| PrefaceMetabolic syndrome (MS) is symptom cluster of metabolic abnormality of glucose and lipid, abdominal obesity, hypertension. It is a major risk factor for cardiovascular disease or cerebrovascular disease. By investigation of epidemiology, the prevalence of MS is different in different nations and areas, economical society background. MS is caused by genetic and environmental factors. The prevalence of MS is affected by diagnostic standards. It is necessary to explore the prevalence and risk factors of MS.The prevalence of MS in city is higher than prevalence of MS in rural area in some articles that have been reported. But the prevalence of chronic disease has changed greatly recently. In our investigation, the prevalence of hypertension in rural area is higher than the level of our country. What is MS in rural area? Prevalence of MS is not clear in rural area. To choose a north rural area with high prevalence of hypertension to study the prevalence and risk factors of MS and analysis risk factors with multivariate factors regression and relationship with cardiovascular disease and cerebrovascular disease. So we can know prevalence of MS and make strategies and measures for controlling MS.Subjects and Methods1. The selection method and standard of study populationUsing the method of clustering multistage sampling method, 5 countrysides were randomly selected in ZhanWu County, LiaoNing Province, and then randomly selected 2 villages in 4 countrysides and 1 village in 1 countryside. All the people above 20 years old in the selected 9 villages were investigated.4780 people have been investigated, the male is 1798, the female is 1798,age range is from 20 to 84 years old.2. The contents of investigation(1)Questionnaires were filled by means of inquiring and measurement in sites. The contents of survey included: general characteristics, alcohol intake, smoking habits, previous disease history and so on, measurement of the blood pressure, body height and weight.(2)Five milliliters blood samples were drawn after an overnight fast. After centrifugation, the serum fraction was removed and frozen in aliquots at -20℃until assayed. The serum was used for the measure of hematological biochemistry assay.3. Diagnosis standard and chemical measurementsDiagnosis standard of MS is According to 2004 Chinese medical association diabetes branch. Three or four abnormal components are diagnosed as MS: over weight and obesity:Body mass index(BMI)≥25.0kg/m~2.High blood sugar: limosis blood sugar≥6.1mmol/L or blood sugar after meal two hours≥7.8mmol/L, diabetes. Hypertension: systolic blood pressure (SBP)/ diastolic blood pressure (DBP)≥140/90mmHg or hypertension diagnosed. Blood lipid abnormal: limosis triglyce-ride(TG)≥1.7mmol/L,high density lipoprotein (HDL)<0.9mmol/L(male)/1.0mmol/L(f emale).The measurement of blood pressure should be carried out according to the unified standard under standard conditions.The blood sugar, triglyceride(TG),high density lipoprotein(HDL) were measured by automatic biochemistry analyzer 7150(HITACHI, Japan).4. Statistical methodsA database was created by SPSS after quality examination of data. Method of analysis includes x~2 test, x~2 trend test, logistic regression. The soft ware used was SAS9.0. A.2-sided value of P<0.05 was regarded as statistically significant. Results1. Metabolic abnormal components and prevalence of MS among people(1) Metabolic abnormal components and prevalence rate of MSAbnormal rate of metabolic component: BMI≥25kg/m~2:30.67%,Sbp≥140mmHg or Dbp≥90mmHg:47.09%, Sbp≥140mmHg:39.33%,Dbp≥90mmHg:37.85%,blood sugar≥6.1mmol/L:6.70%,TG≥1.7mmol/L:25.2%,HDL<0.9mmol/L(male)/1.0mmol/L(f emale):2.1%.BMI has no statistical difference (P>0.05) between the male and the female. Sbp and Dbp, blood sugar, TG, HDL have statistical difference (P<0.05) between the male and the female. The prevalence rate of MS is 11.00%, the male is 12.80%, the female is 9.80%.There is statistical difference (P<0.05) between the male and the female. The standard prevalence rate of MS is 16.43% by 2000 China census.(2)Distribution of metabolic abnormal components and MS among age rangeThe prevalence rate of BMI and Sbp ,Dbp, blood sugar, TG are different among different age range and have statistical difference (P<0.05). The prevalence rate of BMI and Sbp, Dbp, blood sugar, TG have increasing trend with age. The prevalence rate of HDL have no statistical difference (P>0.05) among different age range. The prevalence rate of HDL has no increasing trend with age. The prevalence rate of MS is different among different age range and has statistical difference (P<0.05) . The prevalence rate of MS has increasing trend with age.