| In the 20-30s of the 20th century, Marnon (1922) and Himsworth (1936) firstly described the symptoms of MetS. In 1997, Zimmer et al advocated the nomenclature of these symptoms as metabolic syndromes and was considered in the 16th International Daibetes Federation. However, as it is a complicated entity that comprised of several diseases, large amount of clinical and epidemic work should be done to reveal the hypothesis 'metabolic syndrome exists common causes'. As the know ledge on metabolic syndrome is so far limited, different prospective and retrospective scientific research on different fields is urgently needed. It also provides theoretical clues and directions for this dissertation.Research hypothesis: Metabolic syndrome is associated with obesity, gout, stroke, and arterial atherosclerosis. We select several cross sections that related to the characteristics and mechanism of metabolic syndrome and analyzed possible relationship so as to provide adequate proof and experience for prevention and treatment of metabolic syndrome.Research objective: In the first part, with the aim to investigate whether there existed the prethrombotic state in patients with MetS, we measured the index of prethrombotic state compared with those in control group and make further basic research to explain the possible relationship between MetS and the morbidity of correlated cardio and cerebral events. In the second part, with the aim to investigate the living and behavioral factors in elder Shanghai citizens with MetS and analyze the effect of these characteristics on MetS and its subgroups so as to make timely primary and secondary prevention.Research methods: In the first part of the study, 174 in-patients of Tongji Hospotal was selected with complete clinical data. Fasting blood samples were taken in the next morning after entry at 6:30 am. According to the latest diagnostic criterion of MetS advocated by IDF, we divided the participants into two groups: MetS group and control group. PAI-1 and vWF were investigated analyzed with statistically. In the second part of the study, we took complete data from 836 cases aged from 35 to 97 years old (410 male and 426 female) and inquired about details with self-designed questionnaire. We evaluated the effect of various factors on MetS after grouping.Results: In the first study, a large number of 176 cases had abnormal waistline and 82 of them met the diagnosis criterion of MetS with the morbidity of 46.6%, which is higher than that in social community. In the comparison of baseline data, the waistline of MetS is 85.68±5.48cm, greater than that in control group 77.87±4.86cm. In the serum index investigation, the TG level of MetS 2.4707±2.16280 is higher than that in control group. PAI-1 of MetS group 100.951±36.458 ng/ml is greater than that in control group 44.485±16.392ng/ml. In the analysis of linear regression, we took PAI-1 as dependent variable, the results indicated that blood glucose, LDL-c and uric acid were all inductive factors in increasing PAI-1 level, and in the analysis of vWF, only blood glucose was in inductive factor in increasing the vWF level. As in the analysis of MetS patients with questionnaire of living and behavioral characteristics, we found that waist line (97.69±10.22cm) of MetS group were greater than of control group. TC level and HDL-C level had no significant difference among 2 groups. LDL-C and lgTG level of MetS group (2.54±0.99mmol/L, 0.26±0.23) were significantly higher than those in control group. In the risk factors compared with control group, significant difference existed in smoking, history of drinking, moderate physical exercises, and dietary habit of MetS group. In the comparison of dietary habit, fatty food, frying and pickling food intake were greater than those in control group but lower in fresh vegetable and fruit.Conclusions:(1) In the cohorts complied with the latest criterion of MetS, PAI-1 level 100.951±36.458 ng/ml is much higher than the control group. It imply most of them had combined abnormality of blood coagulation system, fibrolytic system and endothelial cell function, which is in the process called prethrombotic state. MetS patients usually combined with several cardio and cerebral diseases, and the prethrombotic state may be the possible target for secondary prevention of cardio and cerebral events. (2) MetS patients of Shanghai urban citizens have the characteristics of smoking and drinking addiction, fatty and frying dietary habit, insufficient amount of fresh vegetable and fruit and physical exercise. It is important for MetS people to change dietary habit in the process of therapeutic lifestyle change. The recommended recipe is more than three meals a day with low calories, low fat and low glucose food together with more than 300g fresh vegetable and fruit. Frying and pickling food is not acceptable. It is conducive to implement therapeutic lifestyle change supported with moderate clinical therapy to person who has the tendency of obesity with the aim to prevent MetS and its cardio and cerebral complications.
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