基于多中心横断面调查的中国人群代谢综合征的流行情况及危险因素

郭海健; 念馨; 梁友芳; 王新玲; 李凯利; 王清; 涂萍; 严孙杰; 张力辉; 王蓓; 孙子林

doi:10.16462/j.cnki.zhjbkz.2019.07.011

基于多中心横断面调查的中国人群代谢综合征的流行情况及危险因素

doi: 10.16462/j.cnki.zhjbkz.2019.07.011

郭海健¹,
念馨²,
梁友芳³,
王新玲⁴,
李凯利⁵,
王清⁶,
涂萍⁷,
严孙杰⁸,
张力辉⁹,
王蓓¹¹,
孙子林^10, ,

1.
210009 南京, 江苏省疾病预防控制中心综合业务办公室
2.
650032 昆明, 昆明医科大学第一附属医院内分泌一科
3.
530021 南宁, 广西医科大学第一附属医院
4.
830001 乌鲁木齐, 新疆自治区人民医院
5.
830099 乌鲁木齐, 新疆医科大学附属中医院内分泌中心
6.
130033 长春, 吉林大学中日联谊医院
7.
330009 南昌, 南昌市第三医院
8.
350005 福州, 福建医科大学附属第一医院内分泌科
9.
050000 石家庄, 河北医科大学第二医院内分泌科
10.
210009 南京, 东南大学附属中大医院内分泌科, 东南大学糖尿病研究所
11.
210009 南京, 东南大学公共卫生学院

基金项目:

国家重点研发计划 2016YFC1305700

详细信息

通讯作者:
孙子林, E-mail: sunzilin1963@126.com

中图分类号: R589
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- 被引次数: 0
出版历程
- 收稿日期: 2018-11-29
- 修回日期: 2019-03-07
- 刊出日期: 2019-07-10

The prevalence and risk factors of metabolic syndrome in Chinese population based on the multi center cross-sectional survey

1.
Integrated Business Management Office, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
2.
Department of Endocrinology, First Affilicated Hospital of Kunming Medical Universtity, Kunming 650032, China
3.
Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
4.
Department of Endocrinology, People's Hospittal of Xiangjiang Uyghur Autonomous Regeion, Urumqi 830001, China
5.
Department of Endocrinology, Xinjiang Uygur Autonomous Region Hospital of traditional Chinese Medical, Urumqi 830099, China
6.
Department of Endocrinology, China-Japan Union Hospital of Jilin Universiry, Changchun 130033, China
7.
Department of Endocrinology, The Third Hospital of Nanchang, Nanchang 330009, China
8.
Department of Endocrinology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
9.
Department of Endocrinology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
10.
School of Public Health, Southeast University, Nanjing 210009, China
11.
Department of Endocrinology, Zhongda hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing 210009, China

Funds:

