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目的探讨代谢综合征(MS)的临床始动因子。方法以MS患病率较高的德州市机关在职男性作为研究对象进行普查,对被调查人员的MS危险因子:腰围粗(≥90cm)、血压升高(收缩压≥130mmHg或舒张压≥85mmHg)、高血糖(空腹血糖浓度≥5.6mmol/L)、高甘油三酯(≥1.7mmol/L)、高密度脂蛋白胆固醇(HDL-C)水平降低(<1.03mmol/L)进行调查分析;将所有被调查人员分为肥胖组(腰围≥90cm,n=370)和非肥胖组(腰围<90cm,n=228),分析比较两组随年龄增长MS的患病率和MS危险因子的发病特点;选择136名MS患者并随机分为单纯饮食控制组(A组,n=45)、单纯运动组(B组,n=45)和饮食控制+运动组(C组,n=46)干预3个月,根据各组MS危险因子、葡萄糖耐量和胰岛素敏感指数(HOMA-IR)的改善情况,分析和比较A、B、C三组的干预效果;将干预效果较好的C组分为C1组(干预后腰围减少≥7cm,n=21)和C2组(干预后腰围减少<7cm,n=25),比较C1和C2两组干预前后MS危险因子、葡萄糖耐量和HOMA-IR的特点。结果德州市机关男性在职人员MS总患病率为41.3%,MS随年龄增长患病率升高;腰围增粗患病率达62%,并且与高血压和高甘油三酯呈正相关;肥胖组在任何年龄段高血压、高血糖、高甘油三酯等MS危险因子的患病率均明显高于非肥胖组(P<0.05);C组干预后,腰围、血压、甘油三酯脂、HOMA-IR指数及葡萄糖耐量等指标均明显改善(P<0.05);C1组较C2组年龄轻(43±10.6vs48±9.7,P<0.05),干预后血压、甘油三酯,HOMA-IR指数及糖耐量较C2组明显改善(P<0.05)。结论腰围增粗是MS的临床始动因子;控制腰围、饮食加运动可以有效地防治MS,且早期干预受益更大。
Objective To investigate the clinical initiating factors of metabolic syndrome (MS). Methods The male MSDs in Dezhou were enrolled in this study. The MS risk factors were as follows: waist circumference (≥90cm), elevated blood pressure (systolic blood pressure ≥130mmHg or diastolic blood pressure ≥85mmHg) , Hyperglycemia (fasting blood glucose≥5.6mmol / L), high triglyceride (≥1.7mmol / L) and high density lipoprotein cholesterol (HDL-C) were reduced (<1.03mmol / L) All subjects were divided into obesity group (waist circumference ≥90cm, n = 370) and non-obese group (waist circumference <90cm, n = 228). The prevalence of MS and risk factors of MS were compared between the two groups ; 136 patients with MS were selected and randomly assigned to a single diet control group (group A, n = 45), exercise alone group B (n = 45) and diet control + exercise group (group C, n = 46) Month, according to the improvement of MS risk factors, glucose tolerance and insulin sensitivity index (HOMA-IR) in each group, the intervention effects of A, B and C groups were analyzed and compared; the C group with better intervention was C1 Group C (waist circumference reduction ≥7cm, n = 21 after intervention) and Group C2 (waist circumference reduction <7cm, n = 25 after intervention). The risk factors of MS, glucose tolerance and HOMA- IR features. Results The MS prevalence rate of male MS staff in Dezhou was 41.3%. The prevalence of MS increased with age. The prevalence of waist-thickening was 62% and positively correlated with hypertension and triglyceride. The obesity group The prevalence of MS risk factors such as hypertension, hyperglycemia and high triglyceride were significantly higher in all age groups than those in non-obese group (P <0.05). After intervention in C group, waist circumference, blood pressure, triglyceride, HOMA -IR index and glucose tolerance index (P <0.05). Compared with C2 group, C1 group was younger (43 ± 10.6 vs 48 ± 9.7, P <0.05). After intervention, blood pressure, triglyceride, HOMA- Impaired glucose tolerance than C2 group significantly improved (P <0.05). Conclusion Waist circumference thickening is the clinical initiation factor of MS. Controlling waist circumference, diet and exercise can effectively prevent and treat MS, and early intervention may benefit more.