飞行人员代谢综合征与动脉粥样硬化危险因素研究

目的 调查飞行人员代谢综合征(MS)患病率,探讨其发病机制并提出防治策略要点.方法 606例飞行人员为调查对象做断面研究,测量体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、胸围、腰围和臀围.空腹采集静脉血测定甘油三酯(TG)、总胆同醇(TC)、高密度脂蛋白-胆固醇(HDL-C)、空腹血糖(FBG)、血尿酸(PUA)、碱性磷酸酶(ALP)、γ-转肽酶(GGT)和丙氨酸转氨酶(ALT).MS诊断标准:BMI≥25或腰围≥85 cm为肥胖;SBP≥130 mm Hg或(和)DBP≥85 mm Hg为高血压;FBG≥6.10 mmol/L为空腹血糖受损(IFG);TG≥1.70 mmol/L为高TG血症;HDL-C<0.91 mmol/L为低HDL-C血症.上述5项中有任意3项或3项以上者诊断为MS.结果 飞行人员MS检出率为3.80%.MS有3个组分者20例(86.96%);有4个组分者3例(13.04%),以3个组分异常多见.MS组分中:肥胖23例(100%);高TG血症22例(95.65%);低HDL-C血症11例(47.83%);高DBP 9例(31.13%),高SBP 5例(21.74%);IFG 6例(26.09%).MS与非MS两组间比较:BMI、腰围、SBP、DBP、FBG、HDL-C和TG均值水平差异有显著性意义(P<0.01);TC水平、胸围、臀围、吸烟年限及每口吸烟景,均值差异有显著性意义(P<0.01);总飞行时间和年龄,牛化参数GGT、ALP、PUA、ALT均值水平差异有显著性意义(P<0.05或P<0.01).多元逐步回归分析显示烟龄、ALT、PUA 3个变量进入回归方程(P<0.01或P<0.05),烟龄、ALT、PUA水平与MS独立相关. 结论 我军飞行人员MS检出率较低.肥胖和高TG血症是我军飞行人员MS的主要特点.提高对MS的知晓率、控制体重、合理膳食是首要防治策略.

Study on metabolic syndrome and arteriosclerosis risk factors in aircrews

Objective To investigate the prevalence of metabolic syndrome (MS) and its pathological mechanism in aircrews for advancing prevention and cure policy. Methods Six hundred and six pilots were selected as subjects for the cross-sectional study. Body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), chest circumference (CC), waist circumference (WC), hip circumference (HC) were measured. Triglyceride (TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), fasting blood glucose (FBG), plasma uric acid (PUA), alkaline phosphatase (ALP), gamma-giutamyl transpeptidase (GGT) and alanine aminotransferase (ALT) were determined by fasting plasma samples. Five diagnostic criteria for MS were chosen as: ①BMI≥25 or WC≥85 cm is obesity (OB); ②SBP≥130 mm Hg or/and DBP≥85mm Hg is hypertension (HP); ③FBG≥6.10 mmol/L is injured fasting blood glucose (IFG);④TG≥1.70 mmol/L is hypertriglyceridemia; ⑤ HDL-C<0.91 mmol/L is low level of high-density lipoprotein cholesterolemia. If three or more conformities were reached in above five items it would be diagnosed as MS. Results The detection rate of MS was 3.80% in aircrews. Twenty cases (86.96%) reached 3 out of 5 diagnostic critcria comparing to 3 cases (13.04 % ) reached 4. In investigating prevalence of MS, 23 eases of OB (100%), 22 hypertriglyceridemia (95.65%), 11 low level of high-density lipoprotein cholesterolemia (47. 83%), 9 high DBP(31.13%), 5 high SBP(21.74%), 6 IFG (26. 09%)were found. There were significant differences between MS group and none MS group at mean value of BMI, WC, SBP, DBP, FBG, HDL-C,TG (P<0. 01), similarly significances were also found at mean value of TC, smoking years, cigarette bars per day, CC, HC (P<0. 01), and at mean value of total flying hours, age, GGT, ALP, PUA and ALT (P<0.05 or P<0. 01). Multiple regression analysis revealed that smoking years, ALT and PUA levels were independently correlated to MS (P<0. 01 or P<0. 05). Conclusions The results show that the prevalence of MS is lower in Chinese pilot than in ordinary population in Asia and in foreign military pilot. The high prevalence of MS in Chinese military pilot mainly indicates OB and hypertriglyceridemia. For improving the protection of MS mastering knowledge,controlling weight and arranging proper meal are suggested.