The National Key R & D Program of China 2016YFC1305700

More Information

Corresponding author: SUN Zi-lin, E-mail: sunzilin1963@126.com

摘要

摘要: 目的调查中国不同民族人群代谢综合征流行状况及危险因素。方法通过多阶段分层随机抽样，检测调查对象的代谢综合征相关指标，并按照国家第六次人口普查数据进行标化，多因素及对数线性模型分析危险因素及交互作用。结果多民族人群的代谢综合征（metabolic syndrome，MS）患病率为19.58%，朝鲜族的MS患病率最高，其次是汉族，哈萨克族的MS患病率最低；MS及超重肥胖等4项指标检出率，男性高于女性，随着年龄的升高而升高；多因素分析结果显示，女性患MS风险是男性的0.556倍；年龄越大，患MS的风险越大；中心型肥胖人群MS的风险比2.765，同时腰身比大于0.52的风险比为4.259；利用对数线性模型，分析超重/肥胖，高血糖、高血压和血脂紊乱，4个指标之间的关系，显示4个指标有独立的效应，因素之间又有交互作用，且存在部分3因素交互作用。结论不同民族MS发生率存在明显差异，MS的高发生率及各指标间存在正向交互作用。应从公共卫生的防控角度，检出更多的MS，并进行干预，减少MS的患病危险因素，降低心脑血管疾病和糖尿病等发生的风险。
- 代谢综合征 /
- 患病率 /
- 危险因素 /
- 交互作用
Abstract: Objective To understand the prevalence and risk factors of metabolic syndrome (MS) among different ethnic groups. Methods A multicenter cross-sectional survey was conducted. Subjects were selected by multistage stratified random sampling. Physical examination and laboratory testing were performed to collect MS related indicators, and the prevalence was standardized by the 6th general survey data. Further multivariate and logarithmic linear model methods were applied to analyze the risk factors and interaction. Results The overall prevalence of MS was 19.58%. The highest prevalence of MS was in Korean, followed by Han, while the lowest was in Kazakh. The rates of MS, overweight and obesity were higher in men than those in women, and increased along with age. Multivariate analysis result showed that the odds ratio (OR) of female to male was 0.556, and aging increased the risk of MS. The OR of central obesity was 2.765, and would reach to 4.259 when the waist-to-body ratio was over 0.52. The logarithmic linear model showed that the overweight/obesity, hyperglycemia, hypertension and dyslipidemia had independent effects on the risk of MS. Also, there were interactions in the four indicators. Conclusions The incidence of MS is high and the positive interaction between the overweight/obesity, hyperglycemia, hypertension and dyslipidemia is observed, making MS a common crisis to clinical and public health. In order to prevent and control MS, and to reduce the risk of cardiovascular and cerebrovascular diseases and diabetes, early screening of MS should be strengthened and lifestyle intervention should be carried out.
- Metabolic syndrome /
- Prevalence /
- Risk factors /
- Interaction

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表 1 多中心横断面调查人群基本情况

Table 1. The basic information of respondents of multi-center cross-sectional survey

人群	频数(%)	MS检出率(%)	年龄(岁)	身高(cm)	体重(kg)	WC(cm)	WHR	中心性肥胖(%)	BMI(kg/m²)
性别
男	3 396(31.46)	26.97	49.33±13.30	166.79±6.97	70.25±11.96	86.91±10.49	0.52±0.06	36.72	25.21±3.74
女	7 398(68.54)	16.18	49.07±12.05	155.57±6.23	59.72±10.39	80.67±10.56	0.52±0.07	29.74	24.66±3.96
年龄(岁)
≤25	399(3.70)	2.51	22.85±1.73	164.40±8.82	60.13±12.13	77.63±10.06	0.47±0.06	14.04	22.16±3.62
25~	1 498(13.88)	5.67	30.93±2.84	161.66±8.39	62.57±13.01	80.24±11.20	0.50±0.06	25.90	23.84±4.04
35~	2 005(18.58)	13.77	40.97±2.91	159.75±7.92	64.19±12.22	81.93±11.11	0.51±0.06	30.92	25.06±3.81
45~	3 195(29.60)	21.00	50.85±2.85	158.52±7.94	63.68±11.87	82.93±10.88	0.52±0.06	32.02	25.27±3.86
55~	2 803(25.97)	28.36	60.61±2.77	157.84±8.27	62.54±11.31	84.02±10.60	0.53±0.07	36.18	25.05±3.78
≥65	894(8.28)	30.87	67.80±1.34	157.02±8.14	61.76±11.22	85.02±10.09	0.54±0.06	38.70	24.99±3.80
民族
朝鲜族	1 351(12.52)	21.84	50.91±11.32	160.08±7.32	61.54±10.47	78.68±9.20	0.49±0.05	17.02	23.94±3.23
傣族	1 949(18.06)	19.04	47.85±11.02	154.28±7.23	58.14±9.58	76.31±8.54	0.49±0.05	10.21	24.39±3.39
汉族	3 084(28.57)	23.67	53.70±10.77	160.53±8.19	64.55±11.40	84.21±9.77	0.53±0.06	37.65	24.98±3.51
哈萨克族	853(7.90)	15.36	46.16±12.22	160.89±8.43	71.46±13.79	90.15±12.21	0.56±0.08	61.20	27.59±4.81
维吾尔族	1 682(15.58)	11.77	38.52±11.80	162.11±8.32	67.30±12.85	88.52±11.33	0.55±0.07	52.73	25.61±4.56
壮族	1 875(17.37)	20.69	52.66±11.66	157.54±7.72	59.05±10.24	80.77±9.71	0.51±0.06	23.89	23.76±3.57
文化程度
小学及以下	3 328(30.83)	22.51	53.26±10.20	155.88±8.07	61.51±11.71	82.42±11.16	0.53±0.07	31.82	25.24±3.95
初中	3 468(32.13)	18.37	48.05±13.01	159.55±8.14	63.47±12.10	82.98±11.02	0.52±0.07	33.30	24.88±4.01
高中	1 802(16.69)	22.59	50.83±12.07	160.67±8.00	64.42±11.79	83.82±10.57	0.52±0.06	35.29	24.89±3.72
大专大学	910(8.43)	19.34	46.23±12.98	161.92±7.90	65.31±12.62	83.64±10.93	0.52±0.06	34.07	24.82±3.88
大学以上	1 286(11.91)	11.20	41.22±11.60	162.03±7.33	62.23±11.36	79.89±10.07	0.49±0.06	22.32	23.62±3.47
合计		19.58	49.15±12.46	159.10±8.31	63.03±11.95	82.63±10.93	0.52±0.07	31.93

