| The metabolic syndrome (MS), i.e.the clustering of central obesity, dyslipidaemia, elevated blood pressure and high fasting glucose levels, can lead to disorders of the vascular structure and the functional flexibility. It is associated with the development of the cardiovascular diseases. People with MS have a higher risk of cardiovascular disease and, more likely, of type 2 diabetes. Recently, with the economic development, people's diet and lifestyle have undergone tremendous changes. At the same time, the morbidity of MS has increased a lot. An investigation in Beijing Institutional Populations showed that the prevalence rate of MS is 15.1% in male and 13.0% in female. Therefore, how to prevent and control the MS becomes a hot topic.ObjectivesTo investigate the prevalence of MS in medical check-ups in our hospital, and analyse the association between brachial-ankle pulse wave velocity and metabolic syndrome risk factors. To discuss the interaction between MS risk factors, especially the effect of acceleration of arterial stiffening in the presence of raised blood pressure and raised fasting glucose, and provide the scientific evidence for diagnosis, monitoring, intervention, prevention and control in MS.Methods1 Subjects: Who came to have a medical check-up from May, 2008 to November, 2008 in the 2nd Affiliated Hospital, College of Medicine, Zhejiang University were selected.2 Grouping:①The subjects were divided into three groups, according to their age. The subjects aged from 20 to 39 years old were in Youth Group, subjects aged from 40 to 65 years old were in Middle-aged Group and subjects aged from 66 to 80 years old were in Elderly Group.②The subjects were divided into two groups, according to the definition of metabolic syndrome, then compared baPWV in these two groups. Besides, the non-MS group were divided into four groups, according to how many MS risk factors they had. i.e. 'no risk factors', 'one risk factor', 'two risk factors' and 'three and more than three risk factors', then compared baPWV and datas in four groups.③middle-aged male with MS were also classified into four groups based on the presence of raised blood pressure, raised fasting glucose, both abnormalities, or neither abnormality.3 baPWV, height, weight, waist circumference, hip circumference, heart rate, blood pressure, fasting glucose, total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol were measured and collected.Results1 General information: 2982 subjects were selected, who were aged from 25-79 years old, average age (44.91±8.71). Our investigation showed that 705 subjects were MS (male615, female 90) and 2277 subjects (malel698, female579) were non-MS, the prevalence rate of the MS was 23.6%, the prevalence rate of Middle-aged Group was similar to that of Elderly Group, the proportion of MS high risk people was 48.9%. The following showed the prevalence rates of the MS risk factors: central obesity 48.1%, 1435 subjects; abnormal fasting glucose 16.6%, 496 subjects; dyslipidemia 49.3%, 1465subjects; abnormal blood pressure 40.4%, 1206 subjects. We also found that the rates of abnormal fasting glucose, abnormal blood pressure, dyslipidemia and MS in man were higher than that in woman (P < 0.05 ) .2 There was a significant difference between MS group (1460.51±219.18 cm/s) and non-MS group (1333.95±200.67 cm/s) in baPWV (P<0.01).3 In our research, age, heart rate(HR), hip circumference(HC), fasting blood glucose(FBG), HDL cholesterol, systolic blood pressure, diastolic blood pressure, mean blood pressure, and pulse pressure were correlated with baPWV, regression equation:baPWV=70.465+6.900×age+3.386×HR-1.961×HC+0.225vFBG-0.190×HDL+ 9.424×SBP+6.743×DBP+3.521×MBP+5.036xPP , R~2=0.562. Stepwise regression analysis demonstrated systolic blood pressure, age, heart rate, hip circumference, mean blood pressure were independent determinants of baPWV (R~2=0.504)4 The 2277 non-MS subjects were classified into four groups. The results showed that there were no differences between 'one risk factor' and 'two risk factors' in age and heart rate, and no difference between 'one risk factor' and 'three and more than three risk factors' in waist circumference and BMI. But as for other aspects, we found that there were significant differences among these four groups (P<0.05), especially for baPWV, 'three and more than three risk factors' (1608.11±249.29) > 'two risk factors' (1412.41±203.93 )> 'one risk factor' (1327.17±190.25 )> 'no risk factors' (1236.08±142.50) .5 520 subjects with MS were also divided into four groups. There were significant differences between four groups. Stepwise regression analysis revealed that systolic blood pressure ,age, heart rate and fasting glucose were independent determinants of baPWV, and the coexistence of raised blood pressure and raised fasting glucose, rather than the presence of either abnormality alone, cause accelerating of arterial stiffness(P<0.01).Conclusion1 The prevalence rate of MS in our research was much higher than other domestic researches, while it was similar to the studies abroad. Central obesity, abnormal fasting glucose, dyslipidemia and abnormal blood pressure were the main risk factors of metabolic syndrome.2 SBP, age, HR, hip circumference, MBP were independent factors of baPWV in MS high risk people.3 The MS and its risk factors were significantly associated with abnormal baPWV. The presence of an increasing number of MS risk factors was associated with an increasing baPWV, and the function of arterial flexibility in MS group was worse than that in non-MS group.4 In middle-aged people with MS, raised blood pressure and raised fasting glucose which appeared at the same time did lager damages to the arterial flexibility, it also showed that raised blood pressure and raised fasting glucose had a synergistic effect on baPWV, which can accelerate the process of atherosclerosis and increase risks of cardiovascular disease. Stepwise regression analysis demonstrated age, heart rate, systolic blood pressure and fasting glucose were independent determinants of baPWV.
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