| Objective: To understand the prevalence and distribution characteristics of Metabolic Syndrome (MS) among Mongolian population in rural and animal husbandry Area, Tongliao city, Inner Mongolia; to explore risk factors of MS and association of MS with inflammatory and endothelial biomarkers; to analyze the association between MS, inflammatory and endothelial biomarkers and cardio-cerebrovascular events to provide a basis for prevention and control for MS and cardio-cerebrovascular disease .Study Methods: A cross sectional study was carried out during 2002-2003. 32 villages of Kezuohou and Naiman banners (counties) were selected as study fields, and all Mongolian people aged 20 or more were served as subjects. Demographic data and lifestyle factors were investigated, anthropometric parameters and blood pressure were measured and blood sample was collected for all subjects. Fasting plasma glucose (FPG) ,blood lipids, CRP,ICAM-1,E-selectin, insulin, plasma rennin activity (PRA), angiotensin II (Ang II) were examined for all subjects. In 2008 and 2009, a follow-up study was conducted for all subjects to collect the data about incidence of cardio-cerebrovascular diseases.Statistics analysis: Prevalence and distribution characteristics of MS was described among Mongolian population, and levels of risk factors were compared between subjects with MS and without MS. Association of MS with risk factors was analyzed with Logistic regression, and odds ratios (OR) and 95% confident interval (95%CI) were calculated. Levels of CRP,ICAM-1 and E-selectin were grouped according to quartiles, respectively, ORs and 95% CIs of MS associated with CRP,ICAM-1 and E-selectin were calculated using Logistic regression, and trends of OR with level of the biomarkers were analyzed with linear regression model. Accumulative incidence and incidence density for cardio-cerebrovascular diseases were calculated for the Mongolian population; Association of MS, biomarkers including CRP,ICAM-1 and E-selectin with cardio-cerebrovascular diseases were analyzed with Cox regression model, OR and 95%CI were calculated. All analyses were conducted with SAS 9.01 and SPSS 15.0.Results:1. Prevalence of MS was 20.9% among the Mongolian people, and 12.8% for males and 26.6% for females.2. Un-multivariate adjusted results showed that age, gender, family history of hypertension, Apo-b, high Ins, abnormal PRA, high CRP, high ICAM-1, high E-selectin were all associated with MS (all P<0.05). Multivariate adjusted results showed that age, gender, high CRP, high Ins and abnormal PRA were associated with MS, OR(95%CI) of MS associated with age, gender, high CRP, high Ins and abnormal PRA were 1.21 (1.07, 1.38),2.39(1.68, 3.42),2.76(2.08, 3.66),1.38(1.04, 1.84) and 1.35(1.04, 1.75),respectively, all P<0.05.3. Levels of CRP, E-selectin and ICAM-1 were all higher in MS group than that in non-MS group, all P<0.05. Compared with lowest CRP, the ORs(95%CIs) of MS associated with higher CRP (3 and 4 quartiles ) were 1.64 (1.00, 2.44) and 4.36 (2.97, 6.42), respectively, there was a dose–response relationship between CRP and MS. Compared with lowest ICAM-1 , the ORs (95%CIs) of MS associated with higher ICAM-1 levels ( 2, 3 and 4 quartiles ) were 1.45 (1.00, 2.10), 1.57(1.09, 2.26) and 1.72 (1.19,2.48) , respectively, there was also a dose–response relationship between ICAM-1 levels and MS.4. Cumulative incidence (CI) and incidence density (ID) of cardio-cerebrovascular disease was 3.01% and 476.9 /100, 000 (person-years), respectively; CI and ID of Ischemic stroke was 1.58% and 250.8/100, 000 (person-years), respectively; CI and ID of hemorrhagic stroke was 1.35%, and 213.4 /100, 000 (person-years), respectively; CI and ID of coronary heart disease was 1.31%, and 207.9 /100, 000 (person-years), respectively.5. Multivariate adjusted results showed that RR (95 % CI ) of cardio- cerebrovascular events was 1.34 (0.86, 2.08) among the Mongolian population; RR (95 %CI) of Ischemic stroke was 2.44(1.21, 4.90)among the Mongolian population, P<0.05.Conclusions:1. There was higher prevalence for MS and higher incidence of cardio-cerebrovascular diseases among the Mongolian population in rural and animal husbandry area, MS and cardio-cerebrovascular diseases have been important public health issue in local area.2. Elevated CRP and ICAM-1 increase the risk of MS; those findings suggest that inflammation and endothelium dysfunction could play important role in development of MS.3. MS was an important risk factor of cardio-cerebrovascular diseases, especially ischemic stroke among Mongolian population. |
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