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表 2 不同性别和年龄段人群标化后MS患病率及各指标检出情况(%)

Table 2. The standardized prevalence of MS and detection of various indicators in different genders and age groups(%)

分类	MS检出率	超重/肥胖	高血糖	高血压	血脂紊乱
性别
男	26.97	50.47	35.78	44.55	36.01
女	16.18	41.08	28.67	31.82	25.48
年龄(岁)
≤25	2.51	20.55	4.51	8.77	11.53
25~	5.67	32.64	10.61	8.54	20.09
35~	13.77	46.53	22.24	21.55	25.84
45~	21.00	47.79	32.33	38.18	32.33
55~	28.36	46.27	44.02	53.73	33.04
≥65	30.87	47.54	49.89	61.07	31.77
合计	19.58	44.03	30.91	35.83	28.79

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表 3 不同民族标化后MS患病率及各指标检出情况(%)

Table 3. The standardized prevalence of MS and detection of various indicators in different ethnic groups(%)

民族	MS检出率	超重/肥胖	高血糖	高血压	血脂紊乱
朝鲜族	21.09	33.62	34.60	29.22	33.66
傣族	17.31	36.31	20.03	33.40	32.72
汉族	19.91	47.45	29.98	25.99	30.99
哈萨克族	11.70	59.72	14.24	20.59	19.69
维吾尔族	12.60	50.82	15.17	17.35	26.79
壮族	12.73	27.71	21.62	35.66	20.25

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表 4 多元Logistic回归模型的变量赋值表

Table 4. Variable assignment of multicariate Logistic regression model

变量	赋值
MS(结局变量)	0=无，1=有
年龄分组(岁)	1=≤25，2=25~，3=35~，4=45~，5=55~，6=≥65
性别	1=男，2=女
腰身比(WHR)	1= > 0.52，0=≤0.52
饮酒(哑变量)	从不(0, 0)，曾经(0, 1)，现在饮(1, 0)
吸烟(哑变量)	从不(0, 0)，曾经(0, 1)，现在吸(1, 0)
民族(哑变量)	哈萨克族(0, 0, 0, 0, 0)，维吾尔族(0, 0, 0, 1, 0)，壮族(0, 0, 0, 0, 1), 汉族(0, 0, 1, 0, 0)，傣族(0, 1, 0, 0, 0)，朝鲜族(1, 0, 0, 0, 0)
中心型肥胖	0=否，1=是

