| [Background]Metabolic syndrome (MS) is an aggregation of some cardiovascular risk factors. It main includes components, including impaired glucose tolerance (diabetes, impaired fasting glucose), lipid metabolism disorders, hypertension, obesity or central obesity, microalbuminuria and other metabolic disorders. Obesity, especially central obesity is closely related with MS and insulin resistance (IR). The metabolic syndrome has been accepted in the16th World Diabetes Congress in1997, and all countries in the world have carried out a series of studies to understand MS. The adult MS diagnostic criteria enacted in2004in China, and divided into five types, i.e., type I (abnormal glucose metabolism+hypertension and dyslipidcmia), type2(overweight or obesity+hypertension+dyslipidemia). type3(overweight or obesity+abnormal glucose metabolism+dyslipidemia). type4(overweight or obesity+abnormal glucose metabolism, hypertension) and type5(overweight or obesity+abnormal glucose metabolism+hypertension+dyslipidemia).Obesity and a range of related diseases such as diabetes, hypertension, hyperlipidemia are increasing in recent years with an economic growth, changing lifestyles and the population aging process accelerated. MS has become one of the hotspots in the world. Epidemiological studies show that MS as risk factors is associated with the increasing cardiovascular morbidity and mortality, especially in men. Many studies have shown that the incidence of coronary heart disease and stroke risk increased by2times in the patients with MS, accounting for18.0%and4.6%in the cause of death. Currently, MS is a complex metabolic disorder syndrome. It is the risk factors that can lead to diabetes and cardiovascular disease, and its occurrence and development is connected with a variety of factors of obesity, age, genetics, diet, bad behavior, proinflammatory state.Shandong Province is in a period of rapid economic growth, the living environment and lifestyle of the residents has undergone great changes. Differences between inland areas and coastal areas have been small. With the economic development, the MS comprehensive prevention and intervention is imperative because that the MS prevalence will continue to increase. Therefore, we research the epidemiological characteristics of MS among18to69-year-old residents of urban and rural area in the middle south areas of Shangdong as well as the related risk factors of MS to provide guiding significance for the prevention and control of MS in our province.[Objectives]The major purpose of this study as follow:1. With the way of cross-sectional study, to know the epidemic situation of MS among18to69year-old residents in the middle south areas of Shandong province through multi-stage stratified sample survey.2. To explore the risk factors of DM in Shandong province by multivariate analysis.3. To provide scientific data for the development of MS prevention plan and evaluation of the effects of interventions of middle south areas of Shandong province.[Methods]The data in this study were collected from Shandong province chronic diseases and their risk factors monitoring database in2010. This study was a cross-section epidemiological study. The survey included the questionnaire, physical examination and laboratory testing. Fasting venous blood was collected from all of the subjects and the detection indicators include glucose, lipids and so on. Blood glucose was measured at the local laboratory, which had identified by the national standard qualification. Blood lipid results were determinated by the central laboratory of Shandong center for disease control and prevention.All data were analyzed as follow:(1) to describe the prevalence of18to69-year-old resident in the middle south areas of Shandong by sub-urban and rural areas, age group, gender, and other demographic factors;(2) to describe different demographic characteristics, history of chronic diseases, chronic family history, central obesity and other relevant factors of MS;(3) to describe each component of MS;(4) to describe the risk factors of MS using univariate and multiple survey logistic regression analysis.[Results]1General state of subjectsThe survey planned to investigate3000people, and finally got samples for2897people, and the completion rate is96.57%. The average age was45.70years old (SD=12.63). The male subjects were1308,45.15%of the whole subjects, and the average age was45.62years old (SD=13.33). The female subjects were1589,54.85%of the whole subjects, and the average age was45.76years old (SD=12.04). City residents were1093. accounting for37.73%. with an average age of44.87±11.18years. Rural residents were1804. accounting for62.27%. with an average age of46.20±13.42years.2Epidemiology characteristic of MSThe rough prevalence rates of MS of18to69-year-old resident in the middle south of Shandong was17.67%, which the male prevalence rate of17.97%, and17.43%for women. There was not statistically significant between the two groups (P>0.05).There was a statistically significant difference among different age groups on the prevalence of MS. The65to69age group was the highest, about25.75%, and the18-year-old age group was the minimum, about3.52%.The prevalence of MS in city was18.21%and17.35%in rural areas. The difference between the two groups was not statistically significant (P>0.05). There was a statistically significant difference among different occupations, education, marital status on the prevalence of MS (P<0.001).The prevalence of MS of the people who were center obese was much higher than the people who were not non-central obesity, and the difference was statistically significant (P<0.0001).The MS prevalence of the people who have history of chronic diseases was39.49%, higher than those without a history of chronic diseases, and the difference had statistically significant (P<0.0001).The difference on the MS prevalence was not statistically significant in the people who have different smoking, physical activity, but the MS prevalence with different level of drinking crowd was statistically significant (P<0.05), the people with maximum dringking has the highest MS prevalence, about25.93%.3The prevalence of the components of MSThe ratio of typel,2,3,4, and5respectively was8.98%,40.63%,11.72%,15.23%and23.44%. The highest prevalence of the components of MS was hypertension (41.66%), followed by the overweight or obese (41.59%), hyperglycemia is the lowest (20.71%).4Univariate analysesThe difference on the MS prevalence was statistically significant in the people who have different occupation, education level and marital status (P<0.05), but the MS prevalence wih different gender, urban and rural, and income was not statistically significant (P>0.05).Compared with other factors, the difference on the MS prevalence was statistically significant in the people who have central obesity, insulin residents, history of chronic diseases, family history of chrinic diseases, drinking level (.P<0.05), but the MS prevalence with different smoking and physical activity levels was not statistically significant (P>0.05).5Multivariate analysesThe surveylogistic regression showed that, the main risk factors of MS included age, occupation, education level, marital status, central obesity, insulin resitance, history of chronic diseases, family history of the chronic diseases, and drinking level.[Conclusions]1. The MS prevalence of aged18to69-year-old resident in the middle south areas of Shandong is high. The MS prevalence is different in the different age groups, especially in the people over the age of45.2. The MS prevalence is different in different occupations, education level, marital status, waist circumference, history of chronic diseases, family history of chronic disease and drinking crowd of MS prevalence differences. The prevalence of MS was higher in those who are the clerical staff, illiterate, married people, central obesity, a history of chronic diseases, has a family history of chronic disease or drinking population.3. The risk factors of MS include age, occupation, education level, marital status, central obesity, insulin resistance, history of chronic diseases, family history of chronic diseases, and drinking level.4. The highest prevalence of the components of MS is hypertension, followed by the overweight or obesity, the lowest is high blood glucose.[Suggestions]1. To further strengthen epidemiological investigations and studies of MS, particularly on molecular level.2. According to MS risk factors, combined with the existing research results. trying to carry out targeted interventions, strengthen the preventive health education of MS, to improve the awareness of MS in residents and self-protection awareness. At the same time, to strengthen the prevention and treatment of MS research to explore the simple and effective prevention and control of MS.3. Base on the research findings above, to develop particular plan of the projects of prevention and control of MS in Shandong Province. The plan should include prevention and specific interventions. |
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