代谢综合征与前循环脑梗死相关性的研究

目的 研究代谢综合征(MS)及其各组分与前循环脑梗死(ACI)的关系.方法 ACI组271例,诊断符合<中国脑血管病防治指南>脑梗死牛津郡社区卒中研究分型标准,并经CT或MRI证实;对照组147例,均为门诊健康体检者.观察MS在ACI组和对照组的患病率、MS各组分水平以及MS对ACI的危险度.MS诊断采用修订后的中国人MS诊断标准.结果 ACI组和对照组MS的患病率分别为43.17%和19.05%,两组差异有统计学意义(P<0.01).ACI组MS各组分水平与对照组间差异均有统计学意义(P值均<0.05).MS使ACI发病的危险增加3.7倍(P<0.01).结论 MS与ACI关系密切,MS是ACI的重要危险因素.     

墨玉县农村维吾尔族牙周炎与代谢综合征相关性的流行病学研究

目的 探讨慢性牙周炎与代谢综合征患病率的关系.方法 采用分层容量随机抽样方法从墨玉县364村抽取15个村18岁以上维吾尔族成人1 650人,进行问卷调查、血液生化指标检测和相关危险因素调查,口腔检查.依据慢性牙周炎的诊断标准,将调查对象分为牙周炎组和非牙周炎组,其中牙周炎组按其严重程度进一步分为:轻度牙周炎组、中度牙周炎组和重度牙周炎组.代谢综合征采用2005年国际糖尿病联盟(IDF)诊断标准.结果 在资料完整的1415人中有66.0%患慢性牙周炎,275人患有代谢综合征(19.4%).牙周炎人群中代谢综合征的患病率为23.1%,高于非牙周炎人群12.3%(x2=23.9,P=0.000),随牙周炎病变程度的加重,其代谢综合征的患病率显著增加,轻度、中度和重度牙周炎组的代谢综合征患病率分别为19.8%、20.8%、27.6%(x2=31.9,P=0.000).经多因素logistc回归分析提示代谢综合征的患病危险性随牙周炎程度的加重而增加,轻度、中度、重度牙周炎组的OR值分别为1.6、1.7和1.9(P<0.05或P<0.01).结论 维吾尔族代谢综合征的患病率与牙周炎相关,随牙周炎程度的加重而增加.     

代谢综合征与大肠腺瘤的相关性研究

目的 研究代谢综合征(MS)与大肠腺瘤的相关性.方法 选取2009年6月～2012年6月所有接受结肠镜检查的患者,根据排除标准及肠镜检查结果诊断大肠腺瘤组455例,同时选取同期年龄匹配,肠镜结果未见异常的体检者455例为对照组.所有研究对象均检查空腹血糖、血脂,并测量血压、腰围,记录肠镜下腺瘤分布部位、大小、病理结果.对大肠腺瘤组与对照组各临床参数进行比较,运用Logistic回归分析代谢综合征与大肠腺瘤的相关性.结果 (1)大肠腺瘤组代谢综合征患病率高于对照组(P＜0.01),代谢综合征及血糖异常是大肠腺瘤的独立危险因素;(2)代谢综合征病种数量在个体聚集越多,患大肠腺瘤可能性越大;(3)大肠腺瘤合并代谢综合征患者大肠腺瘤数目多为3个或以上,大小为5 ～9 mm,病理多呈进展性改变.结论 代谢综合征与大肠腺瘤密切相关,尽早对代谢综合征患者行结肠镜检查,有利于大肠腺瘤的防治.     

老年人群代谢综合征危险因素相关性分析

据报道,目前世界范围内代谢综合征的患病率均呈逐渐上升的趋势[1].本研究旨在探讨福州地区老年人群罹患代谢综合征的危险因素,以便采取相应的措施降低本地区代谢综合征的患病率.     

台州农村老年代谢综合征成因相关性研究

目的了解沿海农村老年常见病的分布情况发生的危险因素。方法采用随机整群抽样的方法,对农村3567名60岁以上老年人进行健康体检和生活质量问卷调查,并利用非条件Logistic回归进行危险因素分析。结果农村老年人的患病率为94.0%,同时两种以上阳性体征占61.9%,其中高血压占30.5%,高血脂占26.2%,高血糖占11.1%,体质指数≥25.0kg/m2占24.2%。疾病谱顺位为:高血压病(28.6%),白内障(24.0%),高脂血症(21.2%),脂肪肝(18.4%),糖尿病(8.3%),慢性胆囊炎胆石症(7.7%),慢性支气管炎(6.7%),大隐静脉曲张(3.5%),肾和前列腺结石(3.0%),肿瘤(0.17%)。代谢综合征发病高危人群占34.6%,发病率为18.2%。结论农村老年人疾病谱发生改变,代谢综合征已成为沿海农村老年人患病的主要危险因素,定期体检,建立老年人健康档案,可为老年医学研究和疾病早期防治、提高老年人生活质量提供参考依据。     

