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目的探讨血浆醛固酮与代谢综合征(MS)及各组分在老年人群中的关系,为进一步研究MS的发病机制提供依据。方法于2006年采用整群抽样方法,对河北省清河县1 969名70岁以上老年人[男976人,女993人,平均年龄(73.8±3.78)岁]进行问卷调查、体格检查和实验室检验,并用放射免疫分析法测量血浆醛固酮和胰岛素的浓度及肾素活性。结果该研究人群醛固酮水平的中位数是0.18 ng/ml,MS的患病率是30.9%。偏相关分析结果显示调整年龄和性别后,腰围(WC)、三酰甘油(TG)、空腹血糖(FPG)、舒张压(DBP)、总胆固醇(TC)/高密度脂蛋白胆固醇(HDL-C)的比值、体质指数(BMI)与醛固酮水平均呈显著正相关。按醛固酮三分位分组(切点值为0.15和0.22 ng/L),MS的患病率分别是24.4%,31.8%,37.7%。调整年龄和性别后,WC、胰岛素抵抗指数(Homa IR)、TG、FPG、DBP、TC/HDL-C、BMI的均数均随醛固酮的水平升高而升高(P<0.05)。MS的非条件Logistic回归分析结果显示,在控制了性别、年龄、颈股动脉脉搏波传导速度(cfPWV)、吸烟状况、饮酒状况、家族史后,随醛固酮分位数的升高,MS的危险增加(OR2分位=1.41,95%CI:1.07~1.86;OR3分位=1.87,95%CI:1.42~2.44)。结论本组老年人群中醛固酮与Homa IR和MS大部分组分相关。
Objective To investigate the relationship between plasma aldosterone and metabolic syndrome (MS) and its components in the elderly population, and to provide basis for further study on the pathogenesis of MS. Methods A total of 1 969 elderly people aged over 70 in Qinghe County of Hebei Province in 2006 were surveyed by questionnaire, including 976 males and 993 females, with an average age of (73.8 ± 3.78) years. Physical examination and laboratory The levels of plasma aldosterone and insulin and renin activity were measured by radioimmunoassay. Results The median aldosterone level in this study population was 0.18 ng / ml and the prevalence of MS was 30.9%. Partial correlation analysis showed that waist circumference (WC), TG, FPG, DBP, TC / HDL-C ) Ratio, body mass index (BMI) and aldosterone levels were significantly positive correlation. The prevalence of MS was 24.4%, 31.8% and 37.7%, respectively, according to the aldosterone tertiles (cutoff values of 0.15 and 0.22 ng / L). After adjusting for age and gender, mean of WC, Homa IR, TG, FPG, DBP, TC / HDL-C and BMI increased with the increase of aldosterone (P <0.05). The unconditional Logistic regression analysis of MS showed that the risk of MS increased with the increase of aldosterone level after controlling for sex, age, cfPWV, smoking status, drinking status and family history (OR2 quantile = 1.41, 95% CI: 1.07-1.86; OR3 quantile = 1.87, 95% CI: 1.42-2.44). Conclusions Aldosterone in the elderly population correlates with most components of Homa IR and MS.