云南省6县（区）常住居民代谢综合征患病率及其影响因素分析

目的 研究云南省6县（区）≥18岁常住居民代谢综合征（MS）流行特征及其影响因素,为当地MS的防治提供科学依据.方法 2010年10-12月,采用多阶段分层整群抽样的方法对云南省6个国家疾病监测点≥18岁常住居民3 600人开展问卷调查、体格检查及生化指标检测.依据2007年《中国成人血脂异常防治指南》制定的MS诊断标准进行诊断,应用多因素非条件logistic回归分析MS的影响因素.结果 共筛查出568例MS患者,患病率为15.8％,标化患病率为14.8％.男性MS患病率为17.5％,明显高于女性（14.2％）,差异有统计学意义（x2=7.38,P=0.007）.18～岁（青年组）、45～岁（中年组）、60岁及以上（老年组）人群MS患病率分别为11.2％、23.0％和21.7％.中年组、老年组患病率相当,均明显高于青年组,差异有统计学意义（x2值分别为73.25和39.17,P＜0.01）.男性中年组MS患病率最高（23.2％）,女性随年龄增长患病率呈上升趋势（趋势x2值为126.14,P＜0.01）.青年组男性MS患病率（16.0％）明显高于女性（6.8％）,差异有统计学意义（x2=45.62,P＜0.01）,老年组女性（29.6％）明显高于男性（13.2％）,差异有统计学意义（x2=20.02,P＜0.01）.MS各组分检出率从高到低依次为低HDL-C（34.4％）、血压升高（29.3％）、高TG（28.7％）、血糖异常（18.0％）、中心性肥胖（14.4％）.多因素非条件logistic回归分析显示,中年组、老年组MS的患病风险高于青年组（OR=2.496,95％ CI：1.979～3.150; OR=2.351,95％CI：1.688～3.274）；吸烟者患病风险高于不吸烟者（OR=1.299,95％CI：1.011～1.668）；过量饮酒者患病风险高于不饮酒者（OR=1.572,95％CI：1.059～2.334）；静态生活方式者患病风险高（OR=1.953,95％CI：1.185～3.219）；有高血压家族史、糖尿病家族史者患病风险高于没有家族史者（OR=1.584,95％CI：1.232～2.038; OR=2.157,95％CI：1.322～3.518）.汉族MS的患病风险高于其他少数民族（OR=0.661,95％CI：0.520～0.840）.结论 云南省居民MS患病率较高,建议根据可改变的危险因素采取综合防控措施,以降低MS相关慢性病带来的健康损失.

Analysis on the prevalence and influence factors of metabolic syndrome in residents of six counties of Yunnan Province

Objective To investigate the prevalence and influence factors of metabolic syndrome （MS） in residents of six counties of Yunnan Province. Methods With multistage stratified cluster random sampling, 3 600 permanent residents （more than 18 years old） were selected for across-sectional study including questionnaire survey, physical examination and laboratory tests. Multiple logistic stepwise regression analysis was used to identify the risk factors related to MS. Results The morbidity and standardized morbidity of MS were 15.8% and 14.8%, respectively. The morbidity and standardized morbidity of MS in males were 17.5% and 17.0%, respectively, which were significantly higher than those （14.2% and 13.0%） in females （P〈0.01）. The morbidities of MS in older group （≥60 years old, 21.7%） and middle age group （45-59 years old, 23.0%） were significantly higher than that （11.2%） in young group （18-44 years old） （P〈0.01）. The morbidity of MS in male middle age group was the highest （23.2%）. The morbidity of MS in females increased with age （P〈0.01）. The morbidity of MS in male young sub-group was 16.0%, which was significantly higher than that （6.8%） in female young sub-group （P〈0.01）. The morbidity （29.6%） of MS in female older sub-group was obviously higher than that （13.2%） in male older su-bgroup （P〈0.01）. The order of MS detection rate was： low HDL-C sub-group （34.4%）, hypertension sub-group （29.3%）, high TG sub-group （28.7%）, abnormal glucose sub-group （18.0%） and central obesity sub-group （14.4%）. The results of multiple logistic regression showed that the MS risk （OR=2.496,95%CI： 1.979-3.150） in middle age and older groups was obviously higher than that （OR=2.351,95%CI： 1.688-3.274） in young group, the MS risk in smokers was obviously higher than that in nonsmokers （0R=1.299,95%CI： 1.011-1.668）, the MS risk in drinkers was obviously higher than that in non-drinkers （0R=1.572,95%CI： 1.059-2.334）, the MS risk in residents with sedentary behaviour was high （0R=1.953,95%CI： 1.185-3.219）, the MS risk in residents with hypertension family history and diabetes family history was high （0R=1.584,95%CI：1.232-2.038 and OR=2.157,95%CI： 1.322-3.518, respectively）, the MS risk in Han residents was higher than that in other nationalities （OR=0.661,95%CI：0.520-0.840）. Conclusion There isa high prevalence of MS in community residents of Yunnan, the comprehensive prevention and control measures should be taken to reduce MS-related chronic diseases.