Epidemiological Study Of Metabolic Syndrome Cases In Chong Qing Population Health Survey

Objective :Metabolic syndrome(Met S) is a series of physiological and metabolic disorders induced by insulin resistance, ultimately leading to increased risk of cardiovascular and cerebrovascular diseases. Our purpose is to understand the epidemic situation, individual characteristics and serological features of Met S through large-scale, population-based epidemiological study, and to uncover the association between serum liver enzymes and Metabolic syndrome risk.to meet the urgent needs of Sensitive detection of Met S.Method:First, we obtain health survey data from Chong Qing Southwest hospital between March 2011 ——July 2014, 56,653 participants were included, according to the diagnostic criteria for metabolic NCEP-ATPIII and WHO diagnostic criteria for obesity syndrome. The prevalence of Metabolic syndrome and obesity at baseline were analyzed. Describe the epidemic situation, individual characteristics and serological features of Met S through comparative analysis. Second, a case-control study with 6,268 Met S subjects and 6,330 frequency-matched healthy controls was conducted to systematically evaluated levels of four liver enzymes(ALT, AST, GGT and ALP), both in overall populations and in subjects with normal liver enzymes, with Met S risk using both quartiles and continuous unit of liver enzymes.Results :1. 56,653 participants were included in Chong Qing Southwest hospital between March 2011 ——July 2014. Age-standardized prevalence of metabolic syndrome was 13.7% in thispopulation, Met S risk in female(n=1491) was less than risk in men(n=5750)(6.4% vs 17.3%,OR value 0.311,95% CI 0.288 ~ 0.336). Obesity(n=2823), age above 45 years or older(n=3290) population had a higher detection rate with Met S(37.6% & 20.0%,P<0.05).2. There are significant differences in terms of age, education level, smoking and drinking habit and physical activity between Met S patients and healthy controls(P<0.001). Aging, low education level, smoking and drinking habit, less participate in sports seems likely to be risk factors for Met S.3. Significant trends were found for increasing unit of ALT, AST, GGT and ALP(per 5 unit). Successively, ALT(OR:1.41,95%CI:1.38-1.43)、AST(OR:1.33,95%CI:1.29-1.36)、GGT(OR:1.27,95%CI:1.25-1.29)、ALP(OR:1.09,95%CI:1.08-1.10). The ORs was bigger in males for ALT and AST, while the ORs was bigger in females for GGT and ALP.4. Case-control studies have shown elevated liver enzymes lead to significant higher Met S risk, with ORs ranging from 1.15 to 18.15. The highest effected was detected for GGT, for which the OR value for the highest versus lowest quartile was 18.15(95% CI: 15.7-20.9).5. In mutually adjusted models which include all of the four liver enzymes in the logistic regression model, they all remained significantly associated with Met S risk, which means the independence of their relations.6. The robustness of these findings was evaluated by sensitivity analyses. None materially changed the trend, and none of the risk estimates changed by more than 5% when included. We restrict the liver enzymes to levels of within-normal-limits. The significant trend kept and the risk estimates became stronger7. There is an association between elevated liver enzyme levels and fasting glucose, uric acid levels, blood pressure, Tch, TG and other metabolic risk factors.Conclusion :The prevalence of Met S is relatively high in this study population. Health behavior intervention should be strengthen in male, age above 45 years, low education level population. Elevated serum transaminase is an independent risk marker of early development of chronic metabolic diseases, it can be used as a clinical biomarker to predict metabolic syndrome, which will improve early diagnosis and treatment efficiency.