Abd El-Wahab Ekram W, Shatat Hanan Z, Charl Fahmy
Department of Tropical Health, High Institute of Public Health, Alexandria University, Egypt.
Department of Occupational Health and Air Pollution (Division of Occupational Health and Industrial Medicine), High Institute of Public Health, Alexandria University, Egypt.
J Prim Care Community Health. 2019 Jan-Dec;10:2150132719882760. doi: 10.1177/2150132719882760.
Metabolic syndrome (MetS) is a cluster of cardiometabolic disturbances that increases the risk of cardiovascular diseases (CVD) and type 2 diabetes mellitus (DM). The early identification of high-risk individuals is the key for halting these conditions. The world is facing a growing epidemic MetS although the magnitude in Egypt is unknown. To describe MetS and its determinants among apparently healthy individuals residing in urban and rural communities in Egypt and to establish a model for MetS prediction. A cross-sectional study was conducted with 270 adults from rural and urban districts in Alexandria, Egypt. Participants were clinically evaluated and interviewed for sociodemographic and lifestyle factors and dietary habits. MetS was defined according to the harmonized criteria set by the AHA/NHLBI. The risk of ischemic heart diseases (IHDs), DM and fatty liver were assessed using validated risk prediction charts. A multiple risk model for predicting MetS was developed, and its performance was compared. In total, 57.8% of the study population met the criteria for MetS and were at high risk for developing IHD, DM, and fatty liver. Silent CVD risk factors were identified in 20.4% of the participants. In our proposed multivariate logistic regression model, the predictors of MetS were obesity [OR (95% CI) = 16.3 (6.03-44.0)], morbid obesity [OR (95% CI) = 21.7 (5.3-88.0)], not working [OR (95% CI) = 2.05 (1.1-3.8)], and having a family history of chronic diseases [OR (95% CI) = 4.38 (2.23-8.61)]. Consumption of caffeine once per week protected against MetS by 27.8-fold. The derived prediction rule was accurate in predicting MetS, fatty liver, high risk of DM, and, to a lesser extent, a 10-year lifetime risk of IHD. Central obesity and sedentary lifestyles are accountable for the rising rates of MetS in our society. Interventions are needed to minimize the potential predisposition of the Egyptian population to cardiometabolic diseases.
代谢综合征（MetS）是一组心脏代谢紊乱症候群，会增加心血管疾病（CVD）和2型糖尿病（DM）的发病风险。早期识别高危个体是遏制这些疾病的关键。尽管埃及的代谢综合征流行程度尚不清楚，但全球正面临着代谢综合征日益流行的趋势。本研究旨在描述埃及城乡社区健康个体中的代谢综合征及其决定因素，并建立代谢综合征预测模型。对埃及亚历山大城乡地区的270名成年人进行了一项横断面研究。对参与者进行了临床评估，并就社会人口统计学、生活方式因素和饮食习惯进行了访谈。代谢综合征根据美国心脏协会/美国国立心肺血液研究所（AHA/NHLBI）制定的统一标准进行定义。使用经过验证的风险预测图表评估缺血性心脏病（IHD）、糖尿病和脂肪肝的风险。建立了一个预测代谢综合征的多风险模型，并比较了其性能。总体而言，57.8%的研究人群符合代谢综合征标准，且患缺血性心脏病、糖尿病和脂肪肝的风险较高。20.4%的参与者存在无症状心血管疾病危险因素。在我们提出的多变量逻辑回归模型中，代谢综合征的预测因素为肥胖[比值比（95%置信区间）=16.3（6.03 - 44.0）]、病态肥胖[比值比（95%置信区间）=21.7（5.3 - 88.0）]、无工作[比值比（95%置信区间）=2.05（1.1 - 3.8）]以及有慢性病家族史[比值比（95%置信区间）=4.38（2.23 - 8.61）]。每周饮用一次咖啡因可使患代谢综合征的风险降低27.8倍。所推导的预测规则在预测代谢综合征、脂肪肝、糖尿病高风险以及在较小程度上预测缺血性心脏病10年终生风险方面是准确的。中心性肥胖和久坐不动的生活方式导致了我们社会中代谢综合征发病率的上升。需要采取干预措施，以尽量降低埃及人群患心脏代谢疾病的潜在易感性。
