高于男性,差异均有统计学意义（P〈0．05）,男女性之间TG差异无统计学意义。男、女因子分析分别都提取了4个主要因子,因子方差累计贡献率分别为80．898％,78．347％。男女代谢综合征组分的聚集性基本相同但也存在差异,肥胖因子处于核心地位,血压因子为重要且独立的因子,其次是血脂紊乱因子、血糖因子。结论代谢综合征是多因素综合作用的结果,该调查研究显示肥胖因子、血压因子作用较强,男女代谢综合征的因子构成存在差异。     

昌平区居民体质指数和腰围水平与代谢综合征的关系

代谢综合征（MS）是中老年常见的慢性疾病,严重危害人们的身体健康。笔者于2009年8月进行调查,探讨昌平区居民体质指数（BMI）和腰围（WC）与MS的关系。     

体重指数、腰围与代谢性健康风险的关系

目的比较体重指数（BMI）、腰围（WC）与代谢性健康风险的大小。方法对苏州市和常熟市两个社区的江苏省多代谢异常和代谢综合征（MS）防治研究中，经济发达地区基线资料的1604例对象按BMI和WC分组，在正常体重（BMI：18～23．9）、超重（BMI：24～27．9）、肥胖（BMI≥28）类别中，计算高血压、高血糖、血脂异常的相对危险度（RR），并对WC类别中腹型肥胖（男≥85cm，女≥80cm）和WC正常个体进行比较。结果无论是男性还是女性，其高血压、糖脂代谢各项指标以及MS的罹患率均与BMI和WC相关，控制混杂因素后，这样的相关性依然存在；但仅BMI超重时，各项表示代谢性健康风险的aRR值基本上都低于BMI超重合并腹型肥胖的aRR值；男、女性BMI正常但有腹型肥胖时，均较BMI超重而WC正常者的健康风险高。结论WC在表示代谢性健康风险方面比BMI更为有效。     

四川阿坝地区高原藏族代谢综合征患病率及危险因素调查

目的 调查四川省阿坝地区高原藏族人群代谢综合征流行状况及危险因素。方法 通过多阶段分层随机抽样，调查阿坝地区海拔高于1500米地区18～80岁的藏族居民，收集代谢综合征相关指标，分析危险因素。结果 阿坝地区高原藏族人群的代谢综合征检出率为31.95%，其中男性37.87%，女性23.43%（〖XC小五号.EPS;P〗值为34.7，P<0.001）。多因素分析结果显示，男性患代谢综合征风险是女性的1.79倍（95%CI:1.45，2.21），超重者患MS的风险是体重正常者的4.1倍（95%CI:1.06，15.8），肥胖者患MS的风险是体重正常者的17.48倍（95%CI:4.49，68.07）。结论 阿坝地区高原藏族人群的代谢综合征检出率高于国内平均水平，尤其是超重肥胖患者和男性人群，是防控的重点对象。     

Body mass index and cardiovascular risk factors in a rural Chinese population

The metabolic consequences of obesity are well-documented in Western populations. However, limited data are available on the association between body mass index (BMI) and cardiovascular risk factors in developing countries. The authors therefore examined the association between BMI and cardiovascular risk factors in a very lean population in China. A total of 2,542 subjects aged 20-70 years from a rural area of Anqing, China, participated in a cross-sectional survey, and 1,610 provided blood samples in 1993. Mean BMI (kg/m2) was 20.7 for men and 20.9 for women. After adjustment for age, sex, education level, occupation, current alcohol use, and cigarette smoking, BMI was significantly associated with systolic and diastolic blood pressures (p < 0.0001). The adjusted odds ratio for hypertension (systolic pressure > or =140 mmHg or diastolic pressure > or = 90 mmHg) across quintiles of BMI (quintile medians: 18.0, 19.4, 20.6, 21.8, and 24.0) were 1.0, 1.34, 2.46, 2.61, and 4.90 (95% confidence interval: 3.20, 7.50). A higher BMI was directly associated with higher levels of serum total cholesterol, triglycerides, and fasting glucose and lower levels of high density lipoprotein cholesterol. These data from a very lean Chinese population confirm independent relations between body mass and cardiovascular risk factors observed in predominantly overweight Western populations and extend the range of associations to lower BMI levels than do previous studies.     

