健康肥胖表型老年前期人群代谢综合征组分随访研究  

Component Changes of Metabolic Syndrome in Pre-elderly People with Healthy Obese Phenotype

作　　者：鲍婷[1] 洋翰玮 王佑娟[1] 唐怀蓉[1] 黄燕[1] 吴琳娜[1] BAO Ting;YANG Han-wei;WANG You-juan;TANG Huai-rong;HUANG Yan;WU Lin-na(Health Management Center, West China Hospital, Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学华西医院健康管理中心,成都610041

出　　处：《四川大学学报（医学版）》2018年第3期490-494,共5页Journal of Sichuan University(Medical Sciences)

基　　金：四川省科技厅项目(No.2017RZ0046;No.2017SZ0063;No.2014SZ0170)资助

摘　　要：目的研究健康肥胖表型老年前期人群代谢综合征(metabolic syndrome,MS)进展过程及代谢综合征组分的变化情况。方法收集2010~2016年在四川大学华西医院进行健康体检的1 686例受检者的临床资料,基线年龄在45~59岁之间,无糖尿病、高血压、高血脂及心血管疾病病史的健康肥胖表型的老年前期人群,以2010年的临床资料为基线资料,纵向比较2010~2016年连续7年间该部分人群MS组分变化情况和进展为MS患者情况,并采用logistic回归分析MS影响因素。结果通过7年的纵向随访研究,健康肥胖表型人群MS组分数目不断增加,最终有11.0%的研究对象进展为MS,其中男性118例,年龄(53.29±4.00)岁,吸烟率高达66.95%,既往吸烟率5.93%,饮酒率24.58%;女性67例,年龄(52.01±4.06)岁,吸烟率26.87%,既往吸烟率1.49%,饮酒率11.94%;新发MS组分构成排前三位的依次是空腹血糖(FPG)升高、血压升高和三酰甘油(TG)升高;有44例研究对象由基线时的腹型肥胖(1项MS组分异常)转变为健康状态(0项MS组分异常),其中女性27例,男性17例。年龄(β=0.549 5,OR=1.732,95%CI:1.594~1.882,P<0.000 1)、吸烟(β=1.972 5,OR=7.188,95%CI:4.311~11.986,P<0.000 1)及饮酒(β=1.382 7,OR=3.986,95%CI:2.283~6.959,P<0.000 1)依次为MS的危险因素。结论不论男性还是女性,随着随访时间的增加,其进展为MS的趋势逐年递增,且吸烟和饮酒是影响其进展为MS的主要危险因素;建议老年前期健康肥胖表型人群定期监测MS相关代谢性指标,早期纠正吸烟和饮酒的不健康行为。Objective To determine component changes of metabolic syndrome in pre-elderly people with healthy obese phenotype.Methods A total of 1 686 adults aged between 45-59 yr.who underwent health examinations from 2010 to 2016 in West China Hospital of Sichuan University participated in this study.The participants had healthy obese phenotype at the baseline but no history of diabetes,high blood pressure,high cholesterol and cardiovascular disease.Component changes of metabolic syndrome（MS）and associated factors over the seven-year period were analysed using logistic regression modeling.Results The number of MS components increased over the years in centrally obese individuals,and 11.0% developed MS,including 118 men [（53.29±4.00）years old,66.95% current smokers,5.93% past smokers,24.58% alcohol drinkers]and 67 women[（52.01±4.06）years old,26.87% current smokers,1.49% past smokers,11.94% alcohol drinkers].The most frequently presented MS components included higher fasting glucose,higher blood pressure and higher triglyceride.Healthy status（0 MS component）resumed in 44 participants who had abdominal obesity（1 MS component）at the baseline：27 women and 17 men.Age（OR=1.732,95%CI：1.594-1.882,P〈0.000 1）,smoking（OR=7.188,95%CI：4.311-11.986,P〈0.000 1）and drinking（OR=3.986,95%CI：2.283-6.959,P〈0.000 1）were identified as risk factors of MS.Conclusion MS components increase over years in both men and women.Smoking and drinking are the main risk factors of MS progression.Regular MS surveillance and behavioral interventions are recommended for pre-elderly people with healthy obese phenotype.

关 键 词：老年前期 健康肥胖表型 代谢综合征 心血管疾病 

分 类 号：R589[医药卫生—内分泌]