代谢综合征与心脑血管病及死亡前瞻性队列研究  

Association between MS and cardio-cerebrovascular disease and total mortality in Inner Mongolian population

作　　者：张艳芬[1] 佟伟军[2] 刘洋 刘永跃[4] 高秀英[5] 怒特 王健[4] 布仁巴图[4] 林哲[4] 张永红[2] 李永山[6] 张显玉 

机构地区：[1]通辽市医院神经内科,内蒙古028000 [2]苏州大学医学部公共卫生学院 [3]江苏省苏州市姑苏区疾病预防控制中心 [4]内蒙古自治区通辽市疾病预防控制中心 [5]内蒙古自治区通辽市奈曼旗人民医院 [6]内蒙古自治区通辽市科左后旗疾病预防控制中心 [7]内蒙古自治区通辽市奈曼旗疾病预防控制中心

出　　处：《中国公共卫生》2013年第10期1405-1409,共5页Chinese Journal of Public Health

基　　金：国家自然科学基金(30360094)

摘　　要：目的 阐述代谢综合征（MS）与心脑血管疾病及死亡的关联性。方法 采用前瞻性队列研究方法,对内蒙古通辽市农牧区2 589名〉20岁的蒙古族居民进行8年随访,随访结局事件为心脑血管疾病（脑卒中与冠心病）和死亡,采用多结局Cox比例风险模型,以脑卒中、冠心病和死亡为多结局事件计算MS及其他危险因素对多结局事件的HR值及其95%CI。结果 对基线人群2 589人随访8年,其中失访率0.23%,随访18 543人年,发生心脑血管疾病及死亡事件共261例;随访期间脑卒中与冠心病的发病密度分别为533.9/10万人年、253.5/10万人年,死亡密度为620.2/10万人年;为了探讨MS对多结局事件（心脑血管病及死亡事件）的危险性,进行多因素多结局Cox比例风险模型拟合,在调整了年龄、性别、高血压家族史3个传统危险因素后,MS对心脑血管疾病及死亡事件（多结局事件）的风险性依然存在[HR（95%CI）为1.33（1.02~1.74）]。结论 心脑血管疾病是威胁农牧区蒙古族居民健康的重要疾病,MS可增加蒙古族农牧民心脑血管疾病及死亡事件发生33%的风险,即MS对心脑血管疾病及死亡的发生有预测作用。Objective To analyze the association between metabolic syndrome（MS）and cardio-cerebrovascular disease and total mortality.Methods A 8-year follow-up study was conducted among 2 589 Mongolian people aged 20-84 years.The observed outcomes were cardio-cerebrovascular disease（stroke and coronary heart disease）and total mortality.Multivariate proportional hazards model was adopted to analyse the hazard ratios（HR）and their 95% confidence intervals（95%CI）of MS and other risk factors for multilple outcomes.Results Among all participants,the lost to follow-up rate was 0.23% and the total follow-up person-years were 18 543.There were 261 incidences of cardiovascular and cerebrovascular diseases observed.During the follow-up,the incidence density of stroke and coronary heart disease were 533.9/100 000 and 253.5/100 000 person-years,respectively,and the mortality density was 620.2/100 000 person-years.After djusting for age,gender,and the history of hypertension,multi-factor proportional hazards model analyses showed that MS was associated with the outcome,with the HR（95% CI）of 1.33（1.02-1.74）（P=0.034）.Conclusion MS may increase the risk of cardiovascular disease and total mortality by 33% in Mongolian population,suggesting MS could predict the incidence of cardiovascular disease and death.

关 键 词：代谢综合征 心脑血管疾病 死亡 队列研究 多结局Cox比例风险模型 

分 类 号：R589[医药卫生—内分泌]