Otsuka Toshiaki, Kawada Tomoyuki, Yanai Miyuki, Kitagawa Yuko, Kan Hirohiko
Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan.
Sangyo Eiseigaku Zasshi. 2011;53(3):78-86. doi: 10.1539/sangyoeisei.b10013. Epub 2011 Mar 1.
The prevention of metabolic syndrome (MetS) is one of the main targets of health promotion activities in the workplace. The present study aimed to clarify the incidence of MetS and associated lifestyle factors in a worksite male population.
The study subjects consisted of 948 working men (mean age: 44 yr old) who did not meet the Japanese criteria for MetS during the annual health examination at a precision instrument development plant in Kanagawa, Japan, 2005. New-onset MetS was followed using the health examination data from 2006 to 2009. The incidence of MetS according to the combination of the presence of abdominal obesity and the number of other components of MetS (elevated blood pressure, dyslipidemia, and elevated fasting glucose) at baseline were calculated. The incidence of MetS was also compared among the groups with regard to differences in lifestyles (dietary habits, smoking status, sleep duration, exercise habits, and alcohol intake). A Cox proportional hazard model was used to identify independent factors contributing to an increased risk of MetS.
New-onset MetS was observed in 76 subjects during a mean follow-up period of 3.7 yr. The incidence of MetS was 2.2/100 person-years and the 4-year incidence of MetS according to Kaplan-Meier analysis was 8.5%. The highest 4-year incidence of MetS was found in the group without abdominal obesity but with two or more components of MetS (37.9%) and the second highest incidence was found in the group with abdominal obesity and one other component of MetS (24.6%). The presence of abdominal obesity and each increase in the number of other components of MetS had an increased age-adjusted hazard ratio for an increased risk of MetS (5.23 and 4.79, respectively, both p<0.001). Similarly, sleep duration 5 h or less, current smoking, and ethanol intake 300 g/wk or more had an increased age-adjusted hazard ratio for an increased risk of MetS.
The present study showed a high incidence of MetS in not only the group with abdominal obesity, but also the group without abdominal obesity but with two or more components of MetS. Sleep deprivation, current smoking, and excess alcohol intake were found to be factors contributing to an increased risk of MetS among several lifestyle factors examined. The usefulness of health promotion activities that preferentially target subjects who have such medical conditions and/or lifestyles are therefore expected to reduce the incidence of MetS in the workplace, from a high-risk strategy viewpoint.
预防代谢综合征（MetS）是职场健康促进活动的主要目标之一。本研究旨在明确某工作场所男性人群中代谢综合征的发病率及相关生活方式因素。
研究对象为2005年在日本神奈川县一家精密仪器开发工厂年度健康检查中不符合日本代谢综合征标准的948名在职男性（平均年龄：44岁）。利用2006年至2009年的健康检查数据追踪新发代谢综合征情况。根据基线时腹型肥胖的存在情况以及代谢综合征其他组分（血压升高、血脂异常和空腹血糖升高）的数量组合计算代谢综合征的发病率。还比较了不同生活方式（饮食习惯、吸烟状况、睡眠时间、运动习惯和酒精摄入量）组间代谢综合征的发病率。采用Cox比例风险模型确定导致代谢综合征风险增加的独立因素。
在平均3.7年的随访期内，76名受试者出现新发代谢综合征。代谢综合征的发病率为2.2/100人年，根据Kaplan-Meier分析，4年代谢综合征发病率为8.5%。代谢综合征4年发病率最高的是无腹型肥胖但有两个或更多代谢综合征组分的组（37.9%），其次是有腹型肥胖且有一个其他代谢综合征组分的组（24.6%）。腹型肥胖的存在以及代谢综合征其他组分数量的每增加一个，年龄调整后的代谢综合征风险增加的风险比均升高（分别为5.23和4.79，均p<0.001）。同样，睡眠时间5小时或更短、当前吸烟以及每周乙醇摄入量300克或更多，年龄调整后的代谢综合征风险增加的风险比也升高。
本研究表明，不仅腹型肥胖组，无腹型肥胖但有两个或更多代谢综合征组分的组中代谢综合征发病率也很高。在所检查的几种生活方式因素中，睡眠不足、当前吸烟和过量饮酒被发现是导致代谢综合征风险增加的因素。因此，从高危策略的角度来看，优先针对有此类疾病状况和/或生活方式的受试者开展健康促进活动有望降低职场中代谢综合征的发病率。
