代谢综合征及其组分与高同型半胱氨酸血症的相关性

崔淑衡; 赵琦; 王娜; 张越; 丘云; 周晓燕; 郁雨婷; 王瑞平; 姜永根; 赵根明

doi:10.16462/j.cnki.zhjbkz.2020.09.003

代谢综合征及其组分与高同型半胱氨酸血症的相关性

doi: 10.16462/j.cnki.zhjbkz.2020.09.003

1.
200032 上海, 复旦大学公共卫生学院, 公共卫生安全教育部重点实验室
2.
201600 上海, 上海市松江区疾病预防控制中心

基金项目:

国家重点研发计划精准医学重点专项 2017YFC0907001

上海市高峰计划公共卫生与预防医学重点学科建设项目 2016

详细信息

通讯作者:
赵根明, E-mail:gmzhao@shmu.edu.cn

中图分类号: R181
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出版历程
- 收稿日期: 2020-02-25
- 修回日期: 2020-06-30
- 刊出日期: 2020-09-10

Association between metabolic syndrome and its components with hyperhomocysteinemia in community population

1.
Key Laboratory of Public Health Safety, Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
2.
Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China

Funds:

National Key Research and Development Program of China, Precision Medicine Project 2017YFC0907001

Key Diseipline Construction Project for Public Health and Preventive Medi-cine of Shanghai Peak Plan 2016

More Information

Corresponding author: ZHAO Gen-ming, E-mail:gmzhao@shmu.edu.cn

摘要

摘要: 目的了解上海市松江区新桥社区成年人高同型半胱氨酸血症（hyperhomosysteinemia，HHcy）与代谢综合征（metabolic syndrome，MS）及其组分的分布情况，探讨MS及其组分与HHcy的相关性。方法采用随机整群抽样的方法抽取上海市松江区新桥社区20~74周岁的常住居民进行横断面调查，描述MS及其组分的人群分布特征，采用多因素Logistic回归分析模型分析MS及其组分与HHcy之间的关联。结果共纳入研究对象8 201人，HHcy的罹患率为32.59%，MS的患病率为18.53%。MS的5个组分中，血压升高的罹患率最高（61.00%）。多因素Logistic回归分析模型结果显示，MS患者罹患HHcy的概率是非MS患者的1.16倍（OR=1.16，95% CI：1.02~1.33，P=0.030）。MS组分中，中心性肥胖、血压升高、高密度脂蛋白降低和甘油三酯升高均与HHcy独立相关。随着合并MS组分数量的增加，HHcy罹患的风险一定程度上增加。结论上海市松江区新桥社区成年人MS和HHcy罹患率较高，且MS及其组分是HHcy的独立危险因素。需要关注高危人群的血浆Hcy水平，重视MS和HHcy的早期防治，进而预防慢性病的发生与进展。
- 代谢综合征 /
- 同型半胱氨酸 /
- 相关性 /
- 横断面研究
Abstract: Objective To investigate the distributional features of metabolic syndrome (MS) and its components among adults in Xinqiao community Songjiang District, Shanghai City, and to explore the association between MS and its components with hyperhomocysteinemia (HHcy). Methods A community-based cross-sectional study using randomized cluster sampling was conducted among adults aged 20-74 in Xinqiao community. Distributional characteristics of MS and its components were described, and Logistic regression was used to access the association between MS and its components with HHcy. Results Among 8 201 subjects, the prevalence of MS was 18.53%, and the attack rate of HHcy was 32.59%. Among 5 components of MS, the attack rate of raised blood pressure was the highest in subjects (61.00%). Multipel Logistic regression showed that patients with MS were 1.16 times more likely to have HHcy than those without MS (OR=1.16, 95% CI:1.02-1.33, P=0.030). And HHcy was independently associated with central obesity, raised blood pressure, decreased HDL-C and raised triglyceride. The risk of HHcy increased to some extent as the number of MS components increased in individuals. Conclusions The prevalence of MS and attack rate of HHcy appeared relatively high in Xinqiao Community, and MS and its components may be risk factors of HHcy. Plasma Hcy level among high-risk population calls for attention, and it shows an urgent need for early prevention and control of MS and HHcy so as to prevent further chronic disease.
- Metabolic syndrome /
- Homocysteine /
- Association /
- Cross-sectional study

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表 1 研究对象的人群特征与HHcy和非HHcy者的均衡性检验[n(%)]