Serum ferritin and risk of the metabolic syndrome in some Korean rural residents]

OBJECTIVES: The purpose of this study was to examine the relationship between serum ferritin and the metabolic syndrome (MS). METHODS: We conducted a cross-sectional study of 1,444 adults over age 40 and under age 70 that lived in a rural area and participated in a survey conducted as part of the Korean Rural Genomic Cohort Study (KRGCS). The MS was defined as the presence of at least three of the followings: elevated blood pressure, low high density lipoprotein cholesterol, elevated serum triglycerides, elevated plasma glucose, or abdominal obesity. After adjustment for age, alcohol intake, menopausal status, body mass index (BMI), high sensitivity C-reactive protein (hs-CRP), and alanine aminotransferase (ALT), odds ratios (ORs) for the prevalence of the MS by sex were calculated for quartiles of serum ferritin using logistic regression analysis. RESULTS: The MS was more common in those persons with the highest levels of serum ferritin, compared to persons with the lowest levels, in men (37.1% vs. 22.4%, p=0.006) and women (58.8% vs. 34.8, p<0.001). In both sexes, the greater the number of MS components presents, the greater the serum ferritin levels. After adjustment for age, alcohol intake, and menopausal status, the OR for metabolic syndrome, comparing the fourth quartile of ferritin with the first quartile, was 2.21 (95% confidence interval; CI=1.26-3.87; p-trend=0.024) in men and 2.10 (95% CI=1.40-3.17; p-trend=0.001) in women. However, after further adjustment for BMI, hs-CRP, and ALT, the ORs were statistically attenuated in both sexes. CONCLUSIONS: Moderately elevated serum ferritin levels were not independently associated with the prevalence of the MS after adjusting for other risk factors. Further studies are needed to obtain evidence concerning the association between serum ferritin levels and the MS.     

社区体检人群代谢综合征患病情况及相关影响因素的调查分析

目的 了解某社区体检人群代谢综合征（metabolic syndrome,MS）的患病率及其影响因素,为本地区MS的综合防治提供科学依据。方法 采用整群抽样的方法,以某社区参加健康体检的18岁及以上成人作为研究对象进行问卷调查、体格检查和实验室检查,采用非条件Logistic回归分析MS的相关影响因素。结果 收集信息完整的研究对象610名,其中男性334人（54.8%）,女性276人（45.2%）。有82人被检出患有MS,患病率为13.4%,男女患病率分别为15.6%（52/334）和10.9%（30/276）,差异无统计学意义（χ2=2.868,P=0.090）。年龄大、文化程度低、具有高血压或糖尿病家族史、疏于锻炼或盐摄入过多的研究对象MS患病率均高于对照组。MS患者的体质指数（body mass index,BMI）、腰围等体检及实验室检测指标均高于对照组（均有P<0.05）,而高密度脂蛋白胆固醇（high density lipoprotein cholesterol HDL-C）则低于对照组。多因素分析结果显示年龄增大、具有糖尿病家族史、BMI高、高腰围、高血压、高甘油三酯和低HDL-C是MS的危险因素。结论 社区体检人群具有相当比例的个体患有MS,应针对相关危险因素及早采取综合防治措施。     

The Family Risk Score for coronary heart disease: associations with lipids, lipoproteins, and body habitus in a middle-aged bi-racial cohort: The ARIC study

PURPOSE: To examine the association between the Family Risk Score (FRS) for coronary heart disease (CHD) and body mass index (BMI), waist-to-hip ratio (WHR), high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol, triglycerides, and lipoprotein(a) protein [Lp(a)]. METHODS: FRS was computed from observed and expected CHD events using family data collected from 11467 black and white adults of the Atherosclerosis Risk in Communities Study (ARIC). BMI, WHR, and lipids adjusted for study center, race, education, BMI (except BMI), WHR (except for BMI and WHR), cigarette smoking, alcohol, and Keys' score were compared among low (FRS < -0.5), average (-0.5 to 0.5), and high (> 0.5) FRS using analysis of covariance. The association between FRS and these risk factors was compared to that for simpler estimates of family risk. RESULTS: Adjusted means of BMI, WHR, LDL, LP(a), and triglycerides were positively associated with FRS, whereas HDL cholesterol was inversely associated with FRS. Of demographic and behavioral factors, cigarette smoking was most strongly associated with FRS. Based on additional comparisons of adjusted means, high vs. low levels of FRS appear to correlate better with CHD risk factors than do the simpler family history assessments. CONCLUSIONS: In situations were genetic or clinical information is not available, FRS may be a favorable measure of familial burden for CHD.     

Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women

BACKGROUND: Recent prospective data suggest that intake of rapidly digested and absorbed carbohydrates with a high dietary glycemic load is associated with an increased risk of ischemic heart disease. OBJECTIVE: We examined whether a high dietary glycemic load was associated with elevated hs-CRP concentrations and whether this association was modified by body mass index (BMI; in kg/m(2)). DESIGN: In 244 apparently healthy women, we measured plasma hs-CRP concentrations and determined average dietary glycemic loads with a validated semiquantitative food-frequency questionnaire. Using multiple regression models, we evaluated the association between dietary glycemic load and plasma hs-CRP after adjusting for age; treatment status; smoking status; BMI; physical activity level; parental history of myocardial infarction; history of hypertension, diabetes, and high cholesterol; postmenopausal hormone use; alcohol intake; and other dietary variables. RESULTS: We found a strong and statistically significant positive association between dietary glycemic load and plasma hs-CRP. The median hs-CRP concentration for the lowest quintile of dietary glycemic load was 1.9 mg/L and for the highest quintile was 3.7 mg/L; corresponding multivariate-adjusted geometric means were 1.4 and 3.8 mg/L, respectively (P for trend < 0.01). This association was significantly modified by BMI. Among women with a BMI greater-than-or-equal 25, the multivariate-adjusted geometric mean hs-CRP concentration in the lowest quintile was 1.6 mg/L and in the highest quintile was 5.0 mg/L; however, among women with a BMI < 25, the corresponding means were 1.1 and 3.1 mg/L, respectively (P = 0.01 for interaction). CONCLUSIONS: Dietary glycemic load is significantly and positively associated with plasma hs-CRP in healthy middle-aged women, independent of conventional risk factors for ischemic heart disease. Exacerbation of the proinflammatory process may be a mechanism whereby a high intake of rapidly digested and absorbed carbohydrates increases the risk of ischemic heart disease, especially in overweight women prone to insulin resistance.     

有高血压家族史血压正常的青少年血清抵抗素测定及临床意义

目的:探讨有高血压家族史但血压正常的青少年血清抵抗素的变化。方法:研究对象为30例有高血压家族史、本人血压正常的青少年(家族史阳性组,FH+组)和30例无高血压家族史、血压正常的青少年(对照组,FH-组),测定其身高、体重、体重指数(BMI)、血压、空腹血糖(FBG)、血总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)和血清抵抗素(Resistin)。结果:FH+组青少年的BMI、收缩压、FBG、TC、LDL-C和血清抵抗素均高于FH-组,差异有统计学意义(P<0.05)。血清抵抗素水平与收缩压(SBP)和FBG呈正相关(P<0.05)。结论:有高血压家族史的青少年即使在血压尚处于正常范围时,已发生血清抵抗素水平升高,血清抵抗素水平可能与血压相关。     

脂质蓄积指数和体重指数与糖尿病关系比较的前瞻性研究

目的 探讨基线脂质蓄积指数(LAP)与体重指数(BMI)不同水平与随访糖尿病(DM)发病的关系.方法 运用前瞻性研究方法 ,以江苏省多代谢异常和代谢综合征(MS)防治队列研究人群为研究对象,分析并比较基线LAP和BMI不同水平与DM的关系,计算LAP、BMI、腰围(WC)、腰臀比(WHR)对预测随访DM的ROC曲线下面积.结果与BMI相比,不论男女DM发病人数及累计患病率随LAP水平增高而增加的趋势更为明显;调整年龄、DM一般危险因素后,相对危险度(RR)分别随BMI水平和LAP水平增加而增高,但后者更具有统计学意义(P<0.05);4种肥胖指标中,预测随访DM的ROC曲线下面积从大到小依次为LAP、WHR、WC、BMI.结论 高LAP比高BMI更容易导致DM;相对于体重增加,DM的形成可能与体内脂质蓄积关系更为密切.     

