| With the improvement of living standards and lifestyle changes, Metabolic syndrome (MS) characterized by central obesity, hypertension, glucose and lipid abnormalities and other metabolic diseases merger occurs has become a serious threat to human health common and frequently occurring, has attracted worldwide attention of the medical profession, the elderly are at high risk of MS.With the deepening research on MS, it has been found MS is high correlation with diabetes and cardiovascular diseases. An increasing number of clinical studies confirmed, cardiovascular disease and diabetes are closely related, both of which can be derived from a mixed a variety of abnormal metabolic parameters. Can say, MS patients are reserved for cardiovascular and cerebrovascular disease and diabetes, so the early recognition and focus on the prevention of these populations will effectively improve public health. For the identification of MS, a plurality of academic organizations have put forward their work definitions.In practical work, should use what kind of work definition, for a fixed group, what is the difference among the analysis result of different definitions, further research is needed in this area. MS is the interaction of genetic and environmental factors, and its pathogenesis is not clear. MS accompanied by many abnormal metabolic parameters, find a component changes related indicators, will be conducive to the early discovery and intervention of the high risk of MS.This study is to investigate the epidemic status of MS in elderly in Shangcheng District and Jianggan District, Hangzhou. The elderly in physical examination were analyzed by work definitions of International Diabetes Federation (IDF), World Health Organization (WHO) and Chinese Diabetes Society (CDS) respectively. Make use of case-control study to investigate contents of serum free fatty acids (FFA) with MS and to analyze its correlation with the components of MS, in order to provide basic information for timely detection and intervention of clinical MS high-risk patients. The study consists of two parts:Part I:Prevalences of MS in Elderly in Hangzhou with Different Work Definitions of MSObjective:Analysis of prevalence of MS in elderly in Hangzhou with different work definitions of MS. Methods:2242 individuals between the ages of 60-95(mean age 73), had health examination in Third People’s Hospital of Hangzhou and in Hangzhou Jianggan District, Caihe Street Health Center, were surveyed with MS work definitions of IDF, WHO and CDS. Analysis of different gender, different age groups various metabolic parameters and prevalence of MS. Distinction among three work definitions was analyzed. Results:Prevalences (Total/Male/Female) of MS were:22.35%/24.13%/19.49%(IDF),26.14%/28.04%/23.09 (WHO), and 25.65%/27.32%/22.97 (CDS). Age (years) groups (60-65/66-70/71-75/76-80/^81), the prevalence of MS were 20.03%/21.16%/22.91%/24.23%24.02%(IDF), 23.24%/25.78%/26.85%/27.51%/28.07%(WHO), 22.90%/25.12%/26.30%/27.07%/27.74%(CDS). The consistency of three MS work definitions was 72.39%. The consistency between CDS and WHO definitions was the best and Kappa value was 0.88. Conclusions:The prevalence of MS in males than females. Proportion of abnormal metabolic indices increased with ageing. Elderly were liability to MS. The consistency of IDF, WHO and CDS work definitions was good, but also the need more research for the obesity indicators and cut-off point of components.Part II:Analysis of correlation among MS, abnormal metabolic indices and serum free fatty acidsObjective To investigate contents of serum FFA in old patients with MS and to analyze its correlation with the components of MS. Methods Among 2242 old people undergoing physical examination,184 patients with MS and 156 healthy subjects were selected as MS group and control group. The blood pressure, height, weight, waist circumference, and hip circumference were measured. Levels of fasting blood glucose (FBG), triglycerides (TG), high density lipoprotein cholesterol (HDL-C) and serum FFA were measured. Waist-hip ratio (WHR) and body mass index (BMI) were calculated. Analysis of Serum FFA relations with MS and MS each component number and type of complications in different gender. Results The levels of waist circumference (95.59±6.51cm), WHR (0.92±0.07), BMI (26.15±2.50kg/m2), FBG (6.11±1.17mmol/L), TG (1.98±0.88mmol/L) and serum FFA(254.57±87.06μmol/L) in MS group were significantly higher than waist circumference(83.85±6.03cm), WHR(0.85±0.05), BMI(22.84±2.51 kg/m2), FBG (5.42±0.73mmol/L),TG (1.22±0.54mmol/L) and serum FFA (146.11±45.11μmol/L) in control group. The levels of HDL-C were lower in MS group (P< 0.05). Serum FFA level in different gender(Total/Male/Female) was positively correlated with WHR(r=0.208/0.219/0.195), BMI(r=0.306/0.324/0.281), FBG (r=0.214/0.211/0.219) and TG (r=0.325/0.342/0.303) (P<0.01). BMI and TG influenced the level of serum FFA independently. The levels of serum FFA were significantly higher when MS accompanied with glucose disorder and hyperlipemia (P<0.05). According to the number of comorbidities, MS groups was divided into MS-2 group/MS-3 group/MS-4 group, FFA levels (μmol/L) followed by three groups were 246.30±55.67/255.87±59.74/271.85±154.25 (Male),240.78 ±54.81/246.88±60.16/259.80±149.02 (Female),244.50±57.07/252.94 ±62.23/267.92±160.54 (Total). The rise in serum FFA among three groups, But the difference was not statistically significant (P>0.05). The serum FFA levels of MS combined with abnormal glucose metabolism/MS combined hyperlipidemia were 272.14±81.62/271.35±64.12 (Male),266.35±76.43/262.16±59.87 (Female), 270.02±83.68/268.65±67.32 (Total), were significantly higher than MS without abnormal glucose metabolism/MS without hyperlipidemia (Male: 231.69±50.92/236.74±43.26, Female:228.72±52.42/229.53±42.37, Total: 230.75±52.69/234.87±49.66)(P<0.05). Conclusion The levels of serum FFA are associated with many components of MS, and high levels of serum FFA is one of biochemical indexes of MS. |
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