上海市闸北区社区居民代谢综合征流行现状及相关影响因素研究

摘要

目的 了解上海市闸北区社区居民代谢综合征(MetS)的流行现状,探讨其相关影响因素.方法 2009年5-10月在上海市闸北区全区范围内,采用二阶段分层整群随机抽样的方法在全区35岁以上常住居民中选取具有代表性的样本进行横断面调查.调查内容包括问卷调查、体格检查、实验室检查.问卷调查包括基本情况、受教育程度、吸烟、饮酒、睡眠和高血压、冠心病、脑卒中、糖尿病家族史及服药史等;体格检查包括测量腰围、血压[收缩压(SBP)、舒张压(DBP)];实验室检查包括检测空腹血糖(FPG)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C).使用SPSS 16.0统计学软件进行统计分析.结果　调查22 001人,患MetS 6 531例,患病率为29.69%.MetS组和非MetS组性别、年龄、受教育程度、睡眠时间、高血压家族史、腰围、SBP、DBP、FPG、TG、HDL-C比较,差异均有统计学意义(P＜0.05).男性和女性腹型肥胖、高三酰甘油血症、低高密度脂蛋白胆固醇血症、高血压、空腹血糖受损或糖尿病患病率比较,差异均有统计学意义(P＜0.001).男性和女性1、2、4、5种MetS患病数量比较,差异均有统计学意义(P＜0.05).不同年龄组男性和女性居民MetS患病率比较,差异均有统计学意义(P＜0.05);男性和女性MetS患病率随年龄段增长而增长(r男=10.378,P=0.001;r女=767.450,P=0.000).Logistic回归单因素分析结果显示,年龄、性别、受教育程度、睡眠时间、高血压家族史与MetS患病率相关,差异有统计学意义(P＜0.05);多因素分析结果显示,最终进入模型且差异有统计学意义的变量有年龄、性别、吸烟、受教育程度、睡眠时间、糖尿病家族史.其中,女性、吸烟、睡眠时间≤6 h、睡眠时间≥10 h、有糖尿病家族史是MetS的独立危险因素;受教育程度＞9年是MetS的独立保护因素.结论 上海市闸北区35岁以上居民MetS患病率较高,因此,应采取综合措施以降低闸北区MetS的发生率.其中,男性应重点干预高血压,女性应重点干预腹型肥胖,且绝经后女性的MetS预防保健工作应加强.%Objective To understand the prevalence of metabolic syndrome ( MetS ) among residents in Zhabei District of Shanghai and to investigate the risk factors. Methods A cross - sectional study was conducted among representative residents over 35 years old in Zhabei District of Shanghai by using stratified cluster sampling from May to October in 2009. The study consisted of questionnaire survey, physical examination and laboratory test. The questionnaire included general condition, education, smoking, drinking, sleep, hypertension, coronary heart disease, stroke, diabetes history and medication history. Physical examination included waist circumference, blood pressure ( SBP and DBP ) . Laboratory test included FPG, TG and HDL -C. SPSS 16. 0 was used to make statistical analysis. Results A total of 22 001 people were surveyed and 6 531 suffered from MetS with a prevalence of 29. 69% . The sex, age, education, sleep time, family hypertension history, waist circumference, SBP, DBP, FPG, TG and HDL - C between the MetS group and non - MetS group all showed statistically significant differences ( P<0. 05 ) . The prevalence of central obesity, hypertriglyceridemia, hypocholesterolemia, hypertension, impaired fasting glucose and diabetes between males and females all showed statistically significant differences ( P<0. 001 ) . The number of MetS 1, MetS 2, MetS 4 and MetS 5 between males and females all showed statistically significant differences ( P<0. 05 ) . The rnprevalence of MetS between different age groups showed statistically significant differences in both males and females ( P<0. 05 ) . The prevalence of MetS increased with age in both males and females ( rmales= 10. 378, P =0. 001; rfemales=767. 450, P =0. 000 ). Logistic single factor regression analysis showed that age, sex, education, sleep time and family hypertension history were significantly related to the prevalence of MetS ( P<0. 05 ) . Multifactor analysis showed that age, sex, smoking, education, sleep time and family diabetes history entered the model. Female, smoking, sleep time≤6 h, sleep time≥10 h and having family diabetes history were independent risk factors for MetS and education > 9 years was independent protective factor for MetS. Conclusion The prevalence of metabolic syndrome of residents over 35 years old is extremely high in Zhabei District of Shanghai, so intervention should be taken into action immediately to reduce the high prevalence. Intervention should be focused on hypertension in males and abdominal obesity in females, and postmenopausal women should be paid special attention to.