代谢综合征组分影响心脑血管疾病发生的前瞻性研究

目的 探讨代谢综合征(MS)组分聚集对人群心脑血管疾病发生风险的影响.方法 2004年对广西南宁市部分事业单位7917名进行MS流行病学横断面调查,并在此基础上采用整群抽样方法随机抽取其中一个事业单位500名无心脑血管疾病史的中老年人纳入研究,根据MS组分的聚集数量分为4组,随访3.5年,每年定期测量血糖、血压、血脂等生理生化指标,并按WHO-MONICA方案心血管病事件(CVD)的诊断标准确定发生的心血管病事件和死亡事件,作为终点事件.结果 (1)MS组分数量多的组别,其体重指数、腰围、收缩压、舒张压、空腹血糖、餐后血糖、甘油三酯生理生化指标的均数高于MS组分数量少的组别.(2)4个组别人群心脑血管疾病的发生率分别为2.97%、4.19%、7.97%、11.88%.(3)logistic回归分析:相对于非MS人群,MS人群发生心脑血管事件的RR=2.389(95%CI:1.2～4.756);相对于0组,1、2、MS组人群发生心脑血管事件的RR值分别为1.41、2.68、4.00,调整年龄和性别后Cox模型分析:相对于0组,1、2、MS组的人群发生心脑血管事件的RR值分别为1.29、2.47、3.67.(4)Kaplan-Meier分析:MS组人群患心脑血管疾病的累积风险高于0、1、2组人群.随访42个月结束时,MS组人群患心脑血管疾病的累积风险达12.7%.结论 随着MS组分聚集的增加,患者发生心脑血管疾病的风险增加;随着自然病程进展,MS组分聚集越多的患者发生心脑血管疾病的累积风险越大.

The components of metabolic syndrome that influencing the prevalence of cardiovascular disease in a follow-up study

Objective To investigate metabolic syndrome components that influencing the prevalence of cardiovascular disease(CVD).Methods Five hundred persons were selected from a unit in Nanning city,Guangxi,based on the cross-sectional study on a distribution of population with metabolic syndrome in 2004 and followed them up for 3.5 more years.Physical examination would include detection on blood pressure,glucose,serum cholesterol and body index etc.When someone suffered from cardiovascular disease would be viewed as an 'end-point event'.Criteria of diagnosis were under the basis of CVD from the WHO-MONICA.Results(1)The mean value of physical and biochemical index as BMI,waist circumstance,systolic pressure,diastolic pressure.Fast serum glucose,triglyceride in the population with more MS components were higher than the ones with less components.(2)The prevalence rates of CVD in the four groups were 2.97%,4.19%,7.97%,11.88% respectively with significant differences between the groups(P=0.0008).(3)Data from the logistic analysis manifested that when compared to the 0 group,the risk rate of CVD for groups having 1,2,3 components were 1.41,2.68,4.00 respectively.After adjusted age and sex,time of occurrences,results from the Cox model showed that the risk rate of CVD for groups with 1,2,3 components were 1.29,2.47,3.67(RR 95%CI:1.02-13.14)respectively.(4)Kaplan-Meier analysis showed that the cum hazard of CVD in the 3rd group was higher than in the 0,1 group,and at the end of follow-up,the cum hazard of CVD was 12.7% in the 3rd group among population with metabolic syndrome.Conclusion When increasing the number of components of metabolic syndrome,the higher risk ratio for population to suffer from CVD was seen.With the natural process of disease,the more components of metabolic syndrome in population,the higher cum hazard would influence the occurrence of CVD in the future.