(3) Distribution of metabolic abnormal component and MS among nationalityThe prevalence rate of BMI and blood sugar, TG, HDL are not different among different nationality and have no statistical difference (P>0.05). The prevalence rate of Sbp of han nationality is 40.4% and the highest among three nationalities. The prevalence rate of Sbp of man nationality is 30.4% and the lowest among three nationalities. The prevalence rate of MS is not different among different nationality and has no statistical difference (P>0.05) . (4) Distribution of metabolic abnormal component and MS among countrysideThe abnormal prevalence rate of BMI and Sbp ,Dbp, blood sugar, TG, HDL are not different among different countryside and have statistical difference (P<0.05) .The abnormal prevalence rate of BMI is highest in haertao countryside, 39.4%. The abnormal prevalence rate of Sbp is highest in houjinqiu countryside, 47.5%. The abnormal prevalence rate of Dbp is highest in zhanggutai countryside, 43.5%. The abnormal prevalence rate of blood sugar is highest in zhanggutai countryside, 8.5%. The abnormal prevalence rate of TG is highest in houjinqiu countryside, 31.1%. The abnormal prevalence rate of HDL is highest in zhanggutai countryside, 2.9%. The prevalence rate of MS is different among different countryside and has statistical difference (P<0.05) . The prevalence rate of MS is highest in zhanggutai countryside, 13.6%.2. Monovariate analysis on the related risk factors of MSThere was no statistical difference of Smoking, drinking water type, frequence of brined vegetable every day, coronary heart disease heredity between case group and control group (P>0.05). There was statistical difference of sex, age, drinking, hypertension heredity, cerebral hemorrhage heredity, quantity of salt per day (P<0.05) between case group and control group.3. Multivariate conditional Logistic analysisMultivariate analysis was conducted on factors of sex, age, drinking, hypertension heredity, cerebral hemorrhage heredity, quantity of salt per day. We used unconditional Logistic regression analysis constitute model of MS. Age, sex, hypertension heredity, quantity of salt per day are possible risk factors of MS.4. The compare of MS between case group and control group of cerebrovascular diseaseThe prevalence rate of MS is not different between case group and control group of cerebrovascular disease and has statistical difference (P<0.05) .The group of cerebrovascular disease has higher prevalence of MS. MS is possible risk factor for cerebrovascular disease.5. The compare of MS between case group and control group of coronary diseaseThe prevalence rate of MS is not different between case group and control group of coronary disease and has statistical difference (P<0.05) .The group of coronary disease has higher prevalence of MS. MS is possible risk factor for coronary disease.6.Relationship of abnormal components of MS and coronary or cerebrovascular diseasesThe number of abnormal components of MS relates with the number of cerebral hemorrhage, cerebral infarct, coronary diseases and cerebrovascular diseases. The number of cerebral hemorrhage, cerebral infarct, coronary diseases and cerebrovascular diseases has uptrend with abnormal components of MS. Uptrend of abnormal components of MS and cerebral hemorrhage, cerebral infarct, coronary diseases and cerebrovascular diseases has statistical difference (P<0.05) .DiscussionPrevalence rate of MS is increasing because of changing of feeding habit through epidemiology investigation. MS can induce cardiovascular and cerebrovascular disease. MS are affected by many factors, including environment factors and heredity factors. Prevalence rate of MS is affected by diagnosis standard. It is important to study prevalence and risk factors. It is easy to make intervention measures and strategies for reducing prevalence of MS and cardiovascular and cerebrovascular diseases.Prevalence rate of MS is 11.00% in the study. Prevalence rate of fanner is 14.2% in Hebei province. Prevalence rate of farmer is 2.91% in Zhongshan city,Guangdong province(CDS standard).Because different diagnosis standard is adopted in different area ,and area population is not calculated by standard population, prevalence