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表 5 代谢征影响因素非条件Logistic回归分析

Table 5. Non-conditional Logistic regression analysis of influencing factors of MS

因素	β	s_x	Wald值	P值	OR(95% CI)值
常量	-4.115	0.202	416.306	< 0.001
性别	-0.587	0.069	71.882	< 0.001	0.556(0.486~0.637)
年龄组	0.352	0.026	182.219	< 0.001	1.422(1.351~1.496)
中心性肥胖	1.017	0.074	190.967	< 0.001	2.765(2.394~3.194)
腰身比	1.449	0.079	339.599	< 0.001	4.259(3.651~4.969)
饮酒(从不)			10.128	0.006
饮酒(曾经)	0.243	0.081	9.067	0.003	1.274(1.088~1.492)
饮酒(现在饮)	-0.033	0.138	0.056	0.814	0.968(0.738~1.270)
哈萨克族			234.378	< 0.001
朝鲜	1.393	0.134	108.417	< 0.001	4.026(3.097~5.232)
傣族	1.428	0.128	123.481	< 0.001	4.169(3.241~5.363)
汉族	0.820	0.114	51.778	< 0.001	2.271(1.816~2.839)
维吾尔族	-0.028	0.130	0.046	0.830	0.972(0.753~1.255)
壮族	0.898	0.124	52.766	< 0.001	2.456(1.927~3.129)

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表 6 对数线性模型拟合的参数估计

Table 6. Parameter estimation of log-linear model

因素效应	β	s_x	χ²值	P值
独立效应
超重/肥胖	-0.058 2	0.011 8	24.24	< 0.001
高血糖	0.289 2	0.011 6	619.96	< 0.001
高血压	0.164 9	0.011 8	194.37	< 0.001
血脂紊乱	0.369 5	0.011 7	1000.19	< 0.001
二因素交互作用(正向)
超重/肥胖*高血糖	0.129 3	0.011 3	132.08	< 0.001
超重/肥胖*高血压	0.107 5	0.011 8	83.06	< 0.001
超重/肥胖*血脂紊乱	0.214 7	0.011 5	351.58	< 0.001
高血糖*高血压	0.199 9	0.011 1	324.33	< 0.001
高血糖*血脂紊乱	0.175 5	0.011 7	225.01	< 0.001
高血压*血脂紊乱	0.108 2	0.011 6	87.27	< 0.001
三因素交互作用(正向)
超重/肥胖高血糖高血压	0.022 5	0.011 1	4.12	0.042
超重/肥胖高血压血脂紊乱	0.030 2	0.011 4	7.02	0.008

