Xu Tao, Zhu Guangjin, Han Shaomei
Department of Epidemiology and Statistics.
Department of Physiopathology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China.
Medicine (Baltimore). 2020 Oct 30;99(44):e22883. doi: 10.1097/MD.0000000000022883.
People living in the same area are more likely to experience similar socioeconomic characteristics, which leads to cluster effect and influences the generalizability of data regarding metabolic syndrome (MetS). However, previous studies did not consider or adjust for the cluster effect of living circumstances. The aim of this study was to determine the prevalence of MetS and associated lifestyle factors in Chinese adults 18 to 80 years of age, using multi-level generalized estimation equation (GEE).The participants came from a large-scale cross-sectional population survey. A total of 28,062 participants underwent all the blood tests. Participants meeting at least 3 of the 5 diagnostic criteria were defined as having MetS. Multi-level GEE was used to evaluate the relationship between MetS and lifestyle covariates to control the cluster effect of living circumstances. Odds ratios (ORs) and their 95% confidence intervals (CIs) were used to assess the strength of each relationship.A total of 65.70% of the participants had at least 1 clinical feature of MetS, and 2926 were diagnosed with MetS (prevalence 14.03%). 32.74%, 18.93%, 10.25%, 3.25%, and 0.53% of the participants had 1, 2, 3, 4, and 5 components, respectively. The prevalence of MetS in men (12.31%) was lower than in women (15.57%). After controlling for the cluster effect of living circumstances, many demographic and lifestyle characteristics were associated with MetS. Overweight (OR = 1.670, 95%CI: 1.600-1.743), obesity (OR = 2.287, 95% CI: 2.136-2.449), current alcohol consumption (OR = 1.053, 95% CI: 1.020-1.086), physical labor (OR=1.070, 95% CI: 1.040-1.101), a high-salt diet (OR=1.040, 95% CI: 1.009-1.071), hyperuricemia (OR=1.264, 95% CI: 1.215-1.316), short sleep duration (OR=1.032, 95% CI: 1.009-1.055), and a family history of cardiovascular disease (OR=1.065, 95% CI: 1.019-1.113), or cerebrovascular disease (OR=1.055, 95% CI: 1.007-1.104) increased the risk of MetS. The risk of MetS increased 6.9% (OR = 1.069, 95% CI: 1.053-1.085) with each 5% increase in body fat percentage.MetS has become a serious public health challenge in China. Many lifestyle factors have been found to be closely associated with MetS, including obesity, a high-salt diet, alcohol consumption, and short sleep duration. Therefore, changes in lifestyle are very important for adults to reduce the prevalence of MetS.
生活在同一地区的人们更有可能经历相似的社会经济特征，这会导致聚集效应，并影响有关代谢综合征（MetS）数据的普遍性。然而，以往的研究并未考虑或调整生活环境的聚集效应。本研究的目的是使用多水平广义估计方程（GEE）来确定18至80岁中国成年人中代谢综合征及其相关生活方式因素的患病率。参与者来自一项大规模横断面人群调查。共有28062名参与者接受了所有血液检测。符合5项诊断标准中至少3项的参与者被定义为患有代谢综合征。使用多水平GEE来评估代谢综合征与生活方式协变量之间的关系，以控制生活环境的聚集效应。比值比（OR）及其95%置信区间（CI）用于评估每种关系的强度。共有65.70%的参与者至少有1项代谢综合征的临床特征，2926人被诊断为患有代谢综合征（患病率14.03%）。分别有32.74%、18.93%、10.25%、3.25%和0.53%的参与者有1、2、3、4和5项组分。男性代谢综合征的患病率（12.31%）低于女性（15.57%）。在控制了生活环境的聚集效应后，许多人口统计学和生活方式特征与代谢综合征相关。超重（OR = 1.670，95%CI：1.600 - 1.743）、肥胖（OR = 2.287，95%CI：2.136 - 2.449）、当前饮酒（OR = 1.053，95%CI：1.020 - 1.086）、体力劳动（OR = 1.070，95%CI：1.040 - 1.101）、高盐饮食（OR = 1.040，95%CI：1.009 - 1.071）、高尿酸血症（OR = 1.264，95%CI：1.215 - 1.316）、短睡眠时间（OR = 1.032，95%CI：1.009 - 1.055）以及心血管疾病家族史（OR = 1.065，95%CI：1.019 - 1.113）或脑血管疾病家族史（OR = 1.055，95%CI：1.007 - 1.104）会增加代谢综合征的风险。体脂百分比每增加5%，代谢综合征的风险增加6.9%（OR = 1.069，95%CI：1.053 - 1.085）。代谢综合征在中国已成为一项严峻的公共卫生挑战。已发现许多生活方式因素与代谢综合征密切相关，包括肥胖、高盐饮食、饮酒和短睡眠时间。因此，改变生活方式对成年人降低代谢综合征的患病率非常重要。
