北京地区中老年人群代谢综合征的因子分析

目的分析代谢综合征（MS）各组分在不同糖耐量及合并冠心病（CHD）的不同中老年人群中的聚集情况。方法研究对象为北京地区中老年人群糖尿病、高血压病流行病学调查的75g口服葡萄糖耐量试验受试者，分析无糖尿病（DM）史者1254人，年龄60．5岁；其中无CHD的糖耐量正常者752人，男女人数分别为314和438人；CHD患者87人，其中男女人数分别为59和28人；糖耐量异常（IGT）患者312人，男女人数分别为153和159人；新发糖尿病患者103人，男女人数分别为44和59人。对其体质测量、血糖、胰岛素、血脂、血压等指标进行因子分析，因子分析方法采用探索性因子分析，用SAS软件进行。结果探索性因子分析显示肥胖并胰岛素抵抗（IR）、高血糖、血脂紊乱高总胆固醇（TC）、高甘油三酯（TG）和低高密度脂蛋白胆固醇（HDL）]和高血压为构成MS的主要方面。高胰岛素血症总是位于解释较大总方差的主要因子中。不同糖耐量各组结果显示高胰岛素血症组分出现在两个因子中。在糖耐量正常组和CHD组，IR和肥胖组分均构成一个独立的因子分别解释了0．3295和0．2925的总方差。结论MS的病理生理机制复杂，肥胖和胰岛素抵抗是其主要方面，但并不能解释其全部。高胰岛素血症的作用贯穿于MS进展至DM、CHD阶段的始终，针对IR的治疗对CHD及MS的预防可能具有一定意义。

Factor analysis of metabolic syndrome in a population aged over 40 years in Beijing

Objective To evaluate the clustering characteristics of the components of metabolic syndrome （MS） in old and middle-aged people with different glucose tolerance and coronary heart disease（CHD）. Methods The subjects included 1 254 persons without diabetes mellitus （DM） history （mean aged 60.5 years） who underwent a 75g oral glucose tolerance test during a survey of diabetes and hypertension in Beijing area. Factor analysis was performed using the variables of insulin, blood glucose , total cholesterol , triglycerides , high density lipoprotein , systolic blood pressure, diastolic blood pressure, waist circumference and BMI . Results Four principal factors were derived including obesity, insulin resistance（IR）, dyslipidemia and hypertension . The main factors explaining the large portion of the observed variation of MS always included hyperinsulinemia. The factor patterns in subjects with and without CHD were almost similar. In the normal glucose tolerance group and the CHD group , IR and obesity clustered in one factor and explained 32.95% and 29.25% of the total variance respectively. Conclusion Obesity and IR are the most important components of MS. All features of MS cannot be explained by only one factor. Hyperinsulinemia may play a role from MS to the DM or CHD stage, and early treatment of IR may prevent MS and CHD to some degree.