上海社区老年人代谢综合征与脂肪肝的相关性分析

目的探讨上海社区老年人代谢综合征(MS)各组成成分的患病率及与脂肪肝的相关性,为预防MS及其并发症的发生提供数据支持。方法对2018年4～7月在张江社区卫生服务中心参与体检的60岁以上常住居民的常规身体测量指标和生化指标数据进行分析。根据超声把病人分为轻度脂肪肝和中重度脂肪肝,对其与MS的关系进行分析。结果本研究人群MS的患病率为47. 0%。血压升高是MS最主要的组成成分。Logistic回归分析显示,中重度脂肪肝病人MS的患病风险是正常人群的4. 653倍,脂肪肝为MS的独立危险因素。结论脂肪肝是MS的高危因素,给予相应的饮食运动干预,可预防老年人群MS的发生,提高其生活质量。     

代谢综合征(3)代谢综合征在争议中前行(续2)

代谢综合征的提出促进了人们对危险因素聚集的关注和重视,但其定义、机制、治疗仍存在许多值得探讨的问题,因此引起争议,有待进一步研究.     

柳州市成人代谢综合征患病率调查

目的 :评价柳州市人群中代谢综合征的患病情况。方法 :整群抽取柳州市常住成年居民 76 6 0例 ,男 3894例 ,女 376 6例 ,平均年龄 (39.5± 11.0 )岁 ,进行腰围 (WC)、血压、血脂及血糖等指标检测 ,按美国ATPⅢ提出的标准诊断代谢综合征并进行统计分析。结果 :该地区代谢综合征的总患病率为 5 .81% ,男性患病率高于女性 (P <0 .0 1) ,患病率随年龄增大而增高 ,6 5岁以上组为 2 3.70 %。高血压、空腹血糖增高、高三酰甘油者代谢综合征的检出率均随WC增大而增高。结论 :本组中代谢综合征的患病率已达较高水平 ,WC增大对代谢综合征其他成分有重要影响 ;提示在临床工作中要重视对代谢综合征的干预和控制 ,以预防心血管病的发生     

外周血白细胞计数与代谢综合征危险因素的相关性分析

目前认为．代谢综合征(MS)与亚临床炎症有关。为探讨外周血白细胞(WBC)计数与MS危险因素的相关性,2003-2004年。我们对120例初诊2型糖尿病(T2DM)患者和102例体检者进行了相关研究。现报告如下。     

代谢综合征与中老年人结直肠腺瘤型息肉的关系

目的:研究代谢综合征(metabolic syndrome,MS)与中老年人结直肠腺瘤型息肉(colorectal adenoma polyps,CAP)的关系.方法:回顾性分析2007-1/2010-10在中国人民解放军南京军区南京总院干部消化内科住院期间做电子结肠镜检查的45岁以上患者114例的病例资料,根据是否患...     

代谢综合征因素与大肠肿瘤的关系

目的研究代谢综合征因素如血糖、甘油三酯、胆固醇及高血压与大肠肿瘤发病的关系。方法回顾分析2002年1月至2006年6月住院并接受结肠镜检查308名患者的临床资料。结果308例患者中197例患者（64．0％）检出大肠息肉，包括炎性息肉38例（12．3％），瘤性息肉159例（51．6％），其中进展期息病变为78例（25．3％）。分别以患者空腹血糖、甘油三酯、胆固醇、收缩压水平分组，经年龄校正后对上四分之一区组与下四分之一区组息肉检出情况进行比较，结果甘油三酯及血压上四分之一区息肉检出率（75．3％，80．0％），瘤性息肉检出率（63．6％，66．2％），进展期息病变检出率（36．4％，30．8％），均显著高于下四分之一区检出率（除血压分区进展期息病变检出率比较P〈0．10，余均P〈0．05。高甘油三酯对大肠息肉及瘤性息肉OR分别为2．55，2．21，高血压对大肠息肉及瘤性息肉OR分别为2．30，2．16）。血糖及胆固醇分区息肉检出率及瘤性息肉检出率相比差异无统计学意义（P〉0．05）。结论高甘油三酯及高血压可能为大肠肿瘤发病的危险因素，该类患者进展期息病变检出率较高，需进行大肠肿瘤的筛查。     

Utility of the Asia-Pacific colorectal screening scoring system and the presence of metabolic syndrome components in screening for sporadic colorectal cancer