Table 1. The basic information of the respondents and the equilibrium test between HHcy and non-HHcy [n(%)]

项目	非HHcy(n=5 528)	HHcy(n=2 673)	合计(n=8 201)	t/χ²值	P值
男性	1 593(28.82)	1 774(66.37)	3 367(41.06)	1 049.82	< 0.001
年龄组(岁)				170.28	< 0.001
20~	286 (5.17)	141(5.27)	427(5.21)
30~	751(13.59)	297(11.11)	1 048(12.78)
40~	887(16.05)	414(15.49)	1 301(15.86)
50~	1 628(29.45)	1 144(42.80)	2 772(33.80)
60~	1 158(20.95)	358(13.39)
≥70	818(14.80)	319(11.93)	1 137(13.86)
MS	982(17.76)	538(20.13)	1 520(18.53)	6.66	0.011
吸烟	789 (14.27)	1 011(37.82)	1 800(21.95)	583.30	< 0.001
饮酒	479(8.66)	523(19.57)	1 002(12.22)	199.63	< 0.001
糖尿病	746(13.49)	317(11.86)	1 063(12.96)	4.27	0.040
高血压	2 590(46.85)	1 378(51.55)	3 968(48.38)	15.94	< 0.001
高脂血症	1 533(27.73)	920(34.42)	2 453(29.91)	38.43	< 0.001
腰围[cm, (x±s)]	81.18±10.18	83.94±9.76	82.08±10.13	141.24	< 0.001
BMI [kg/m², (x±s)]	24.06±3.50	24.52±3.47	24.21±3.50	37.54	< 0.001
SBP [mmHg, (x±s)]	132.94±20.96	133.87±20.00	133.24±20.66	4.54	0.033
BDBP [mmHg,(x±s)]	76.93±11.10	80.19±11.01	77.99±11.18	158.56	< 0.001
血清肌酐[mmol/L,(x±s)]	68.13±17.20	81.39±29.51	72.45±22.84	986.73	< 0.001
HDL-C [mmol/L,(x±s)]	1.44±0.29	1.34±0.30	1.41±0.30	279.59	< 0.001
LDL-C [mmol/L, (x±s)]	2.75±0.86	2.69±0.84	2.73±0.85	6.20	0.013
TC [mmol/L,(x±s)]	4.89±0.97	4.81±0.93	4.87±0.96	8.09	0.004
FBG [mmol/L,(x±s)]	4.78±1.18	4.77±1.22	4.78±1.20	1.23	0.270

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表 2 研究人群MS及其组分的分布情况

Table 2. The distribution of MS and its components among respondents

项目	男性(n=3 367)	女性(n=4 834)	合计(n=8 201)	χ²值	P值
MS	674(20.02)	846(17.50)	1 520(18.53)	8.63	0.004
MS组分
中心性肥胖	1 116(33.15)	1 473(30.47)	2 589(31.57)	7.68	0.010
血压升高	2 236(66.41)	2 767(57.24)	5 003(61.00)	73.75	< 0.001
HDL-C降低	651(19.33)	1 122(23.21)	1 773(21.62)	17.09	< 0.001
TG升高	1 184(35.16)	1 242(25.69)	2 426(29.58)	81.15	< 0.001
FBG升高	624(18.53)	725(15.00)	1 349(16.45)	19.33	< 0.001
MS组分数目				120.78	< 0.001
0	646(19.19)	1 402(29.00)	2 048(24.97)
1	929(27.59)	1 245(25.76)	2 171(26.51)
2	886(26.31)	1 065(22.03)	1 951(23.79)
3	574(17.05)	662(13.69)	1 236(15.07)
4	272(8.08)	332(6.87)	604(7.36)
5	60(1.78)	128(2.65)	188(2.29)

