The Prevalence And Risk Factors Of Metabolic Syndrome In Heathy Women With Different Age

Objective: The metabolic syndrome (MS) identifies a cluster of risk factors associated with the cardiovascular disease (CVD) , including abdominal obesity, high blood pressure, impaired glucose metabolism and dyslipidemia. High prevalence of MS in healthy populations had been observed in many epidemic surveys. As an increasing common disorder,MS affects about 25% population in western countries,and the prevalence of MS increased with age .Men were at a higher risk for MS than women, and the trend changed markedly with age. MS patients had higher risk for CVD, stroke and diabetes mellitus(DM) . The MS-associated CVD prevalence in the population aged>50 years was 2-times that of the control. A greater risk of CVD was found to be associated with MS in women than in men.Men with MS caused a 1.57-fold risk for stroke comparing with the common population,and women with MS caused a 2.81-fold risk,which suggested that women with MS caused a higher risk for stroke than men. Based on above-mentioned , this study intended to analyze the prevalence and risk factors of MS in female healthy population and estimate the estrogen's role on the prevalence of metabolic syndrome of post-menopause women.Methods: 1.1760 healthy individuals attended an annual health check-up from January 2008 to December 2008 at Third hospital of Hebei medical university . 16 subjects were excluded due to organ transplantation(including bone marrow transplantation), long-term immunosuppressive agents administration or HIV infection,bone marrow hematopoietic dysfunction or recent upper respiratory tract infection,gastrointestinal tract infection or chronic wasting disease,taking antibiotics or antiviral drugs in two weeks,and the subjects with incomplete data were excluded too. Finally, An overall of 1744 individuals were enrolled in the study, their age ranged from 20 to 88years with a mean of 47.74±12.89 years.Among of them, 1035 individuals were men (59.35%), with a mean age of 48.27±13.612 years ; 709 were women (40.65%) with a mean age of 47.37±12.368 years (P>0.05).2.All participants underwent a physical examination and filled questionnaire forms. Overnight fasting blood specimens were taken for measure of biochemical and haematological parameters.which including fast blood glucose,serum lipids level and HCMV IgG,et al.Otherwise,height,weight,waist circumfere- nce, body waist index(BMI) and blood pressure of the subjects were measured . Socio-demographic characteristic data including gender,age, unhealthy habit such as smoking,etc, past history consist of coronary heart disease,stroke,diabetes mellitus, hypertension,hyperlipoidemia,et al,medication history and family history of cardiovascular related diseases, were investigated. BMI=weight/height2(kg/m2).3. Diagnostic criteria:MS was estimated according to the modified National Cholesterol Education Program Expert Panel Adult Treatment Panel III (NCEP ATP III) criteria.4.Research methods:1) All subjects were dividied into youth,middle-aged,and aged group according to the classified standard of 20～44years, 45～64years,≥65years. The prevalence and risk factors of MS were analysized between both genders of different age groups.2) In order to show the trend of the prevalence of MS with age clearly, the subjects were classifised into six different age groups, increasing with a range of 10 years as follows: 20~29years,30~39years,40~49years,50~59years,60~69years,≥70 years. We can draw a curve of the prevalence of MS depending on different morbilities of MS in both genders of different age groups. Further to study the role of estrogen on the prevalence of MS.5.Statistical analysis:The data were analyzed using statistical programme for social sciences (SPSS) version 13.0. The measurement data was described by mean±standard deviation, comparison among groups were calculated through independent Student t test, variance analysis ,or non-parameter rank sum test. Numeration data was described by positive example and rate, then performed chi-square test.Multiple logistic regression analysis was perform- ed to investigate the association of risk fators with MS.The results were expressed as adjusted odds ratios with 95% confidence interval. Statistical significance was defined as P<0.05.Result:1.The prevalence of MS in total population:1744 individuals were enrolled, including 1035 male and 709 female. The prevalence of MS was 25.75%(449/1744), among of them, 30.92%(320/1035)in men and 18.19%(129/709) in women(χ2 = 35.630,P=0.000).2.The prevalence and risk factors of MS in different age groups:The prevalence of MS in youth,middle-aged and aged group were12.74%,32.69%,47.03% respectively; there was a tendency of rising with aging.The differences between each group were obvious(χ2youth vs middle=86.234,χ2youth vs aged= 129.541,χ2middle vs aged= 15.883;all P-values =0.000).Adjusted smoking,drinking,body waist index(BMI)etc, the results showed that hyperglycemia was always an independent risk factor of MS in 3 groups. The ORs of hyperglycemia for mortality of MS were 1.950(95%CI=1.299~ 2.928),1.661(95%CI=1.268~2.177),2.047(95%CI =1.320~3.176) respectively,all P-values≤0.001.And high density lipoprotein- cholesterol(HDL-C) was a protective factor for MS in all subjects,with ORs=0.001(95%CI=0.000~0.016),0.001(95%CI= 0.000~0.005),0.017(95%CI=0.003~0.104)respectively,all P-values≤0.001.3. The trend of the prevalence of MS of different genders in different age-groups.There were significant differences bettween the prevalence of MS in men and in women of the same age groups.The prevalence of MS in women of youth and middle-aged groups was 2.55%,22.78% respectively, which were lower than men in the same age groups(19.65%,38.89%;χ2=49.249,127.365;all P-values=0.000).The prevalence of MS in women of aged group was 50.00%,showing no difference comparing with aged men(44.26%,χ2=0.779;P=0.378).Multiple logistic regression analysis showed that gender was an independent risk factor for MS in the youth and middle-aged population (ORyouth=22.346,95%CI=4.392～113.697,ORmiddle=23.475,95%CI=8.874～62.102;all P values= 0.000).But gender had no influence on the aged group.The prevalence of MS in men and women of the same age groups from 20~29years to≥70 years in order were 6.67%vs0.00%(χ2=7.254,P=0.007),14.35%vs1.25%(χ2=12.180 ,P=0.000),34.22%vs6.40%(χ2=24.500,P=0.000),41.45% vs24.84%(χ2=5.789,P=0.016),40.19%vs43.82%(χ2=0.382,P=0.567),41.54%vs54.41%(χ2=2.885,P=0.089)respectively. The prevalence of MS was lower in women than men until after age 60 years.And the prevalence of MS in women increased remarkably after 40 years,although showing a cross over beyond the age group of 60–69 years, becoming higher in women.There were remarkable differences in the prevalence of MS between men and women of the same age-groups, and the prevalence of MS in women increased remarkably after menopause. It demonstrated that the reduced estrogen levels after menopause might be an independent risk factor of MS in middle-aged and aged women. Estrogen may have a protective effect on MS in youth women. We should pay attention to the fact that post-menopause women .were at a high risk for MS. Therapeutic approaches should be taken into consideration for the prevention and treatment of MS in postmenopausal women.Conclusion:1 The study population showed a high prevalence of MS.in a large professional population.And the prevalence of MS increased with aging in both male and female population.2 There were obvious differences in the prevalence of MS bettween different genders of the same age-groups.The results showed that gender was an independent risk factor for MS in youth and middle-aged population.The prevalence of MS was lower in women than in men of youth and middle-aged, also showing a crossover after menopause, even over men after 60 years. The results demonstrated that reduced estrogen after menopause might be an important factor resulting in MS of women.3 Hyperglycemia and low HDL-C level were independent risk factors for MS in all ages.