Study On The Metabolic Abnormality And Cardiovascular Disease Incidence And Mortality In Elderly Male

China had entered the aging society,the health care concerns of elderly persons had become the most urgent task of medical workers.A survey was carried out among elderly male subjects aged 60 and over who took health examination regularly in our hospital.The objectives of our study were as followed:1.to understand the decade mortality and the cause of death in this population of Beijing.2.to survey the epidemic state of MS in the elderly male population and study the relationship of MS and cardiovascular disease(CVD), and also to investigate the association between the cluster of MS components and CVD mortality.3.to provide evidences of the establishment of IFG diagnostic criteria.Our study showed that in the male senile population,the total mortality of this population was 14.7 per 1000 person-year.Malignant tumor,cardiocerebrovascular disease and respiratory system disease were the main causes of death.The first cause of death was cardio-cerebrovascular disease in the patients with diabetes or hypertension.The 25.0kg/m~2≤BMI＜28.0kg/m~2 group had increased cardio-cerebrovascular disease mortality compared with the 18.5kg/m~2≤BMI＜25.0 kg/m~2 group after age and past history were adjusted,and that was no difference compared with the population whose BMI≥28.0 kg/m~2.The prevalence of MS in the population was 25.54%.In MS group the prevalences of diabetes,hypertension and CVD were significantly higher than those of non-MS population.After adjustment for age the relative risk(RR)of CVD in MS population was 1.559(95%CI 1.220-1.992).Among the components of MS hyperglycemia,hypertension and obesity were associated with the risk of CVD.During the follow-up period,there were 191 subjects had new onset cardiovascular events.The subjects who had new onset CVD were older,had higher levels of FPG and SBP,lower level of HDL-C than the control ones, furthermore there were much more MS in this group.The MS population had higher incidence of new onset cardiovascular diseases than the control group (42.6%vs 29.2%,P＜0.05).After adjustment for age,the RR of new onset CVD was 1.670(95%CI 1.091-2.588)in MS population.The logistic multiple regression analysis showed that hyperglycemia,hypertension and low HDL-C level were associated with the risk of new onset CVD.Compared with the non-MS group,the RR of CVD mortality in MS group was 1.101 after adjustment of age.After adjustment of other clinical factors,the RR was 3.154 compared with the non-MS group.The following two clusters of MS components posed the highest risk for CVD mortality:the elevated glucose and BP and dyslipidemia group and four components coexisted group.After adjustment of age and other clinical factors,the cardiovascular mortality of 5.6mmol/L≤FPG＜6.1 mmol/L group was significantly elevated then that of FPG＜5.6mmol/L group.The RR was 2.337(95%CI 1.007-5.608).So the conclusions of our study were as followed:1.In elderly male population,accompany with the age the various kind of mortalities were increased.Malignant tumor,cardio- cerebrovascular disease and respiratory system disease were the main causes of death.In the population of diabetes,hypertension or obesity,the risks of cardio-cerebrovascular disease were all increased.The risk of cardio-cerebrovascular disease mortality elevated when BMI≥25.0kg/m~2 in elderly male.2.In elderly male population the prevalence of MS was high.The risk of CVD and new onset cardiovascular events were both increased in the MS patients than in the non-MS population.Among these components of MS,hyperglycemia and hypertension were likely the most important with the risk of CVD.3.MS was strongly correlated with the CVD mortality.The population with MS had higher CVD mortality rate and risk.The cluster of components was associated with the increased risk of mortality.In the MS population,there was different mortality of cardiovascular disease among various clusters of components.So it was important to carry out the risk assessment individually.4.IFG group had increased metabolic factors and more abnormal metabolic conditions than normal FPG population.The CVD mortality of IFG group was also elevated and this phenomenon took place even when FPG was more than 5.6mmol/L.So the lower threshold of IFG should be revised from 6.1mmo/L to 5.6 mmo/L in the male senile population according to our study.