Prevalence and risk factors of metabolic syndrome among pre-menopausal and post-menopausal women of Uygur in Tianshan District of Urumqi
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摘要:
目的 了解乌鲁木齐市天山区维吾尔族女性围绝经期、绝经后期代谢综合征(MS)现况，分析其危险因素。 方法 2017年5月在乌鲁木齐市天山区进行横断面调查，采用整群随机抽样方法，对其中4个社区进行问卷调查、体格检查及实验室检查。 结果 40岁以上维吾尔族女性共计822例，年龄为(50.44±9.16)岁，围绝经期439例，绝经后期383例。40岁以上维吾尔族妇女MS患病率为32.8%，围绝经期为19.1%，绝经后期为48.6%，绝经前后患病率差异有统计学意义(P＜0.01)。中心性肥胖、血压、血糖、TG、高密度脂蛋白胆固醇(HDL-C)异常患病率分别为76.6%、40.3%、31.1%、32.7%、7.8%，随着年龄增长腰围异常、血压异常、血糖异常、TG异常、MS均显著增加，差异有统计学意义(均P＜0.05)，不同年龄段HDL-C异常差异无统计学意义(P>0.05)。MS相关影响因素的logistic回归分析结果显示：绝经与MS显著相关(OR=4.972，95% CI：2.607~9.482，P＜0.001)，MS其他危险因素有高BMI、糖尿病家族史、重体力活动、吸烟、打鼾。 结论 乌鲁木齐市天山区维吾尔族绝经后期女性MS患病率较高，随着年龄增长呈显著上升趋势，应加强围绝经期及绝经后期女性教育，及早采取预防和干预措施，合理饮食、控制体重，降低绝经后期MS及心血管疾病的发生风险，提高生活质量。 Abstract:Objective To investigate the prevalence of metabolic syndrome (MS) among pre-menopausal and post-menopausal women of Uygur in Tianshan District of Urumqi and analyze the risk factors. Methods A cross-sectional survey was carried out in Tianshan District, Urumqi City in May 2017. A cluster random sampling method was used to conduct a questionnaire survey, physical examination and laboratory examination in four communities. Results The number of observation cases of this study was 822. The mean age of the subjects was (50.44±9.16) years old, 439 cases of pre-menopausal, 383 cases of post-menopause. The prevalence of MS in women over 40 years old was 32.8%, 19.1% in perimenopause and 48.6% in post-menopause. The prevalence difference in pre-menopausal and post-menopausal women was statistically significant (P < 0.01). The prevalence of central obesity, blood pressure, blood glucose, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) were 76.6%, 40.3%, 31.1%, 32.7% and 7.8%, respectively. Abnormal waist circumference, abnormal blood pressure, abnormal blood glucose, abnormal TG and MS levels were significantly increased with increasing age, with a statistically significant difference (all P < 0.05). There was no significant difference in HDL-C abnormalities among different age groups (P>0.05). The logistic regression analysis of relative risk factors for MS showed that the MS was associated with menopause significantly (OR=4.972, 95% CI: 2.607-9.482, P < 0.001), and the other risk factors for MS were high BMI, family history of diabetes, heavy physical activity, smoking, and snoring. Conclusion Post-menopausal women are at high-risk of MS, significant upward trend with age. We should strengthen the education of perimenopausal and postmenopausal women, take early prevention and intervention measures, reasonably diet, control weight, reduce the risk of postmenopausal MS and cardiovascular disease, and improve quality of life. -
Key words:
- Uygur /
- Menopausal /
- Metabolic syndrome /
- Prevalence /
- Risk factors
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表 1 围绝经期与绝经后期女性一般情况比较(x±s)
Table 1. Comparison of general situation between perimenopausal and postmenopausal women(x ±s)