AIM: To determine the utility of the Asia-Pacific colorectal screening (APCS) scoring system and metabolic syndrome components in individual screening for sporadic colorectal cancer.METHODS: The subjects were patients admitted to the Peking University People’s Hospital for colonoscopy between October 2012 and July 2013. Clinical information, including patient willingness to undergo colonoscopy, medical history, endoscopic findings, histology, and other information, was collected, and the patients were grouped according to APCS scores and the presence of metabolic syndrome components. Colorectal tumor detection rates were compared between the groups.RESULTS: A total of 219 patients were included in the study, 108 were male and 111 were female, resulting in a male-to-female ratio of 1:1.03. The average age of the patients was 56.8 ± 13.7 years. According to APCS scores, 88 (40.2%) patients were included in the average-risk (AR) group, 113 (51.6%) patients were included in the moderate-risk (MR) group, and 18 (8.2%) patients were included in the high-risk (HR) group. Colorectal tumors were detected in 69 (31.5%) subjects, and the detection rates in the AR, MR, and HR groups were 15.9%, 36.3%, and 77.8%, respectively. The difference in the detection rates between the three groups was statistically significant (P < 0.01). The combined detection rate of colorectal tumors in the APCS MR and HR groups was 42.0%. However, patients in the MR and HR groups who presented with metabolic syndrome components, in particular obesity, exhibited a significantly higher colorectal tumor detection rate (59.5%) than did those without these components (19.2%, P < 0.01) and those who underwent colonoscopy because of doctor’s recommendation (36.5%, P < 0.01).CONCLUSION: The APCS scoring system can be used in individual screening for sporadic colorectal cancer. The combined use of APCS scores and the metabolic syndrome components, in particular obesity, will significantly improve the efficacy of individual colorectal cancer screening.     

上海市成人代谢综合征与脂肪肝关系分析

目的探讨代谢综合征与脂肪肝的关系,并评估脂肪肝预测代谢紊乱危险因素聚集的价值。方法采取随机多级分层整群抽样方法调查3175名上海市16岁以上居民,内容包括问卷调查、体检、葡萄糖耐量试验、血脂全套和肝脏实时超声。代谢综合征的诊断根据美国国家胆固醇教育计划成人治疗组第三次报告(NCEPATPⅢ)标准(中心性肥胖诊断参照世界卫生组织西太平洋区标准)。结果3175名成人中代谢综合征和脂肪肝检出率分别为22.9%和20.8%。无论男性还是女性,与肥胖、中心性肥胖相比,脂肪肝判定危险因素的聚集率、特异度、阳性预测值以及归因度百分比最高。中心性肥胖、糖尿病、血脂异常、高血压病等人群脂肪肝患病风险分别是对照人群的32.8倍(95%CI,14.9～72.4)、31.6倍(95%CI,14.2～70.4)、22.6倍(95%CI,10.3～50.0)、23.3倍(95%CI,10.5～51.3),而代谢综合征人群脂肪肝患病风险是对照人群的39.3倍(95%CI,17.8～87.1)。661例脂肪肝患者根据体重指数(BMI)分层后,仅腹型肥胖患病率随BMI增加而增加;即使是体重正常的脂肪肝患者,其代谢紊乱1项和5项指标检出率分别达86.1%、2.8%。结论上海市成人代谢综合征和脂肪肝同为常见病,两者关系密切;脂肪肝能较好预测代谢紊乱危险因素聚集。     

Helicobacter pylori infection concomitant with metabolic syndrome further increase risk of colorectal adenomas

AIM: To investigate the association of colorectal adenomas with both Helicobacter pylori (H. pylori) infection and metabolic syndrome. METHODS: Using a cross-sectional hospital-based study, we analyzed physical examination data from 9311 healthy subjects with overnight physical examinations performed between January 2004 and December 2006. Examined data included gender, age, life style, anthropometric measurements, blood pressure, biochemical and hematological studies, H. pylori infection detected by esophagogastroduodenoscopy and biopsy urease tests, and colorectal adenomas detected with a complete total colonoscopy. RESULTS: The prevalence values for H. pylori infection, metabolic syndrome, and colorectal adenoma were39.2%, 18.7%, and 20.7%, respectively. Colorectal adenoma risk factors included male gender [odd ratio (OR): 2.005, 95% conf idence interval (CI): 1.740-2.310, P < 0.001], advanced age (OR: 1.046, 95% CI: 1.040-1.052, P < 0.001), smoking (OR: 1.377, 95% CI: 1.146-1.654, P = 0.001), increased body fat (OR: 1.016, 95% CI: 1.007-1.026, P = 0.001), higher white blood cell count (OR: 1.038, 95% CI: 1.005-1.073, P = 0.025), H. pylori infection (OR: 1.366, 95% CI: 1.230-1.517, P < 0.001), and metabolic syndrome (OR: 1.408, 95% CI: 1.231-1.610, P < 0.001). In addition, concomitant H. pylori infection with metabolic syndrome further increased the probability of colorectal adenomas. CONCLUSION: Our study revealed H. pylori infection with concomitant metabolic syndrome might further increase the risk of colorectal adenomas.     

