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城市积极应对的非洲裔和高加索裔男性的代谢综合征指标及靶器官损害:南非城乡心脏代谢健康与衰老队列研究

Metabolic syndrome indicators and target organ damage in urban active coping African and Caucasian men: the SABPA study.

作者信息

de Kock A, Malan L, Potgieter J C, Steenekamp W, van der Merwe M T

机构信息

School for Psychosocial Behavioural Sciences, North-West University, Potchefstroom Campus, University of Pretoria, Potchefstroom 2520, Pretoria, South Africa.

出版信息

Exp Clin Endocrinol Diabetes. 2012 May;120(5):282-7. doi: 10.1055/s-0031-1295472. Epub 2012 Jan 9.

Abstract

Psychosocial stress relating to an urban environment or acculturation increases the prevalence of metabolic syndrome (MetS). The objectives of this study were firstly to indicate and compare differences regarding appraisal of stress or active coping responses in urban African (n=88) and Caucasian (n=101) male teachers of South Africa, in accord with the prevalence of MetS indicators. And secondly to investigate the extent to which utilisation of active coping responses, together with MetS indicators, predict target organ damage, in these men. The Coping Strategy Indicator determined high and low active coping responses in male teachers from the Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) study. SABPA inclusion and exclusion criteria were used. Additionally, diabetic medication users (n=8), and participants with renal impairment (n=2) or HIV positive (n=13), were excluded. MetS indicators included glucose, triglyceride, high-density lipoprotein cholesterol, blood pressure, and waist circumference, independent of confounders (age, physical activity, gamma glutamyl transferase). Microalbuminuria and carotid intima-media thickness indicated target organ damage. More MetS indicators exceeded the IDF cut-off points in high active coping African men (14.71%) than in their Caucasian counterparts (3.33%), as determined from χ² analyses. Furthermore, stepwise regressions indicated that more MetS indicators predicted endothelial dysfunction, especially in the high active coping African men. High active coping African men showed more manifestation of MetS, compared to their Caucasian counterparts, and revealed progress towards endothelial dysfunction.

摘要

与城市环境或文化适应相关的社会心理压力会增加代谢综合征(MetS)的患病率。本研究的目的,一是根据MetS指标的患病率,指出并比较南非城市非洲裔(n = 88)和高加索裔(n = 101)男性教师在压力评估或积极应对反应方面的差异;二是调查在这些男性中,积极应对反应的运用程度与MetS指标一起,对靶器官损伤的预测能力。应对策略指标确定了来自非洲人交感神经活动与动态血压(SABPA)研究中的男性教师的高、低积极应对反应。使用了SABPA的纳入和排除标准。此外,排除了糖尿病药物使用者(n = 8)以及有肾功能损害(n = 2)或HIV阳性(n = 13)的参与者。MetS指标包括血糖、甘油三酯、高密度脂蛋白胆固醇、血压和腰围,不受混杂因素(年龄、身体活动、γ-谷氨酰转移酶)影响。微量白蛋白尿和颈动脉内膜中层厚度表明靶器官损伤。根据χ²分析,高积极应对的非洲男性(14.71%)中超过国际糖尿病联盟(IDF)切点的MetS指标比高加索男性(3.33%)更多。此外,逐步回归表明,更多的MetS指标可预测内皮功能障碍,尤其是在高积极应对的非洲男性中。与高加索男性相比,高积极应对的非洲男性表现出更多的MetS症状,并显示出内皮功能障碍的进展。

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