| Objective1. To investigate and validate the risk factors of inheritance, life style and occupational risk factors of metabolic syndrome (MS), provide guidance suggestion for making prevent measure for MS.2. To study the incidence of MS of Tianjin male policemen by prospective cohort study, and investigate the risk factors of inheritance, life style and occupational risk factors of MS, and the relationship between MS and serum uric acid (SUA). Methods11:4matched case-control study was used, based on physical examination data of Tianjin Policemen in2010,708people were selected as cases, which were diagnosed by CDS criteria rescently; matched on sex and age (±1year),2832people who were healthy were selected as controls. An epidemiological investigations on the past exposure status of several possible risk factors was made, and conditional logistic regression analysis was used to analyze the data, and calculate the population attributable risk factors.2The "Tianjin police health cohort" was set up in March2007. The inclusion criteria: without MS at baseline, with the whole data (2007physical examination and police health questionnaire).3835male policemen aged21-85years old who completed baseline survey were selected in the cohort (average age=40.20±11.002). The cohort was divided into four sub-groups:SUA1, SUA2, SUA3, SUA4according to quartile of baseline SUA values. After4years (1/year) follow-up, all the subjects unified medical examination at the Tianjin Public Security Hospital, and fill out the police health questionnaires which identical to the baseline survey. The MS diagnostic criteria based on the Chinese Medical Association Diabetes Branch (CDS) standards to calculate the MS4-year cumulative incidence and incidence density. Cox regression model was used to analyze the risk of uric acid, genetic, behavioral, lifestyle, occupational factors to MS (hazard ratio, HR) and its95%confidence interval (CI). Stratified analysis was used to further explore the relation between SUA or other factors and MS.Results1. case-control study1.1Multivariate conditional logistic regression analysis suggested that, family history of hypertension, family history of diabetes, smoking, snoring, hyperuricemia, type A personality, work intensity, occupational stressful events, security policemen and criminal investigation policemen could significantly increase the risk of disease development, but dairy products is a protect factor for MS.12. Results from population attributable risk factors analysis show that, the control of smoking, snoring, hyperuricemia, work intensity, occupational stressful events can decreased the risk of MS are16.26%,11.71%,48.24%,56.87%and8.97%, respectively.2. cohort study2.13835male police aged21～85years old were followed up, the cumulative incident rate was11.58%. In the4uric acid groups,65,95,121,160male police developed into MS, respectively, resulting6.28%,9.15%,11.67%,15.43%cumulative incidence rate. The relationship between MS and SUA was positively (chi-square trend test p<0.001), and MS incidence rate increased with increasing age (chi-square trend test p<0.05).2.2A multivariate model, adjusting the genetic, behavioral lifestyle and occupational factors and other factors found that SUA can increase the risk of MS in male police, compared with SUA,, the HR of SUA2, SUA3, SUA4were1.302(95%CI0.862-1.965),1.919(95%CI=1.302-2.829),2.147(95%CI=1.457-3.163), the linear trend test p<0.05.2.3Stratified analysis:<35years and the number of baseline MS components were the two sensitive populations, compared with the people older than35and the baseline Mscomponents less than2. Somking and drinking were the effect modifiers of SUA increase the incident of MS. The relationship between SUA and MS were independent of stratification factors.2.4Receiver operating characteristic curve (ROC) was used to find the cutoff point of serum uric acid (SUA) in Chinese male police. The cutoff point was326.25μmol/L, area=0.603, sensitivity=0.637,1-specificity=0.474.2.5Results from population attributable risk factors analysis show that, the control of SUA levels below326.25μmol/L, BMI, blood pressure, blood lipids at normal levels, the incidence of MS can be reduced by14.26%,29.97%,11.64%and25.38%.Conclusion1. Many factors contribute to the incidence to MS, including genetic factors, behavioral and lifestyle factors and occupational factors. MS has become a significant public health problem among policemen, it’s necessary to take measures on life style, occupational risk factors to reduce the incidence of MS, and improve the level of healthy among policemen.2. Uric acid is an independent risk factor of MS in Tianjin male police. The results of this study extends previous research results, provides a new idea for the police crowd to reduce MS risk. Play an important role to control uric acid levels, and continuously improve the health of the police and self-awareness of health protection. |
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