Metabolic syndrome and risk of subsequent colorectal cancer

The metabolic syndrome and visceral obesity have an increasing prevalence and incidence in the general population. The actual prevalence of the metabolic syndrome is 24% in US population and between 24.6% and 30.9% in Europe. As demonstrated by many clinical trials (NAHANES Ⅲ, INTERHART) the metabolic syndrome is associated with an increased risk of both diabetes and cardiovascular disease. In addition to cardiovascular disease, individual components of the metabolic syndrome have been linked to the development of cancer, particularly to colorectal cancer.Colorectal cancer is an important public health problem; in the year 2000 there was an estimated total of 944 717 incident cases of colorectal cancer diagnosed world-wide. This association is sustained by many epidemiological studies. Recent reports suggest that individuals with metabolic syndrome have a higher risk of colon or rectal cancer. Moreover, the clusters of metabolic syndrome components increase the risk of associated cancer. The physiopathological mechanism that links metabolic syndrome and colorectal cancer is mostly related to abdominal obesity and insulin resistance. Population and experimental studies demonstrated that hyperinsulinemia, elevated C-peptide, elevated body mass index, high levels of insulin growth factor-1, low levels of insulin growth factor binding protein-3, high leptin levels and low adiponectin levels are all involved in carcinogenesis. Understanding the pathological mechanism that links metabolic syndrome and its components to carcinogenesis has a major clinical significance and may have profound health benefits on a number of diseases including cancer, which represents a major cause of mortality and morbidity in our societies.     

中年人群代谢综合征及其组分与心电图QT间期关系研究

目的探讨中年人群代谢综合征(metabolic syndrome,MS)及其组分与心电图QT间期的关系。方法2003—2006年对975名"宫内发育与成人疾病"队列人群(1948—1954年在北京协和医院出生的活产单子,其中男494名,女481名,年龄41~53岁)进行流行病学调查、身体测量、血生化指标测定及MS诊断,记录标准12导联心电图,用Bazett公式计算校正的QT间期(QTc)。采用稳态模式评估法计算胰岛素抵抗指数(HOMA-IR)。结果该中年人群心电图QT间期延长者262例(占26.9%),MS、HOMA-IR、中心性肥胖、高血压、高血糖、高三酰甘油(TG)、低高密度脂蛋白胆固醇(HDL-C)的检出率分别为19.7%,19.5%,42.5%,34.3%,26.3%,34.6%,31.1%。心电图QT间期延长与中心性肥胖、高血糖、高TG、胰岛素抵抗(IR)、MS及异常组分聚集有相关关系(P<0.05)。结论心电图QT间期延长与多项代谢异常组分、代谢异常聚集及代谢综合征有相关联系。     

血清肾素-血管紧张素醛固酮水平与代谢综合征的相关性

目的:研究血清肾素-血管紧张素醛固酮水平与代谢综合征(MS)及其组分的相关性。方法:198例体检者采空腹静脉血查血糖(FPG)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)及肾素、血管紧张素、醛固酮水平、行糖耐量(OGTT)检测,测血压、身高及体重,计算体重指数(BMI)及醛固酮肾素比值,相关回归分析血清RAAS水平与血脂、血压、血糖、BMI及MS的相关性。根据是否患有MS分为MS组及对照组,比较2组的肾素、血管紧张素、醛固酮水平及醛固酮肾素比值大小。结果:血管紧张素Ⅱ与血脂组分TC(r=0.329)、TG(r=0.936)及BMI(r=0.29)正相关,与HDL-C(r=-0.256)负相关,与LDL-C(r=0.116,P=0.111)无明显相关性,Logestic回归分析血管紧张素Ⅱ与高血压、高血糖、高血脂及代谢综合征均有明显相关性(P0.001),其中与MS回归系数最高(Exp(B)=1.082),MS组血清肾素、血管紧张素Ⅰ、血管紧张素Ⅱ、醛固酮水平均明显高于对照组(P=0.000),2组醛固酮肾素比值无差异。结论:RAAS水平与MS密切相关。     

Specific metabolic biomarkers as risk and prognostic factors in colorectal cancer

Advances in genomics,molecular pathology and metabolism have generated many candidate biomarkers of colorectal cancer with potential clinical value.Epidemiological and biological studies suggest a role for adiposity,dyslipidaemia,hyperinsulinemia,altered glucose homeostasis,and elevated expression of insulin-like growth factor(IGF)axis members in the risk and prognosis of cancer.This review discusses some recent past and current approaches being taken by researches in obesity and metabolic disorders.The authors describe three main systems as the most studied metabolic candidates of carcinogenesis:dyslipidemias,adipokines and insulin/IGF axis.However,each of these components is unsuccessful in defining the diseases risk and progression,while their co-occurrence increases cancer incidence and mortality in both men and women.