Epidemiological Characteristics Of Metabolic Syndrome And The Effect Of Comprehensive Intervention In Tianjin

Purpose1.An epidemiological cross-sectional study was implemented in Tianjin,to explore the prevalence of metabolic syndrome(MS)and the influencing factors of MS.2.To explore the effect and feasibility of comprehensive interventions,including reasonable diet,physical exercise,stop smoking and alcohol limit,for patients with metabolic syndrome(MS).Method1.A total of 10080 objects lived in Tianjin were recruited by using the random cluster sampling method.The measurement datas included height,weight,waist circumference,hip circumference and blood pressure.Homocysteine(Hcy),fasting blood glucose(FPG),total cholesterol(TC),three glycerol ester(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)and fasting insulin(FINS)were measured.Demographic data,medical history information,family history and life habits information were collected by useing the Standard questionnaire.The prevalence of MS and its components were explored and the influencing factors were analysed according to the diagnostic standard of metabolic syndrome setted by International Diabetes Federation(IDF)in April 2005.2.1152 MS patients lived in Tianjin were diagnosed according to the International Diabetes Federation criteria,and were randomly divided into control group and intervention group by communities.Interventions were performed for 12 months,all patients receiving the relevant healthy courses once every 2 months.The intervention group patients received additional comprehensive interventions,including reasonable diet,physical exercise,stop smoking and alcohol limit,self-management method is applied to develop individualized intervention programs for each patients and conducted an individual guidance once a month.Medical examination and biochemical markers were detected before the intervention began,6 months and 12 months after the intervention respectively.Questionnaire investigations on MS related knowledge were implemented before and after the interventions.Results1.The prevalence and age-standardized prevalence of metabolic syndrome about research objects were 33.6% and 30.4%.The prevalence of central obesity,hypertension,hypertriglyceridaemia,low HDL-C and high FPG/diabetes were 48.4%,46.2%,24.3%,0.5%,30.5% respectively,and the age-standardized prevalence were46.0%,40.9%,23.2%,0.47%,26.0% respectively.Multivariate logistic stepwise regression analysis showed that the independent risk factors of MS included age(OR=1.046),low education level(compared with the “middle school and lower”,the OR for “high school/technical secondary school”,“college”,“undergraduate”,“postgraduates and higer” were 5.985,3.370,3.031,2.819 respectively),divorce or widowed(OR=1.446),snoring(OR= 3.187),smoking(OR=1.537)and family history of hypertension(OR=1.374).Protective factors included women(OR=0.704),physical exercise(OR=0.864),vegetables and fruits consumption(OR=0.746)and married(OR=0.110).2.The awareness rate of MS related knowledge was increased for both group patients,but the intervention group were higher significantly than the control group.Body mass index(BMI),waist circumference(WC),systolic blood pressure(SBP),diastolic blood pressure(DBP),triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),fasting plasma glucose(FPG)levels were declined,while high-density lipoprotein cholesterol(HDL-C)levels were increased for both two groups of patients,but changes in the intervention group were bigger than the control group,the difference was statistically significant.More patients in the intervention group reduced the components of metabolic syndrome and fewer patients increased the components than that in the control group.Conclusion1.The high prevalence of low educated people with MS,to reduce the prevalence rate of culture to raise the level of MS;in addition to HDL-C,the metabolic syndrome and its components in the prevalence increases with age,age 60 to 79 years to reach the peak,but decreased after 80 years;between 18 and 79 years old,male MS the prevalence is higher than female.Age,low education level,divorced or widowed,snoring,smoking,family history of hypertension is an independent risk factor for MS,physical exercise,eating vegetables or fruits,women,married is a protective factor.2.Comprehensive interventions,including reasonable diet,physical exercise,stop smoking and alcohol limit,was effective for MS patients.It can decrease patients' BMI and WC levels,and improve patients' blood pressure,blood lipid andblood sugar markers significantly.