组别 例数 年龄(岁) 腰围(cm) BMI 收缩压(mm Hg) 舒张压(mm Hg) 心率(次/min) FPG(mmol/L) 围绝经期 439 43.45±3.29 89.74±10.27 26.87±4.38 117.59±15.50 75.88±10.36 81.80±11.45 5.53±1.96 绝经后期 383 58.47±6.91 97.17±10.84 28.73±4.50 131.08±20.53 80.97±12.18 79.68±11.24 6.41±2.77 t值 38.852 9.980 5.923 10.361 6.327 2.633 5.150 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 0.009 ＜0.001 组别 例数 2hPG(mmol/L) HbA1C(%) TG(mmol/L) TC(mmol/L) LDL-C(mmol/L) HDL-C(mmol/L) 尿酸(μmol/L) 围绝经期 439 6.15±2.71 5.51±1.12 1.46±1.09 4.50±0.87 2.63±0.68 1.38±0.29 274.94±98.84 绝经后期 383 7.33±3.14 6.18±1.63 1.82±1.35 4.95±1.01 2.98±0.79 1.42±0.30 304.16±88.00 t值 5.183 6.721 4.232 6.876 6.672 1.438 4.454 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 0.153 ＜0.001 
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表 2 不同年龄段女性WC、血压、血糖、TG、HDL-C异常及MS的患病情况[例(%)]
Table 2. Abnormal WC, blood pressure, blood glucose, TG, HDL-C and MS prevalence in women of different ages[cases (%)]
年龄(岁) 人数 WC异常 血压异常 血糖异常 TG异常 HDL-C异常 MS 40~44 278 175(62.9) 54(19.4) 44(15.8) 62(22.3) 24(8.6) 44(15.8) 45~49 179 138(77.1) 55(30.7) 40(22.3) 48(26.8) 12(6.7) 40(22.3) 50~54 119 89(74.8) 58(48.7) 43(36.1) 48(40.3) 5(4.2) 44(37.0) 55~59 83 74(89.2) 45(54.2) 34(41.0) 37(44.6) 9(10.8) 39(47.0) 60~64 78 72(92.3) 57(73.1) 42(53.8) 28(35.9) 7(9.0) 46(59.0) 65~69 59 56(94.9) 40(67.8) 34(57.6) 33(55.9) 4(6.8) 37(62.7) ≥70 26 26(100.0) 22(82.6) 19(73.1) 13(50.0) 3(11.5) 20(76.9) χ2值 58.952 43.315 61.846 31.251 7.217 32.675 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 0.301 0.004
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表 3 围绝经期与绝经后期妇女WC、血压、血糖、TG、HDL-C异常患病情况[例(%)]
Table 3. Abnormal prevalence of WC, blood pressure, blood glucose, TG and HDL-C in perimenopausal and postmenopausal women[cases (%)]
组别 人数 WC异常 血压异常 血糖异常 TG异常 HDL-C异常 MS 围绝经期 439 298(68.2) 109(24.8) 81(18.5) 106(24.1) 36(8.2) 84(19.1) 绝经后期 383 332(89.7) 222(58.0) 175(45.7) 163(42.6) 28(7.3) 186(48.6) χ2值 41.825 37.007 46.518 27.588 1.261 31.627 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 0.261 ＜0.001
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表 4 40岁以上女性患MS的危险因素分析变量赋值表
Table 4. Risk factor analysis variable assignment table for MS in women over 40 years old
变量 赋值方法 是否绝经 是=1，否=0 BMI ＜24=1，≥24=2，≥28=3 糖尿病家族史 是=1，否=0 体力活动 轻=1，中=2，重=3 家庭年收入 ＜5万=1，5万~10万=2，>10万=3 文化程度 小学及以下=1，初中=2，高中及以上=3 是否吸烟 是=1，否=0 是否喝酒 是=1，否=0 是否打鼾 是=1，否=0 规律运动 是=1，否=0 运动强度 低强度=1，中强度=2，高强度=3
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表 5 40岁以上女性患MS影响因素的logistic回归分析
Table 5. Logistic regression analysis of the influencing factors of MS in women over 40 years old
变量 B SE Ward χ2 P值 OR(95% CI) 绝经 1.604 0.329 23.706 ＜0.001 4.972(2.607~9.482) BMI 超重 0.839 0.533 2.477 0.115 2.313(0.814~6.571) 肥胖 2.094 0.509 16.957 ＜0.001 8.119(2.996~21.998) 家族史 0.942 0.360 6.846 0.009 2.566(1.267~5.197) 体力活动 中 1.213 0.465 6.116 0.008 3.362(1.366~7.870) 重 0.960 0.468 4.208 0.040 2.613(1.044~6.540) 家庭年收入 5万~10万 0.275 0.419 0.431 0.512 0.760(0.334~1.726) ﹥10万 0.300 0.710 0.178 0.673 1.350(0.336~5.425) 文化程度 初中 0.729 0.449 2.487 0.115 2.031(0.842~4.900) 高中及以上 0.153 0.428 0.128 0.720 1.166(0.504~2.696) 饮酒 0.624 0.424 2.160 0.142 1.866(0.812~4.287) 吸烟 0.702 0.291 5.830 0.016 2.018(1.141~3.567) 打鼾 0.799 0.160 24.816 ＜0.001 2.222(1.623~3.042) 规律运动 0.618 0.452 1.868 0.172 0.539(0.222~1.308) 运动强度 中 0.729 0.712 0.990 0.320 2.032(0.503~8.209) 高 0.756 1.178 0.411 0.521 0.470(0.047~4.728)