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[15]	时颖, 张普洪, 焦淑芳. 代谢综合征流行水平及其危险因素研究进展[J]. 中国慢性病预防与控制, 2007, 15(6): 615-617. DOI: 10.3969/j.issn.1004-6194.2007.06.042. Shi Y, Zhang PH, Jiao SF. The advance on the epidemic status and its risk factors of metabolic syndrome[J]. Chin J Prevent Control Chronic Dis, 2007, 15(6): 615-617. DOI: 10.3969/j.issn.1004-6194.2007.06.042.
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人群	频数(%)	MS检出率(%)	年龄(岁)	身高(cm)	体重(kg)	WC(cm)	WHR	中心性肥胖(%)	BMI(kg/m²)
性别
男	3 396(31.46)	26.97	49.33±13.30	166.79±6.97	70.25±11.96	86.91±10.49	0.52±0.06	36.72	25.21±3.74
女	7 398(68.54)	16.18	49.07±12.05	155.57±6.23	59.72±10.39	80.67±10.56	0.52±0.07	29.74	24.66±3.96
年龄(岁)
≤25	399(3.70)	2.51	22.85±1.73	164.40±8.82	60.13±12.13	77.63±10.06	0.47±0.06	14.04	22.16±3.62
25~	1 498(13.88)	5.67	30.93±2.84	161.66±8.39	62.57±13.01	80.24±11.20	0.50±0.06	25.90	23.84±4.04
35~	2 005(18.58)	13.77	40.97±2.91	159.75±7.92	64.19±12.22	81.93±11.11	0.51±0.06	30.92	25.06±3.81
45~	3 195(29.60)	21.00	50.85±2.85	158.52±7.94	63.68±11.87	82.93±10.88	0.52±0.06	32.02	25.27±3.86
55~	2 803(25.97)	28.36	60.61±2.77	157.84±8.27	62.54±11.31	84.02±10.60	0.53±0.07	36.18	25.05±3.78
≥65	894(8.28)	30.87	67.80±1.34	157.02±8.14	61.76±11.22	85.02±10.09	0.54±0.06	38.70	24.99±3.80
民族
朝鲜族	1 351(12.52)	21.84	50.91±11.32	160.08±7.32	61.54±10.47	78.68±9.20	0.49±0.05	17.02	23.94±3.23
傣族	1 949(18.06)	19.04	47.85±11.02	154.28±7.23	58.14±9.58	76.31±8.54	0.49±0.05	10.21	24.39±3.39
汉族	3 084(28.57)	23.67	53.70±10.77	160.53±8.19	64.55±11.40	84.21±9.77	0.53±0.06	37.65	24.98±3.51
哈萨克族	853(7.90)	15.36	46.16±12.22	160.89±8.43	71.46±13.79	90.15±12.21	0.56±0.08	61.20	27.59±4.81
维吾尔族	1 682(15.58)	11.77	38.52±11.80	162.11±8.32	67.30±12.85	88.52±11.33	0.55±0.07	52.73	25.61±4.56
壮族	1 875(17.37)	20.69	52.66±11.66	157.54±7.72	59.05±10.24	80.77±9.71	0.51±0.06	23.89	23.76±3.57
文化程度
小学及以下	3 328(30.83)	22.51	53.26±10.20	155.88±8.07	61.51±11.71	82.42±11.16	0.53±0.07	31.82	25.24±3.95
初中	3 468(32.13)	18.37	48.05±13.01	159.55±8.14	63.47±12.10	82.98±11.02	0.52±0.07	33.30	24.88±4.01
高中	1 802(16.69)	22.59	50.83±12.07	160.67±8.00	64.42±11.79	83.82±10.57	0.52±0.06	35.29	24.89±3.72
大专大学	910(8.43)	19.34	46.23±12.98	161.92±7.90	65.31±12.62	83.64±10.93	0.52±0.06	34.07	24.82±3.88
大学以上	1 286(11.91)	11.20	41.22±11.60	162.03±7.33	62.23±11.36	79.89±10.07	0.49±0.06	22.32	23.62±3.47
合计		19.58	49.15±12.46	159.10±8.31	63.03±11.95	82.63±10.93	0.52±0.07	31.93

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基于多中心横断面调查的中国人群代谢综合征的流行情况及危险因素

doi: 10.16462/j.cnki.zhjbkz.2019.07.011

通讯作者:
孙子林, E-mail: sunzilin1963@126.com

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The prevalence and risk factors of metabolic syndrome in Chinese population based on the multi center cross-sectional survey

Corresponding author: SUN Zi-lin, E-mail: sunzilin1963@126.com

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基于多中心横断面调查的中国人群代谢综合征的流行情况及危险因素

doi: 10.16462/j.cnki.zhjbkz.2019.07.011

通讯作者: 孙子林, E-mail: sunzilin1963@126.com

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The prevalence and risk factors of metabolic syndrome in Chinese population based on the multi center cross-sectional survey

Corresponding author: SUN Zi-lin, E-mail: sunzilin1963@126.com

计量

出版历程

目录

通讯作者:
孙子林, E-mail: sunzilin1963@126.com