Healthcare Data Science Research Unit, Institute for Future Initiatives, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
MCVP Division, AXA Life Insurance Co., Ltd, Tokyo, Japan.
BMC Geriatr. 2023 Jul 17;23(1):438. doi: 10.1186/s12877-023-04145-0.
The prevalence of metabolic syndrome (MetS) in Japan, a super-aged society, is increasing and poses a major public health issue. Several studies have reported sex differences in the association between age and MetS prevalence. This study aimed to examine the association between age and the prevalence of MetS based on multiple screening criteria and MetS components by sex.
We used 6 years of individual-level longitudinal follow-up data (June 2012 to November 2018; checkup year: 2012-2017) of middle-aged and older adults aged 40-75 years in Japan (N = 161,735). The Joint Interim Statement criteria, International Diabetes Federation criteria, and another set of criteria excluding central obesity were used as the screening criteria for MetS. The prevalence of MetS and MetS components was cross-sectionally analyzed according to sex and age. A longitudinal association analysis of age, MetS, and MetS components by sex was performed using a multilevel logistic model, adjusted for lifestyle- and regional-related factors.
Sex differences were observed in the prevalence and association of MetS and MetS components. In all age groups, the prevalence of central obesity was higher among women, and the prevalence of high blood pressure and fasting glucose was higher among men (P < 0.001). The prevalence of high triglyceride and low high-density lipoprotein cholesterol was higher among women aged > 60 years (P < 0.05). Based on the criteria of the Joint Interim Statement and International Diabetes Federation, the prevalence of MetS was higher among women than in men aged > 55 years (P < 0.001). Men had a higher prevalence of MetS without central obesity than women in all age groups (P < 0.001). The odds ratio for MetS and MetS components with aging was greater among women than in men.
Medical management should be based on the prevalence of MetS and its components according to sex and age. In particular, the high prevalence of MetS without central obesity in middle-aged and older Japanese men suggests that the adoption of the Joint Interim Statement criteria, which do not precondition central obesity, should be considered.
在老龄化严重的日本，代谢综合征（MetS）的患病率正在上升，这是一个主要的公共卫生问题。一些研究报告称，年龄与 MetS 患病率之间的关联存在性别差异。本研究旨在根据多种筛查标准和 MetS 成分，按性别检查年龄与 MetS 患病率之间的关联。
我们使用了日本 40-75 岁中老年人 6 年的个体水平纵向随访数据（2012 年 6 月至 2018 年 11 月；体检年份：2012-2017 年）（N=161735）。采用联合临时声明标准、国际糖尿病联合会标准和另一组排除中心性肥胖的标准作为 MetS 的筛查标准。根据性别和年龄对 MetS 和 MetS 成分的患病率进行横断面分析。使用多水平逻辑模型对性别、年龄、MetS 和 MetS 成分进行纵向关联分析，并调整了生活方式和区域相关因素。
在 MetS 和 MetS 成分的患病率和相关性方面观察到了性别差异。在所有年龄组中，女性的中心性肥胖患病率较高，男性的高血压和空腹血糖患病率较高（P<0.001）。年龄>60 岁的女性高甘油三酯和低高密度脂蛋白胆固醇的患病率较高（P<0.05）。根据联合临时声明和国际糖尿病联合会标准，年龄>55 岁的女性 MetS 的患病率高于男性（P<0.001）。在所有年龄组中，男性的非中心性肥胖 MetS 患病率均高于女性（P<0.001）。女性年龄增长与 MetS 和 MetS 成分的比值大于男性。
应根据性别和年龄的 MetS 及其成分的患病率进行医疗管理。特别是，日本中老年人中高发的非中心性肥胖 MetS 表明，应考虑采用不预设中心性肥胖的联合临时声明标准。