Breast feeding and blood lipid concentrations in male Brazilian adolescents

OBJECTIVE: To assess the association between breast feeding and blood lipid levels in adolescence. DESIGN: Population based prospective birth cohort study. SETTING: City of Pelotas, Brazil. SUBJECTS: All hospital births taking place in 1982; 79% of all males (n = 2250) were followed up for 18 years, and 2089 blood samples were available. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Total cholesterol and fractions (very low density lipoprotein cholesterol (VLDL), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL)), LDL/HDL ratio, serum triglycerides. RESULTS: Three breast feeding variables were studied: total duration of breast feeding, duration of exclusive or predominant breast feeding, and ever compared with never breast fed. Adjusted analyses were controlled for family income, household assets index, maternal education, maternal pre-pregnancy body mass index (BMI), skin colour, birth weight, gestational age, maternal smoking during pregnancy, and adolescent BMI, and behavioural variables (fat content of diet, physical activity, smoking, and alcohol drinking). Only one association reached borderline significance (p = 0.05): LDL cholesterol was slightly higher among never (mean 41.0 mg/dl; 95% CI 39.4 to 42.7) than among ever breast fed men (38.6 mg/dl; 95% CI 38.6 to 40.3), in the adjusted analyses. All other associations were not significant (p> or =0.09). There was no evidence of effect modification according to preterm status, intrauterine growth retardation, socioeconomic level, growth velocity in the first two years of life, or nutritional status at 2 years of age. CONCLUSIONS: There was no clear association between breast feeding duration and serum lipid concentrations at the age of 18 years in this sample of Brazilian men.     

Association of Free Sugars Intake with Cardiometabolic Risk Factors among Japanese Adults: The 2016 National Health and Nutrition Survey,Japan

The relationship between free sugars intake and cardiometabolic risk factors is unclear in Japanese adults. This cross-sectional study aimed to investigate this association using data from the 2016 National Health and Nutrition Survey, Japan. The percentage of energy intake from free sugars was estimated based on the 1-day weighed dietary record data of Japanese men (n = 4071) and women (n = 5794) aged ≥ 20 years. Associations between free sugars intake and cardiometabolic risk factors, including body mass index (BMI), waist circumference (WC), systolic and diastolic blood pressures, glycated haemoglobin (HbA1c) level and levels of serum total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol, were investigated using linear regression and Dunnett’s test, with the lowest category of quartiles as a reference. After adjustment for potential confounding factors, free sugars intake was inversely associated with blood pressures (men only) and HDL-cholesterol level (both sexes) and positively associated with total-cholesterol level (women only) and LDL-cholesterol level (both sexes), whereas no association was observed for BMI, WC, and HbA1c level. This study identified both positive and inverse associations of free sugars intake with cardiometabolic risk factors in Japanese adults.     

A potential inverse association between insulin-like growth factor I and hypertension in a cross-sectional study

PURPOSE: Elevated circulating insulin-like growth factor I (IGF-I) levels increasingly are being implicated as a potential risk factor for the development of some cancers; however, relatively few epidemiologic studies have focused on potential relationships between circulating IGF-I levels and cardiovascular risk factors or cardiovascular disease. Hence, our objective is to examine relationships between IGF-I levels; body mass index (BMI); fasting insulin level; IGF binding protein 1 (IGFBP-1), IGFBP-2, and IGFBP-3 levels; and an array of traditional cardiovascular risk factors. METHODS: Our analysis included 715 men and women aged 30 to 62 years who participated in the V?sterbotten Intervention Project cohort. IGF-I and IGFBP-1, -2, and -3 were measured in stored plasma samples. Cardiovascular risk factors of interest included glucose level (fasting and 2-hour postload), lipid levels (total cholesterol, high-density lipoprotein cholesterol, and triglycerides), blood pressure (systolic and diastolic), and hypertension status. All presented results were adjusted for age, sex, and laboratory batch. RESULTS: IGF-I quartile was associated inversely with 2-hour glucose level and diastolic blood pressure. There was a stepwise inverse graded association between increasing IGF-I quartile and hypertension, with an odds ratio of 0.51 (95% confidence interval, 0.29-0.90) for hypertension comparing the fourth IGF-I quartile with the first. Further adjusting for BMI and IGFBP-3 level simultaneously strengthened the inverse association, with an odds ratio of 0.42 (95% confidence interval, 0.22-0.80) for hypertension comparing the fourth with the first IGF-I quartile. CONCLUSIONS: Contrary to positive associations between IGF-I levels and some cancers, our results suggest that IGF-I level may be related inversely to prevalent hypertension, a risk factor for cardiovascular disease.