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代谢综合征组分与糖尿病的相关性:来自中国国家脑卒中筛查与防治工程的证据。

The association of metabolic syndrome components and diabetes mellitus: evidence from China National Stroke Screening and Prevention Project.

机构信息

Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, China.

Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.

出版信息

BMC Public Health. 2019 Feb 14;19(1):192. doi: 10.1186/s12889-019-6415-z.

Abstract

BACKGROUND

The metabolic syndrome (MetS) is related with cardiovascular disease. However, its relationship with diabetes mellitus (DM) has not been examined in Chinese population with a larger sample. We aimed to assess the relationship between metabolic syndrome (MetS) and its components, and DM, and to determine the best one from the available definitions of Mets when assessing the risk of DM.

METHODS

This was a cross-sectional survey in a nationally representative sample of 109,551 Chinese adults aged ≥40 years in 2014-15. MetS was defined according to three criteria including the updated International Diabetes Federation (IDF) criterion, the National Cholesterol Education Program Third Adult Treatment Panel (NCEP ATP III) criterion and American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) criterion. Logistic regression models were used to estimate the odds of DM.

RESULTS

MetS as defined by three criteria including IDF, NCEP ATP III,and AHA/NHLBI all increased the prevalence of DM, and the adjusted ORs with 95% CI was more higher using NCEP ATP III (3.65, 3.52-3.79) than IDF (2.50, 2.41-2.60) and AHA/NHLBI (3.03, 2.92-3.24). The odds of DM was highest in hyperglycemia with cut-off glucose≥6.1 mmol/L (14.55, 13.97-15.16), and other components were also associated significantly with DM. There was heterogeneity for OR of DM associated with various trait combinations.

CONCLUSIONS

The NCEP ATPIII MetS definition may be more suitable for assessment of DM risk in Chinese population. Hyperglycemia, as previous study reported, are important risk factors of DM. Besides, other traits of Mets are also significantly associated with DM and should therefore be of greater concern.

摘要

背景

代谢综合征(MetS)与心血管疾病有关。然而,在具有更大样本量的中国人群中,尚未研究其与糖尿病(DM)的关系。我们旨在评估代谢综合征(MetS)及其成分与 DM 之间的关系,并确定在评估 DM 风险时,从现有的 MetS 定义中选择最佳定义。

方法

这是 2014-15 年对年龄≥40 岁的 109551 名中国成年人进行的全国代表性样本的横断面调查。MetS 根据三个标准定义,包括更新的国际糖尿病联合会(IDF)标准、美国国家胆固醇教育计划第三成人治疗专家组(NCEP ATP III)标准和美国心脏协会/美国国立心肺血液研究所(AHA/NHLBI)标准。使用逻辑回归模型估计 DM 的比值比(OR)。

结果

使用 IDF、NCEP ATP III 和 AHA/NHLBI 三个标准定义的 MetS 均增加了 DM 的患病率,调整后的 OR(95%CI)使用 NCEP ATP III(3.65,3.52-3.79)比 IDF(2.50,2.41-2.60)和 AHA/NHLBI(3.03,2.92-3.24)更高。空腹血糖≥6.1mmol/L(14.55,13.97-15.16)的高血糖患者 DM 的发生几率最高,其他成分也与 DM 显著相关。与各种特征组合相关的 DM 的 OR 存在异质性。

结论

NCEP ATP III MetS 定义可能更适合评估中国人群的 DM 风险。如既往研究报道,高血糖是 DM 的重要危险因素。此外,MetS 的其他特征也与 DM 显著相关,因此应引起更多关注。

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