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[1] ZHAO D, LIU J, WANG M, et al. Epidemiology of cardiovascular disease in China: current features and implications[J]. Nat Rev Cardiol, 2019, 16(4): 203-212. doi: 10.1038/s41569-018-0119-4 [2] 黄志英, 丁岩. 乌鲁木齐市维吾尔族围绝经期女性代谢综合征的激素水平研究[J]. 中华全科医学, 2020, 18(3): 352-354, 399. doi: 10.16766/j.cnki.issn.1674-4152.001244HUANG Z Y, DING Y. Study on hormone levels of metabolic syndrome in perimenopausal Uigur women in Urumqi City[J]. Chinese Journal of General Practice, 2020, 18(3): 352-354, 399. doi: 10.16766/j.cnki.issn.1674-4152.001244 [3] 孙敏英, 利耀辉, 梁会营, 等. 广州市绝经后女性代谢综合征流行状况及其危险因素分析[J]. 广东医学, 2017, 38(21): 3347-3349. https://www.cnki.com.cn/Article/CJFDTOTAL-GAYX201721031.htmSUN M Y, LI Y H, LIANG H Y, et al. Prevalence and risk factors of metabolic syndrome in postmenopausal women in Guangzhou[J]. Guangdong Medical Journal, 2017, 38(21): 3347-3349. https://www.cnki.com.cn/Article/CJFDTOTAL-GAYX201721031.htm [4] 王家威, 樊琼玲, 罗园园, 等. 新疆牧区哈萨克族牧民代谢综合征患病率及影响因素研究[J]. 中国全科医学, 2020, 23(15): 1950-1955. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202015037.htmWANG J W, FAN Q L, LUO Y Y, et al. Prevalence and Influencing Factors of Metabolic Syndrome among Kazakh Herdsmen in Xinjiang Pastoral Area[J]. Chinese General Practice, 2020, 23(15): 1950-1955. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202015037.htm [5] 田露, 刘斌. 身体活动与运动对代谢综合征的影响与作用[J]. 中国组织工程研究, 2020, 24(2): 296-302. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF202002026.htmTIAN L, LIU B. Effects of physical activity and exercise on metabolic syndrome[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(2): 296-302. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF202002026.htm [6] 诸骏仁, 高润霖, 赵水平, 等. 中国成人血脂异常防治指南(2016年修订版)[J]. 中华全科医师杂志, 2017, 16(1): 15-35. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXH201610002.htmCHU J R, GAO R L, ZHAO S P, et al. Guidelines for Prevention and Treatment of dyslipidemia in Adults in China (Revised Edition 2016)[J]. Chinese Circulation Journal, 2017, 16(1): 15-35. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXH201610002.htm [7] SANTILLI F, D' ARDES D, GUAGNANO M T. Metabolic syndrome: sex-related cardiovascular risk and therapeutic approach[J]. Curr Med Chem, 2017, 24(24): 2602-2627. [8] HALLAJZADEH J, KHORAMDAD M, IZADI N, et al. Metabolic syndrome and its components in premenopausal and postmenopausal women: a comprehensive systematic review and meta-analysis on observational studies[J]. Menopause, 2018, 25(10): 1155-1164. [9] MARCHI R, DELL C, LOPES T, et al. Prevalence of metabolic syndrome in pre-and postmenopausal women[J]. Arch Endocrinol Metab, 2017, 61(2): 160-166. [10] 董莹, 王馨, 张林峰, 等. 新疆地区≥35岁人群代谢综合征患病率情况调查[J]. 中华疾病控制杂志, 2017, 21(7): 684-687, 692. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201707009.htmDONG Y, WANG X, ZHANG L F, et al. The current status of metabolic syndrome among adults aged 35 years and above in Xinjiang[J]. Chinese Journal of Disease Control & Prevention, 2017, 21(7): 684-687, 692. