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目的:探讨代谢综合征各组分个数的递增会否增加动脉硬化的患病风险。方法:在上海市嘉定区40岁及以上居民中进行问卷调查、体格检查、血生化及肱-踝动脉脉搏波传导速度(baPWV)检测,对其中数据完整的2 097人进行统计分析。baPWV值>1 753 cm/s定义为动脉硬化;代谢综合征按美国国家胆固醇教育计划成人治疗组第3次报告(NCEP-ATPⅢ)标准诊断。采用多元线性回归和Logistic回归法分析代谢综合征及其组分与动脉硬化的相关性。结果:本研究人群中男、女性动脉硬化的患病率分别为23.64%和25.61%(P=0.195 2);代谢综合征患病率男性明显低于女性(31.28%比35.71%,P=0.034 5);将人群按代谢综合征组分个数的多少进行分组比较,发现随着代谢组分个数的递增,其动脉硬化患病率逐步增加,分别为2.69%、20.19%、29.81%、28.74%和37.16%,组间有显著差异(趋势P<0.000 1);多元逐步回归筛选变量发现,baPWV与代谢综合征组分中的收缩压、空腹血糖和三酰甘油显著相关(β值分别为0.46、0.08和0.08,均P<0.000 1);Logistic回归分析显示,在校正了多个混杂因素后,代谢组分每增加1项,其动脉硬化发生风险将为原来的1.46倍[95%可信区间(CI):1.29~1.67,P<0.000 1];代谢综合征患者发生动脉硬化的风险是非代谢综合征患者的1.53倍(95%CI:1.13~2.08,P=0.006 0)。结论:代谢综合征组分个数的递增会增加动脉硬化的患病风险。
Objective: To investigate whether the increasing number of components of the metabolic syndrome may increase the risk of atherosclerosis. Methods: Questionnaires, physical examinations, blood biochemistry and baPWV were performed among residents aged 40 years and over in Jiading District of Shanghai. Statistical analysis was performed on 2 097 of them with complete data. BaPWV> 1 753 cm / s was defined as arteriosclerosis; Metabolic syndrome was diagnosed according to the NCEP-ATP III criteria of the American National Cholesterol Education Program Adult Treatment Group. Multivariate linear regression and Logistic regression analysis of the correlation between metabolic syndrome and its components and atherosclerosis. Results: The prevalence of atherosclerosis in men and women in our study was 23.64% and 25.61% respectively (P = 0.195 2). The prevalence of metabolic syndrome was significantly lower in males than in females (31.28% vs. 35.71%, P = 0.034 5). According to the number of metabolic syndromes, the prevalence of atherosclerosis was gradually increased with the increase of the number of metabolic components, which were 2.69%, 20.19%, 29.81%, respectively. 28.74%, and 37.16%, respectively, with significant differences between groups (trend P <0.0001); multiple stepwise regression screening of variables found that baPWV was significantly associated with systolic blood pressure, fasting plasma glucose, and triglyceride in the components of the metabolic syndrome Logistic regression analysis showed that the risk of atherosclerosis increased by 1.46 times for each additional 1 metabolite component after correction for multiple confounding factors (95% confidence interval, 0.46, 0.08 and 0.08 respectively) Confidence Interval (CI): 1.29-1.67, P <0.0001]. The risk of developing atherosclerosis in patients with metabolic syndrome was 1.53-fold (95% CI: 1.13-2.08, P = 0.0060) in patients with non-metabolic syndrome. CONCLUSIONS: Increasing the number of metabolic syndrome components increases the risk of developing atherosclerosis.