不同性别人群吸烟与代谢综合征危险因素相关性分析

目的 探讨北京社区成人吸烟与代谢综合征危险因素的关系.方法 2007年4至8月期间接受代谢综合征危险因素调查的社区居民10 054名(18～92岁),使用卡方检验、Logistic回归分析对吸烟状况与代谢综合征的关系进行评估.结果 男性人群平均血压、甘油三酯(TG)、腰围水平高于女性,而高密度脂蛋白胆固醇(HDL-C)、体质指数(BMI)水平低于女性(P＜0.05).男性BMI、腰围分别为24.99 kg/m2、89.13 cm,女性分别为25.49 kg/m2、85.49 cm.两组人群年龄、血糖水平差异无统计学意义.男性吸烟人群的代谢综合征患病率显著高于不吸烟人群(23.0%比21.2%,P＜0.05).男性戒烟后腹围有升高的趋势,但吸烟者的高甘油三酯血症和低HDL-C血症发生风险显著升高.校正年龄、饮酒、运动后,从不吸烟、过去吸烟和现在吸烟的男性人群高甘油三酯血症相对风险[OR(95%CI)]分别为1.00、1.19(0.92～1.47)和1.36(1.02～1.69)(P＜0.05),低HDL-C血症分别为1.00、1.08(0.79～1.32)和1.59(1.13～1.89)(P＜0.05).患代谢综合征分别为1.00、1.10(0.76～1.43)和1.49(1.06～1.89)(P＜0.05).已戒烟男性随着戒烟时间的延长,代谢综合征的发生风险呈下降趋势.女性人群中吸烟仅与低HDL-C血症显著相关.结论 吸烟不显著增加女性代谢综合征发生风险.而在男性人群,尽管戒烟可能增加中心型肥胖的风险,但仍是男性人群发生代谢综合征的重要危险因素.

Abstract：

Objective Cigarette smoking is a risk factor for the development of insulin resistance.However,whether a smoker has a lesser waist circumference (WC) and whether the potential changes in WC may reduce the benefits of smoking cessation remains in dispute. The aims of this study are to re-examines the relationships between smoking and metabolic risk factors by the data from Beijing adults. Methods A total of 3710 men and 6344 women,aged 18 -92 years old,were sampled from community centers in Beijing for this cross-sectional clinical study between April and August 2007. Their concentrations of total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),triglycerides (TG),low-density lipoprotein cholesterol (LDL-C) and plasma glucose (PG) were measured. And the anthropometric parameters (WC,body weight and height) and blood pressure (BP) were record according to a standard protocol. Their social,demographic,personal medical history and behavioral characteristics were collected by the welltrained staff. Metabolic syndrome was defined according to the International Diabetes Federation (IDF) criteria. The relationships between smoking and metabolic syndrome were analyzed by x2 test and logistic regression. Results The mean age and glucose concentration were similar in both genders. Males tended to have a higher mean BP ( systolic and diastolic ),a higher level of TG and a lower HDL-C. Among the obesity indices,the mean WC was higher in males than that in females whereas the mean BMI higher in females. The means of BMI and WC were 24. 99 kg/m2 and 89. 13cm for males and 25.49 kg/m2 and 85.49 cm for females respectively. Smoking was an independent risk factor of metabolic syndrome in male subjects.It was mainly due to a higher prevalence of dyslipidemia,i.e. a higher level of TG and a lower level of HDL-C in smokers. And the trough prevalence of central obesity was higher in former smokers than current smokers. With adjustment for age,alcohol intake,and regular physical activity,the odds ratios[OR( 95%CI)] of never smokers,ex-smokers,and current smokers were 1.00,1.10(0. 92 - 1.47),and 1.36( 1.02- 1.69) for hypertriglyceridemia ( P ＜ 0. 05 ) and 1. 00,1.08 (0. 79 - 1.32),and 1.59 ( 1.13 - 1.89 ) for low H DL-C respectively (P ＜ 0. 05 ). The odds ratios of the MS were 1.00 (referent),1.10 (0. 76 -1.43 ),and 1.49 ( 1.06 - 1.89 ) for never smokers,ex-smokers,and current smokers respectively ( P ＜ 0. 05 ).Cessation of smoking had a general trend of lowering the risk of metabolic syndrome in a year-dependent manner in males. In females,the prevalence of metabolic syndrome and obesity was similar between smokers and nonsmokers. Among the features of metabolic syndrome,only a low HDL-C was associated with chronic smoking in females. Conclusion Although smokers tend to have a lower waist circumference than nonsmokers,the males have higher risk factors for metabolic disorders. There is no significant relationship between smoking and metabolic syndrome in female subjects.

Gender difference in association between smoking and metabolic risks among community adults

Objective Cigarette smoking is a risk factor for the development of insulin resistance.However,whether a smoker has a lesser waist circumference (WC) and whether the potential changes in WC may reduce the benefits of smoking cessation remains in dispute. The aims of this study are to re-examines the relationships between smoking and metabolic risk factors by the data from Beijing adults. Methods A total of 3710 men and 6344 women,aged 18 -92 years old,were sampled from community centers in Beijing for this cross-sectional clinical study between April and August 2007. Their concentrations of total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),triglycerides (TG),low-density lipoprotein cholesterol (LDL-C) and plasma glucose (PG) were measured. And the anthropometric parameters (WC,body weight and height) and blood pressure (BP) were record according to a standard protocol. Their social,demographic,personal medical history and behavioral characteristics were collected by the welltrained staff. Metabolic syndrome was defined according to the International Diabetes Federation (IDF) criteria. The relationships between smoking and metabolic syndrome were analyzed by x2 test and logistic regression. Results The mean age and glucose concentration were similar in both genders. Males tended to have a higher mean BP ( systolic and diastolic ),a higher level of TG and a lower HDL-C. Among the obesity indices,the mean WC was higher in males than that in females whereas the mean BMI higher in females. The means of BMI and WC were 24. 99 kg/m2 and 89. 13cm for males and 25.49 kg/m2 and 85.49 cm for females respectively. Smoking was an independent risk factor of metabolic syndrome in male subjects.It was mainly due to a higher prevalence of dyslipidemia,i.e. a higher level of TG and a lower level of HDL-C in smokers. And the trough prevalence of central obesity was higher in former smokers than current smokers. With adjustment for age,alcohol intake,and regular physical activity,the odds ratios[OR( 95%CI)] of never smokers,ex-smokers,and current smokers were 1.00,1.10(0. 92 - 1.47),and 1.36( 1.02- 1.69) for hypertriglyceridemia ( P ＜ 0. 05 ) and 1. 00,1.08 (0. 79 - 1.32),and 1.59 ( 1.13 - 1.89 ) for low H DL-C respectively (P ＜ 0. 05 ). The odds ratios of the MS were 1.00 (referent),1.10 (0. 76 -1.43 ),and 1.49 ( 1.06 - 1.89 ) for never smokers,ex-smokers,and current smokers respectively ( P ＜ 0. 05 ).Cessation of smoking had a general trend of lowering the risk of metabolic syndrome in a year-dependent manner in males. In females,the prevalence of metabolic syndrome and obesity was similar between smokers and nonsmokers. Among the features of metabolic syndrome,only a low HDL-C was associated with chronic smoking in females. Conclusion Although smokers tend to have a lower waist circumference than nonsmokers,the males have higher risk factors for metabolic disorders. There is no significant relationship between smoking and metabolic syndrome in female subjects.