代谢综合征的临床始动因子分析  

Clinical initiation factor of the metabolic syndrome

作　　者：王敏[1] 王磊[2] 赵家军[3] 高聆[3] 

机构地区：[1]德州市人民医院内二科,山东德州253014 [2]德州市人民医院心内科,山东德州253014 [3]山东大学附属省立医院内分泌科,济南250021

出　　处：《山东大学学报（医学版）》2010年第12期11-14,18,共5页Journal of Shandong University:Health Sciences

摘　　要：目的探讨代谢综合征(MS)的临床始动因子。方法以MS患病率较高的德州市机关在职男性作为研究对象进行普查,对被调查人员的MS危险因子:腰围粗(≥90cm)、血压升高(收缩压≥130mmHg或舒张压≥85mmHg)、高血糖(空腹血糖浓度≥5.6mmol/L)、高甘油三酯(≥1.7mmol/L)、高密度脂蛋白胆固醇(HDL-C)水平降低(<1.03mmol/L)进行调查分析;将所有被调查人员分为肥胖组(腰围≥90cm,n=370)和非肥胖组(腰围<90cm,n=228),分析比较两组随年龄增长MS的患病率和MS危险因子的发病特点;选择136名MS患者并随机分为单纯饮食控制组(A组,n=45)、单纯运动组(B组,n=45)和饮食控制+运动组(C组,n=46)干预3个月,根据各组MS危险因子、葡萄糖耐量和胰岛素敏感指数(HOMA-IR)的改善情况,分析和比较A、B、C三组的干预效果;将干预效果较好的C组分为C1组(干预后腰围减少≥7cm,n=21)和C2组(干预后腰围减少<7cm,n=25),比较C1和C2两组干预前后MS危险因子、葡萄糖耐量和HOMA-IR的特点。结果德州市机关男性在职人员MS总患病率为41.3%,MS随年龄增长患病率升高;腰围增粗患病率达62%,并且与高血压和高甘油三酯呈正相关;肥胖组在任何年龄段高血压、高血糖、高甘油三酯等MS危险因子的患病率均明显高于非肥胖组(P<0.05);C组干预后,腰围、血压、甘油三酯脂、HOMA-IR指数及葡萄糖耐量等指标均明显改善(P<0.05);C1组较C2组年龄轻(43±10.6vs48±9.7,P<0.05),干预后血压、甘油三酯,HOMA-IR指数及糖耐量较C2组明显改善(P<0.05)。结论腰围增粗是MS的临床始动因子;控制腰围、饮食加运动可以有效地防治MS,且早期干预受益更大。Objective To explore the clinical initiation factor of the metabolic syndrome（MS）.Methods The subjects were selected from male workers on the job who had a high prevalence rate of MS by the authorities in Dezhou.The MS risk factors,such as increased waist circumference（WC≥90 cm）and blood pressure（systolic blood pressure≥130 mmHg or diastolic blood pressure ≥85 mmHg）,elevated levels of blood glucose and triglyceride（fasting glucose≥5.6 mmol/L,triglyceride≥1.7 mmol/L）and decreased level of high-density lipoprotein cholesterol（HDL-C〈1.03 mmol/L）,were investigated and analyzed among the subjects.The subjects were divided into two groups：the obese group（WC≥90 cm,n=370）and the non-obese group（WC〈90 cm,n=228）,and the prevalence of MS and characteristics of MS risk factors were compared between the two groups.136 MS patients selected from the subjects were randomly divided into the diet-alone group（group A,n = 45）,the exercise-alone group（group B,n=45）and the diet ＋ exercise group（group C,n=46）for 3-month intervention.The intervention effects were compared and ev-al uated according to improvements of MS risk factors,oral glucose tolerance test（OGTT）and HOMA-IR among groups A,B and C.Group C,which had a better intervention effect,was further divided into two groups according to the improvement of WC after 3-month intervention：group C1（WC shortening ≥7 cm,n=21）and group C2（WC shortening〈7 cm,n=25）.Improvements of MS risk factors,OGTT and HOMA-IR were compared between groups C1 and C2.Results MS prevalence of male workers on the job selected by the authorities was 41.3% in Dezhou.The prevalence of MS increased with age.Increased WC had a high prevalence（62%）and a positive-correlation with increased blood pressure and elevated triglyceride.Blood pressure,blood glucose and triglyceride levels were significantly higher in the obese group at every age stage than those in the non-obese group（P〈0.05）.WC,blood pressure,triglyceride,HOMA-IR and

关 键 词：代谢综合征 危险因子 临床始动因子 

分 类 号：R589.9[医药卫生—内分泌]