Characteristic Of Risk Factor And Its Comprehensive Intervention In Metabolic Syndrome

Metabolic syndrome (MS) is that the cluster of risk factors, such as type 2 diabetes mellitus, impaired glucose tolerance, hypertension, dyslipidemia and central obesity. MS was definited by WHO in 1999. Epidemiological studies have shown that the prevalence of MS and its cardiovascular complications were incredibly increasing in the past decades. Prevalence and pathogenesis of MS was related to regions, races, social economic status and environmental factors. Chongqing locates in Southwest of China, with lower rate of city population and lower level of social economy. But its traditional diets are very unique compared with other cities. To control MS well in Chongqing area, this study aims to study the characteristics of risk factors of MS and provide a strategy for MS treatment. Subjects and Methods 1. Subjects 759 objects were enrolled in this study.,which include 529 patients and 230 control. Subjects were divided into four groups: essential hypertension group (EH, 144), diabetes mellitus group (DM, 167), metabolic syndrome group (MS, 218) and control group (230). All of subjects finished the questionnaire of risk factors. The MS definition was suggested by a working group consulted by the WHO in 1999 (glucose intolerance or insulin resistance or diabetes together with 2 or more the following risk factors: blood pressure( BP)≥140/90 mmHg; fasting triglycerides (TG)>1.7, and/or HDL cholesterol(HDL-C) < 0.9 mmol/L; central body obesity and/or BMI ≥25; microalbuminuria). Total 529 patients with type 2 diabetes mellitus, essential hypertension, and hypertensive diabetes were evaluated using MS criteria in this study. The EH definition was suggested by the WHO/ISH in 1999,exception the secondary affection hypertension. Type 2 diabetes mellitus was diagnosed by America Diabetes Association in 1997. 2. Methods All patients were collected venous blood to assay fasting glucose ,fasting insulin, fasting triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), creatinine (Cr),uric acid (UA) and free fatty acid(FFA). Urinary albumin excretion (UAE) were detected. Part patients were tested Oral Glucose Tolerant Test (OGTT). All patients were tested body high, weight and waist. Caculating body mass index (BMI), high waist-to-hip ratio (WHR). Results 1. There are discrepancies in sex between male and female in MS, female is more than male when compared with NT (P=0.035). Furthermore, the patients with MS have higher profession and education (P<0.05), but lower work intensity when compared with NT (P=0.032). There are discrepancies in passively smoking, gain weight, family history of hypertension and diabetes between MS and EH group (P<0.05). 2. There are significantly different in carbohydrate intake in MS, EH and DM groups compare with control group (P value are 0.002,0.023,0.042, respectively). When comparing with control group, vegetables and milk intake were significantly decreased and nut intake was significantly increased in MS group. 3. There are significantly different in smoking; dietary taste and gain weigh between MS and DM group. When compared with control group, vegetables intake were significantly decreased in MS group (P=0.001). 4. When compared with control group, exercise capacities were markedly reduced, but meat intake and payroll incomes are higher in EH, DM and MS group (P<0.05), however, there are no significantly difference among EH, DM and MS groups (P>0.05). 5. When compared with control group, higher work stress in MS, EH and DM groups (P<0.05). There are discrepancies in anxious and testiness character in MS group, EH group compare with control group (P<0.001). There is no significantly between DM group and control group (P>0.05). 6. The study has shown that incidence of MS is increasing in which middle income families than lower income families (P<0.01). There is significantly higher income in MS, EH and DM group compared with control group (P<0.001). OR value is 18.53, 15.85, 13.51, respectively. 7. Waist circumference is an independent risk factor of MS. Higher BMI and higher WHR can increase risk of MS. The study has shown that WHR>1 of the patients with MS can increase risk of MS (P<0.001), When BMI>30 kg/m2 can enhance risk of EH, DM andMS (P<0.05). Conclusions 1. There are differences in the risk factor and genetic background among hypertension, diabetes mellitus and metabolic syndrome. Central obesity, low labor intensity, higher economic income, smoking, character agitation, short of exercise, high salt intake, high carbohydrate intake, high fat intake, and family history of hypertension and diabetes mellitus were associated with the metabolic syndrome in Chongqing population. It indicates that bad life style, economic status and genetic background were closely related to MS. 2. MS subjects in Chongqing area have both risk factors of developed and developing countries. 3. Gender difference in prevalence of MS was found in our survey population.