School of Public Health, Dalian Medical University, No. 9 West Section Lvshun South Road, Dalian, 116044, Liaoning Province, China.
BMC Public Health. 2018 Jun 7;18(1):707. doi: 10.1186/s12889-018-5599-y.
Metabolic syndrome (MetS) increases the incidence of cardiovascular disease and diabetes mellitus. It is essential to study the natural progression of MetS in the interest of prevention. Information on the dynamic changes in MetS in developing countries is limited. This study aimed to simulate the progression of each component of MetS and explore the potential role of these components in early prevention and intervention.
This study involved 5881 individuals, aged 20 to 60 at study entry, who underwent at least two consecutive years of health check-ups in the seven-year study period at our institution's health check-up center. Participants were divided into four groups by age (a 20- to- 40-year-old group and a 40- to 60-year-old group) and gender. A Markov model containing 7 stages (no components, isolated hypertension, isolated obesity, isolated hyperglycemia, isolated dyslipidemia, a 2-component state, and the MetS state) was constructed for each group.
In women and young men (20- to 40-year-old men), dyslipidemia and obesity were the two most probable states for individuals who were transitioning from no components to one of the other six states. Among those who had no components and were 30 years old at study entry, MetS was estimated to develop within 10 years in 11.42% of men and 3.04% of women. Among those who had no components and were 50 years old at study entry, MetS was estimated to develop within 10 years in 25.04% of men and 7.09% of women. The estimated prevalence of MetS over the next 10 years was higher in individuals starting with the obesity component than in individuals starting with any other isolated component. In a comparison of interventions targeting single components, simulations showed that the obesity intervention produced the largest relative reduction in the prevalence of MetS.
Markov models are suitable for describing and predicting the dynamic development of MetS. The occurrence of MetS most frequently began with dyslipidemia or obesity. Obesity played a predominant role in the development of MetS. Early obesity intervention was extremely important for MetS prevention.
代谢综合征（MetS）会增加心血管疾病和糖尿病的发病率。研究 MetS 的自然进展对于预防具有重要意义。关于发展中国家 MetS 动态变化的信息有限。本研究旨在模拟 MetS 各组成部分的进展，并探讨这些组成部分在早期预防和干预中的潜在作用。
本研究纳入了 5881 名年龄在 20 至 60 岁的个体，他们在本机构健康检查中心的 7 年研究期间至少接受了两次连续的健康检查。参与者按年龄（20 至 40 岁组和 40 至 60 岁组）和性别分为四组。为每个组构建了一个包含 7 个阶段（无组分、孤立性高血压、孤立性肥胖、孤立性高血糖、孤立性血脂异常、2 个组分状态和 MetS 状态）的马尔可夫模型。
在女性和年轻男性（20 至 40 岁的男性）中，从无组分状态向其他六个状态之一转变的个体中，血脂异常和肥胖是最可能的两种状态。在无组分且在研究开始时年龄为 30 岁的个体中，估计有 11.42%的男性和 3.04%的女性在 10 年内发展为 MetS。在无组分且在研究开始时年龄为 50 岁的个体中，估计有 25.04%的男性和 7.09%的女性在 10 年内发展为 MetS。从肥胖组分开始的个体比从任何其他孤立组分开始的个体在未来 10 年内 MetS 的预估患病率更高。在针对单个组分的干预措施比较中，模拟显示肥胖干预措施可使 MetS 的患病率相对降低幅度最大。
马尔可夫模型适用于描述和预测 MetS 的动态发展。MetS 的发生最常始于血脂异常或肥胖。肥胖在 MetS 的发生发展中起主要作用。早期肥胖干预对 MetS 的预防极为重要。