rate of MS can not be compared directly. In 2000,an investigation is studied about MS, we can find prevalence rate of MS in north is higher than that of south, city is higher than rural area. In this investigation, male's abnormal rate of hypertension, blood sugar, TG, MS is higher than that of female. In some study, female's prevalence rate of MS is higher than male's. Rate of metabolic abnormal components is different among different age range and ascend with age. Result of study is same to others'. When prevalence rate of MS and metabolic abnormal components are analyzed among nationality, comparing abnormal rate of Sbp and Dbp,han nationality's is higher than meng and man nationality's. There is not obviously different among BMI, blood sugar, TG, HDL,MS of han, man, meng nationality. In minority area, for example Sinkiang, han nationality's abnormal rate of BMI, blood sugar, TG, HDL and prevalence rate of MS are higher than meng nationality's. When prevalence of MS and abnormal components of MS are analyzed among countryside, prevalence rate of MS and abnormal components of MS rate are different. In Countryside with high prevalence rate of MS and abnormal components of MS rate, prevention and cure should be made.When risk factor is analyzed, age and sex, hypertension heredity, quantity of salt per day are risk factors of MS.Male is risk factor of MS. Because male's abnormal rate of metabolic component and prevalence rate of MS are higher than that of female. Result of study is same to Jiang Jianhua's. Other's study indicates that the prevalence rate of MS of female is lower than that of male because of estradiol against the pro-oxidant effect.Quantity of salt per day means salt intake. In other study, excessive salt intake is risk factor for hypertension. Mechanism that salt can induce hypertension can induce insulin resistance, insulin resistance can promote hypertension. Insulin resistance decreases sensitivity of insulin and induces metabolic abnormality of carbohydrate and lipid, also makes more components of abnormal metabolism.Hypertension heredity is risk factor. People with hypertension heredity have more probability to have MS. If mother or father has hypertension, children are easy to have MS. Components of MS are interdependent, but they influence each other. Knowing components of MS and risk factors, it is advantageous to control MS and reduce cardiovascular or cerebrovascular disease. In this investigation, components of abnormal metabolism are hypertension, high BMI, high TG. Controlling hypertension, BMI, TG can reduce components of abnormal metabolism and MS.Diagnosis standard of MS includes world health organization (WHO) standard, national cholesterol education programs adult treatment panelIII(NCEP-ATPIII), international diabetes federation (IDF), Chinese medical association diabetes branch(CDS). Different diagnosis standards of MS lay particular emphasis. Diagnosis standard of IDF and CDS have fine coincidence rate (79.95%). MS that have been diagnosed by diagnosis standard of IDF and CDS have similar incidence rate of cardiovascular or cerebrovascular disease. Diagnosis standard of IDF and CDS can reflect prevalence rate of MS and be used widely.Comparing prevalence of MS about case group and control group of coronary or cerebrovascular disease, MS is probably risk factor for coronary or cerebrovascular disease. More number of abnormal metabolic components, more number of cerebral hemorrhage, cerebral infarct , coronary and cerebrovascular disease. MS can affect coronary or cerebrovascular disease greatly. Cohort study can reveal people with MS have more prevalence rate of cardiovascular or cerebrovascular disease than people without MS.Exploring possible risk factors for MS initially, it is necessary to study risk factors profoundly. MS can affect cardiovascular or cerebrovascular disease development. It is necessary to study metabolic factors that can affect cerebrovascular disease greatly, this is pity. Cohort study should be carried out to study relation of between components of abnormal metabolism and cardiovascular or cerebrovascular disease.ConclusionStudy finding: components of abnormal metabolism are BMI, hypertension, TG. Male and hypertension heredity, quantity of salt per day, age are risk factors of MS. MS and components of abnormal metabolism are risk factors of cardiovascular disease or cerebrovascular disease.
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