Tanchoco Celeste C, Cruz Arsenia J, Duante Charmaine A, Litonjua Augusto D
Food and Nutrition Research Institute, Department of Science and Technology, Gen. Santos Ave, Bicutan, Taguig, Metro Manila, Philippines.
Asia Pac J Clin Nutr. 2003;12(3):271-6.
This study sought to determine the prevalence of metabolic syndrome, using data collected from 4,541 adults aged 20 years and over covered in the Fifth National Nutrition Survey conducted in 1998. The metabolic variables analyzed were: total cholesterol, LDL-c, HDL-c, triglycerides and fasting blood glucose. In addition, measurements of obesity such as body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (WC) as well as blood pressure were taken. Comparing the mean metabolic characteristics of the non-obese, total obese and the android obese, results showed significant differences in almost all the variables except for the HDL-c. By gender, non-significant differences were observed between males and females in the non-obese group in terms of the BMI and glucose levels and in the android group, in terms of total cholesterol. In all three groups, the biggest difference was observed in the mean triglycerides, where males had significantly higher mean than the females. Comparing adults with >125 mg/dl fasting blood sugar (FBS) there were higher rates of hypertension, high waist-to-hip ratio (WHR), high cholesterol, high triglycerides, high LDL-c, low HDL-c, among the overweight and obese than among those with normal BMI. In general, the proportion of subjects with co-morbid factors increased with higher levels of FBS, except for high cholesterol wherein no pattern was established. The highest prevalence of high FBS was found in both males (35.8%) and females (14.5%) with the following combined characteristics: high BMI, high WHR and high WC. Males with co-existing high BMI, high WHR, and high WC were observed to have the highest prevalence rate of hypertension (66.5%). Among females, the highest prevalence rate of hypertension (37.9%) was seen among those with high fasting blood sugar. The proportion of subjects with hypertension generally increased with age irrespective of the BMI status. One of the significant correlates of high FBS is waist-hip ratio. Males with WHR of equal or greater than 1 have almost six times the risk of having high FBS, while females with WHR of equal or greater than 0.85 have five times the risk of having high FBS compared to those with normal WHR. Among females with triglyceride levels of equal or greater than 200 mg/dL, the risk of having high FBS is five times compared to those with triglyceride levels below 200 mg/dL. Univariate analysis to see the effect of the type of obesity to dyslipidaemia and hypertension revealed that females with high waist circumference generally provided greater risk compared to those who were overweight and obese as well as those with android obesity. For males, high waist circumference had greater risk of developing high triglyceride and high LDL-c. Android obese males had greater risk to high FBS. The results showed that the prevalence rate of metabolic syndrome is 0.28%, based on the number of individuals with the following characteristics: high FBS, hypertensive, android obese, with body mass index (BMI) of > or =25.0 and high WC. Females had a higher rate than males - almost twice. Considering that metabolic syndrome, with its co-morbidity factors is prevalent among some Filipino adults aged 20 years and over, it is recommended that health programs geared towards minimizing the morbid risk factors be properly developed, promoted and fully implemented.
本研究旨在利用1998年第五次全国营养调查收集的4541名20岁及以上成年人的数据,确定代谢综合征的患病率。分析的代谢变量包括:总胆固醇、低密度脂蛋白胆固醇(LDL-c)、高密度脂蛋白胆固醇(HDL-c)、甘油三酯和空腹血糖。此外,还测量了肥胖指标,如体重指数(BMI)、腰臀比(WHR)和腰围(WC)以及血压。比较非肥胖者、总体肥胖者和腹型肥胖者的平均代谢特征,结果显示除HDL-c外,几乎所有变量均存在显著差异。按性别划分,在非肥胖组中,男性和女性在BMI和血糖水平方面无显著差异;在腹型肥胖组中,男性和女性在总胆固醇方面无显著差异。在所有三组中,甘油三酯均值差异最大,男性的甘油三酯均值显著高于女性。比较空腹血糖(FBS)>125 mg/dl的成年人,超重和肥胖者中高血压、高腰臀比(WHR)、高胆固醇、高甘油三酯、高LDL-c、低HDL-c的发生率高于BMI正常者。总体而言,除高胆固醇未呈现出规律外,合并症因素的受试者比例随FBS水平升高而增加。FBS患病率最高的是男性(35.8%)和女性(14.5%),其具有以下综合特征:高BMI、高WHR和高WC。同时存在高BMI、高WHR和高WC的男性高血压患病率最高(66.5%)。在女性中,空腹血糖高者高血压患病率最高(37.9%)。无论BMI状况如何,高血压受试者比例一般随年龄增长而增加。高FBS的一个显著相关因素是腰臀比。腰臀比等于或大于1的男性患高FBS的风险几乎是腰臀比正常者的六倍,而腰臀比等于或大于0.85的女性患高FBS的风险是腰臀比正常者的五倍。甘油三酯水平等于或大于200 mg/dL的女性患高FBS的风险是甘油三酯水平低于200 mg/dL者的五倍。单因素分析肥胖类型对血脂异常和高血压的影响显示,腰围高的女性相比超重、肥胖以及腹型肥胖女性,通常风险更大。对于男性,腰围高患高甘油三酯和高LDL-c的风险更大。腹型肥胖男性患高FBS的风险更大。结果显示,基于具有以下特征的个体数量,代谢综合征患病率为0.28%:高FBS、高血压、腹型肥胖、体重指数(BMI)≥25.0且腰围高。女性患病率高于男性——几乎是男性的两倍。鉴于代谢综合征及其合并症因素在一些20岁及以上的菲律宾成年人中普遍存在,建议制定、推广并全面实施旨在降低发病风险因素的健康计划。