Association Between Combined Healthy Lifestyle And The Risk Of Metabolic Syndrome In Rural Adults

Objective:The increasing prevalence of metabolic syndrome in the world has become a serious public health problem.Early prevention and control of its risk factors can effectively prevent the risk of metabolic syndrome.The association between lifestyles(such as smoking,drinking,physical activity,and diet)and metabolic syndrome has been confirmed by a large number of studies.But the origin of lifestyle is complex,and it is difficult to judge the impact of a single lifestyle on health.Although more and more studies have focused on the relationship between the combined effects of lifestyle and disease,only a few studies have explored the association between lifestyle scores and metabolic syndrome and its components,which needs to be explored with representative population epidemiological surveys and follow-up studies.Liaoning Province is the worst-hit area for obesity,and unhealthy lifestyles are common among residents.Therefore,this study conducted an epidemiological survey among adults in rural areas of a city in Liaoning Province to explore the correlation between combined healthy lifestyle and metabolic syndrome among adults.Methods:A longitudinal observational study design was used in this study.Questionnaire survey,physical examination,and blood sample collection were implemented in 4 towns of a city in Liaoning Province.A total of 1025 adults over 35 years old were included according to the corresponding exclusion criteria.The questionnaire mainly includes general information,diseases situation,and personal living habits.The physical examination includes measurements of height,weight,waist circumference,hip circumference,and blood pressure.Blood samples were collected and laboratory tests were performed to obtain fasting blood glucose,triglycerides,and HDL-cholesterol.Binary Logistic regression analysis was used to analyze the correlation between lifestyle composite score and metabolic syndrome and its components.Odds ratios(OR)and 95%confidence intervals(95%CI)were calculated,and the stability of the results was verified by hierarchical analysis.Results:1.This study included 332 males,accounting for 32.39%,and 693 females,accounting for 67.61%of the total.In 2021 the overall incidence of metabolic syndrome was 12.10%(124 cases),with the incidence of females(13.56%)than males(9.04%),and the difference is statistically significant(χ~2=4.328,P=0.037).2.There were 653 participants with the combined healthy lifestyle score≥4 points,accounting for 63.71%of the total population.The proportion of the combined healthy lifestyle≥4 points in males was 47.29%,which was significantly lower than that in females(71.57%),and the difference was statistically significant(χ~2=57.249,P<0.001).From 2019 to 2021,the proportion of people with the healthy lifestyle,current non-smoking,current non-drinking,mild or above physical activity,healthy diet,and normal total cholesterol showed an increasing trend,while the proportion of people with normal BMI decreased slightly.3.In univariate analysis,the combined healthy lifestyle score<4 points was positively correlated with metabolic syndrome and its components(new-onset metabolic syndrome:OR=2.77,95%CI:1.89-4.07;abdominal obesity:OR=1.88,95%CI:1.44-2.45;hypertension:OR=1.73,95%CI:1.32-2.27;hyperglycemia:OR=1.51,95%CI:1.08-2.10;high triglycerides:OR=1.62,95%CI:1.17-2.26),but no association between the lifestyle composite score and low HDL-cholesterol was established(P>0.05).In multivariate-adjusted models,taking the combined healthy lifestyle score≥4 points as a reference,the combined healthy lifestyle score<4 points was positively correlated with the incidence of metabolic syndrome,and the OR and 95%CI were 3.38(2.25-5.07).The correlations with metabolic syndrome components were:abdominal obesity(OR=2.30,95%CI:1.73-3.05),hypertension(OR=1.49,95%CI:1.12-1.98),hyperglycemia(OR=1.52,95%CI:1.07-2.15),high triglycerides(OR=1.96,95%CI:1.38-2.78),but no association was found with low HDL-cholesterol.The results of the stratified analysis showed that there was still a certain correlation between the lifestyle composite score and metabolic syndrome and its components.4.After adjusting for all confounding factors,compared with the participants who had adhered to the combined healthy lifestyle,participants who adhered to the low combined healthy lifestyle score(OR=5.21,95%CI:3.08-8.81),switched from the high combined healthy lifestyle score to the low group(OR=2.12,95%CI:1.07-4.17),and switched from the low group to the high group(OR=3.15,95%CI:1.89-5.24)were all positively correlated with the risk of metabolic syndrome.Conclusion:The incidence of metabolic syndrome in this study was slightly higher than that in other relevant studies,the rate of abdominal obesity and hypertension was higher than the national level,and the rate of high triglyceride and low HDL-cholesterol was lower.The proportion of participants with more than 4 healthy behaviors(the lifestyle composite score≥4 points)was higher.From 2019 to 2021,the prevalence of other components of metabolic syndrome showed an increasing trend except for the rate of low HDL-cholesterol.Among all healthy behaviors,only the healthy BMI rate decreased slightly,while the proportion of other healthy behaviors increased.A low combined healthy lifestyle score was associated with an increased risk of developing metabolic syndrome and its components,but no association was found with low HDL-cholesterol.Adherence to combined healthy lifestyle is a protective factor against the onset of metabolic syndrome.Therefore,long-term and sustained adherence to combined healthy lifestyle can effectively reduce the impact of metabolic syndrome and its components on health.