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表 3 MS及其组分个数与HHcy发生的相关性分析

Table 3. Association analysis of MS and its components with HHcy

MS及其组分	HHcy (n=2 673)	单因素Logistic回归分析模型		多因素Logistic回归分析模型^a
MS及其组分	HHcy (n=2 673)	OR(95% CI)值	P值	OR(95% CI)值	P值
MS	538(20.13)	1.17(1.04~1.31)	0.010	1.16(1.02~1.33)	0.030
中心性肥胖	894(33.45)	1.14(1.03~1.25)	0.010	1.19(1.06~1.34)	0.002
血压升高	1 714(64.12)	1.22(1.11~1.34)	< 0.001	1.21(1.07~1.36)	0.002
HDL-C降低	601(22.48)	1.08(0.96~1.20)	0.180	1.16(1.02~1.31)	0.020
TG升高	953(35.65)	1.52(1.38~1.68)	< 0.001	1.22(1.09~1.37)	< 0.001
FBG升高	400(14.96)	0.85(0.75~0.96)	0.010	0.85(0.73~0.99)	0.030
MS组分个数
0	548(20.50)	1.00		1.00
1	745(27.87)	1.43(1.25~1.63)	< 0.001	1.35(1.16~1.57)	< 0.001
2	669(25.03)	1.43(1.25~1.64)	< 0.001	1.38(1.17~1.61)	< 0.001
3	425(15.90)	1.43(1.23~1.67)	< 0.001	1.29(1.08~1.54)	0.005
4	226(8.45)	1.64(1.35~1.98)	< 0.001	1.52(1.21~1.90)	< 0.001
5	60(2.24)	1.28(0.93~1.77)	0.130	1.64(1.13~2.38)	0.010
注：^a表示调整了性别、年龄、血清肌酐、吸烟和饮酒。

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项目	非HHcy(n=5 528)	HHcy(n=2 673)	合计(n=8 201)	t/χ²值	P值
男性	1 593(28.82)	1 774(66.37)	3 367(41.06)	1 049.82	< 0.001
年龄组(岁)				170.28	< 0.001
20~	286 (5.17)	141(5.27)	427(5.21)
30~	751(13.59)	297(11.11)	1 048(12.78)
40~	887(16.05)	414(15.49)	1 301(15.86)
50~	1 628(29.45)	1 144(42.80)	2 772(33.80)
60~	1 158(20.95)	358(13.39)
≥70	818(14.80)	319(11.93)	1 137(13.86)
MS	982(17.76)	538(20.13)	1 520(18.53)	6.66	0.011
吸烟	789 (14.27)	1 011(37.82)	1 800(21.95)	583.30	< 0.001
饮酒	479(8.66)	523(19.57)	1 002(12.22)	199.63	< 0.001
糖尿病	746(13.49)	317(11.86)	1 063(12.96)	4.27	0.040
高血压	2 590(46.85)	1 378(51.55)	3 968(48.38)	15.94	< 0.001
高脂血症	1 533(27.73)	920(34.42)	2 453(29.91)	38.43	< 0.001
腰围[cm, (x±s)]	81.18±10.18	83.94±9.76	82.08±10.13	141.24	< 0.001
BMI [kg/m², (x±s)]	24.06±3.50	24.52±3.47	24.21±3.50	37.54	< 0.001
SBP [mmHg, (x±s)]	132.94±20.96	133.87±20.00	133.24±20.66	4.54	0.033
BDBP [mmHg,(x±s)]	76.93±11.10	80.19±11.01	77.99±11.18	158.56	< 0.001
血清肌酐[mmol/L,(x±s)]	68.13±17.20	81.39±29.51	72.45±22.84	986.73	< 0.001
HDL-C [mmol/L,(x±s)]	1.44±0.29	1.34±0.30	1.41±0.30	279.59	< 0.001
LDL-C [mmol/L, (x±s)]	2.75±0.86	2.69±0.84	2.73±0.85	6.20	0.013
TC [mmol/L,(x±s)]	4.89±0.97	4.81±0.93	4.87±0.96	8.09	0.004
FBG [mmol/L,(x±s)]	4.78±1.18	4.77±1.22	4.78±1.20	1.23	0.270

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代谢综合征及其组分与高同型半胱氨酸血症的相关性

doi: 10.16462/j.cnki.zhjbkz.2020.09.003

通讯作者:
赵根明, E-mail:gmzhao@shmu.edu.cn

计量

Association between metabolic syndrome and its components with hyperhomocysteinemia in community population

Corresponding author: ZHAO Gen-ming, E-mail:gmzhao@shmu.edu.cn

计量

目录

留言板

代谢综合征及其组分与高同型半胱氨酸血症的相关性

doi: 10.16462/j.cnki.zhjbkz.2020.09.003

通讯作者: 赵根明, E-mail:gmzhao@shmu.edu.cn

计量

出版历程

Association between metabolic syndrome and its components with hyperhomocysteinemia in community population

Corresponding author: ZHAO Gen-ming, E-mail:gmzhao@shmu.edu.cn

计量

出版历程

目录

通讯作者:
赵根明, E-mail:gmzhao@shmu.edu.cn