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201707009.htm [11] MUMUSOGLU S, YILDIZ B O. Metabolic Syndrome During Menopause[J]. Curr Vasc Pharmacol, 2019, 17(6): 595-603. [12] KO S H, KIM H S. Menopause-associated lipid metabolic disorders and foods beneficial for postmenopausal women[J]. Nutrients, 2020, 12(1): 202. [13] 盛祝梅, 黄坚, 李婧, 等. 杭州地区围绝经期及绝经后女性代谢综合征的调查研究[J]. 浙江医学, 2016, 38(7): 451-454, 464. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJYE201607002.htmSHENG Z M, HUANG J, LI J, et al. Prevalence of metabolic syndrome in Hangzhou perimenopausal and postmenopausal women[J]. Zhejiang Medical Journal, 2016, 38(7): 451-454, 464. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJYE201607002.htm [14] 唐敏. 围绝经期妇女性激素六项对血脂四项水平的影响和意义[J]. 当代医学, 2021, 27(22): 40-42. https://www.cnki.com.cn/Article/CJFDTOTAL-DDYI202122016.htmTANG M. The influence and significance of six sexual hormones on four levels of blood lipids in perimenopausal women[J]. Contemporary Medicine, 2021, 27(22): 40-42. https://www.cnki.com.cn/Article/CJFDTOTAL-DDYI202122016.htm [15] MOGAREKAR M R, KULKARNI S K. Small dense low density lipoprotein cholesterol, paraoxonase 1 and lipid profile in postmenopausal women: quality or quantity?[J]. Arch Med Res, 2015, 46(7): 534-538. [16] ROSALES C, GILLARD B K, XU B, et al. Revisiting reverse cholesterol transport in the context of high-density lipoprotein free cholesterol bioavailability[J]. Methodist Debakey Cardiovasc J, 2019, 15(1): 47-54. [17] 黄志英, 丁岩. 围绝经期女性代谢综合征的相关研究进展[J]. 国际妇产科学杂志, 2020, 47(1): 84-87. https://www.cnki.com.cn/Article/CJFDTOTAL-GWVC202001021.htmHUANG Z Y, DING Y. Advances in Research on Metabolic Syndrome in Perimenopausal Women[J]. Journal of International Obstetrics and Gynecology, 2020, 47(1): 84-87. https://www.cnki.com.cn/Article/CJFDTOTAL-GWVC202001021.htm [18] 洪忻, 李解权, 王志勇, 等. 糖尿病家族史和肥胖对高血糖发病的联合作用[J]. 中华疾病控制杂志, 2017, 21(11): 1102-1105, 1110. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201711006.htmHONG X, LI J Q, WANG Z Y, et al. The combined effect of obesity and family history of diabetes on the incidence of hyperglycemia[J]. Chinese Journal of Disease Control & Prevention, 2017, 21(11): 1102-1105, 1110. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201711006.htm [19] 申倩, 祝楠波, 余灿清, 等. 中国成年人吸烟与心血管疾病发病风险的关联及其性别差异分析[J]. 中华流行病学杂志, 2018, 39(1): 8-15.SHEN Q, ZHU N B, YU C Q, et al. Sex-specific associations between tobacco smoking and risk of cardiovascular diseases in Chinese adults[J]. Chinese Journal of Epidemiology, 2018, 39(1): 8-15. [20] LI M, LI X, LU Y. Obstructive sleep apnea syndrome and metabolic diseases[J]. Endocrinology, 2018, 159(7): 2670-2675. [21] 魏嘉洁, 矫杰, 周迎生, 等. 阻塞性睡眠呼吸暂停低通气综合征与代谢综合征的相关性研究[J]. 心肺血管病杂志, 2019, 38(8): 838-842. https://www.cnki.com.cn/Article/CJFDTOTAL-XFXZ201908007.htmWEI J J, JIAO J, ZHOU Y S, et al. Association between obstructive sleep apnea hypopnea syndrome and metabolic syndrome[J]. Journal of Cardiovascular and Pulmonary Diseases, 2019, 38(8): 838-842. https://www.cnki.com.cn/Article/CJFDTOTAL-XFXZ201908007.htm -
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