An Epidemiological Study On The Prevalence Of Metabolic Syndrome And Its Relationship To Pwd And Qtd In Older Community Rsdidents Of Zhuhai

With the continued growth of our economic development, our aging population, people’s dietary and lifestyle changes and an increasing global disease incidence (year by year) of MS, a serious threat to human life and property is developing. The rising global MS epidemic has become the new focus of public heal. According to epidemiological data, the incidence of metabolic syndrome in adults is20%to30%in most countries around the world and there is a rising trend. The MS prevalence among American adults rose to24%in the period1988to1994, it increased to27%during1999to2000. The Asian Cardiovascular Disease Cooperative conducted a survey on15,828adults in our country, and it showed that the MS prevalence in those surveyed was16.5%, The prevalence in the southern and northern regions is respectively11.5%and23.3%, and it is14.7%and23.5%in rural and urban areas. Figures for an MS epidemiological survey for the11provinces and cities in China in2006showed that the prevalence was18.7%among the age of35to64in those surveyed. The Diabetes Society of the Chinese Medical Association organized a sample survey in people over the age of20at all levels in Chinese towns from2007to 2008which show that MS valence in those surveyed was14%. Figures released from Beijing show that the prevalence of MS in people over the age of18was14%in2010. In Xiangxi ethnic minority areas, the prevalence of MS in adults was25.9%in2012. It was also reported that the prevalence of MS in Wuhan2006,in people over the age of60was25.95%and that in Guangzhou2010it27%.MS is a series pathological state and clinical syndrome which people suffer through traditional and non-traditional cardiovascular risk factors such as obesity,hypertension, impaired glucose tolerance, hyperuricemia, lipid metabolism disorders, micro-inflammatory state. Each MS component increases the risk of cardiovascular disease, and has a synergistic. Effect between the individual components, the more risk factors grouped together, the higher the risk of cardiovascular disease will increase. The incidence of MS in special populations such as hypertension, diabetes and obesity, gout is as high as50%to80%. In2010, Mottillo analyzed and summarized87in ternational research results in a total of950,000people looking for the relationship between metabolic syndrome and cardiovascular disease morbidity and mortality risks are higher than non-metabolic syndrome crowd in patients tith metabolic syndrome, the relative risk of cardiovascular disease was2.40(95%CI12.02-2.73), the relative risk of myocardial infarction was2.99(95%CI11.61-2.46), the relative risk of cardiovascular disease mortality was2.40(95%CI11.87-3.08).The international academic community and the medical community agreed that the monitoring and prevention of MS cardiovascular events were important to the life and property of the citizens.because of its High incidence of metabolic syndrome and high-risk in cardiovascular events. With the development of medical technology and medical devices, diagnostic methods and instruments for cardiovascular disease are more and more. Coronary angiography is currently accepted valuable means of early diagnosis on cardiovascular disease.But, the technical procedure is complex, the need for catheterization is invasive examination, and there are some complications and risk, which also needs high technology,and equipment requirements, the popularity of its application in the community and grassroots is limted.ECG device is simple, easy, cheap, which is another noninvasive detection technology to cardiac electrophysiology following Holter, and abnormal ECG is the basic feature of the early diagnosis of cardiovascular disease. So far, the ECG has been the more common non-invasive examination method for the early diagnosis of cardiovascular disease, at all levels of hospitals. meanwhile it can reduce the patients’ economic burden and mental stress. P wave is on behalf of atrial depolarization wave. formed by the left and right atria depolarization. which has close relationship to atrial conduction and diameter. And the P wave broadening prompted left atrial hypertrophy or room conduction delay. P wave dispersion(Pwd) refers to the difference between the largest P wave duration and the minimum P-wave duration in synchronous12-lead ECG, When the difference is greater than40ms, suggesting that there are not homogeneous electrical activity in different parts of the atrium, and can trigger atrial arrhythmias and atrial fibrillation. Pwd is a simple, basic, noninvasive indicators to the diagnos of atrial arrhythmias, which is a new index to predicted atrial arrhythmia. in recent years, QT interval (QT)reflects ventricular action potential changes in addition to the pole and repolarization process.The QT dispersion (QTd) is the difference between the largest QT interval (QTmax) and the minimum QT interval (QTmin) in the ECG, which represented ventricular depolarization and repolarization of the whole process,is the sign of extreme differences in ventricular repolarization changes, reflects the degree of asynchronous ventricular repolarization and heart electrical instability. The prolongation of the QT interval and QTd increase reflects ventricular repolarization disorders, increased risk of ventricular arrhythmias. T he QT interval exceeds500ms is obvious abnormal, which can lead to torsades de pointes ventricular tachycardia, cardiac ejection will be significantly reduced or even stopped,Cardiac ischemia can even occur, resulting in syncope or sudden death.It has been showed that the metabolic syndrome can cause changes in the structure and function of the ventricular myocardium, resulting in various parts of repolarization heterogeneity increase, causing reentrant ventricular arrhythmias showed QTd increases.MS patients with abnormal ECG single factor related with the metabolic syndrome, central obesity, hyperlipidemia, insulin resistance, hyperuricemia can significantly prolong the QT interval.There are a large number of studies have confirmed the close relationship between metabolic syndrome and coronary heart disease, peripheral vascular disease and other cardiovascular diseases, but the subclinical metabolic syndrome and cardiovascular disease risk factors such as P wave, Pwd The QT, QTd rareresearch.The elderly are a high-risk population of the metabolic syndrome and arrhythmia, so we have to monitor the elderly metabolic syndrome with ECG QT interval and QT interval dispersion relationship. Actively control the body MS metabolic abnormalities, can reduce the QT interval prolongation incidence, an important role in the prevention of occurrence of MS cardiovascular disease.Zhuhai is a special economic zone of Chinese coastal economic which living standard is foefrant in the country. Wan Zai Community of Zhuhai is a typical local with priminal resident, which has high incidence of "diseases of affluence". In recent years. The residents less to eat breakfast, eat dinner and supper in rich, traditional Local diet transits from vegetarian to the high-fat, high-protein, high in animal foods, mainly in livestock, meat, eggs, fats and oils, vegetables, and fruits are less impressive. To detect the prevalence of metabolic syndrome(MS) and its components in elderly residents aged over65years in Zhuhai on the grand of their epidemiological data. And it’s relationship to ECG P wave dispertion (Pwd), QT dispersion (QTd). To reduce cardiovascular risk factors, to provide a reference for the prevention of cardiovascular events.The residents aged over65years old in Wanzai community, Zhuhai, were screening. The healthy information collecting, physical examination, and laboratory tests were performed. Meanwhile, standard12-lead ECG were performed for all residents and the P wave interval, Pwd, QT, and QTd intervals were evaluated, then QTc, QTcd were calculated. Also, the insulin resistance index (HOMA-IR) were estimated.Totally385elderly residents over65years old were screened. The prevalence of the metabolic syndrome was30.13%.75cases with factors affecting ECG were excluded, then a total of310residents were enrolled in the study.69cases diagnosed as metabolic syndrome were included in the metabolic syndrome group (MS group), and the remaining241cases were included in the non-metabolic syndrome group (NMS group). The difference of gender, proportion of hypertension and abdominal obesity, body mass index, blood glucose, fasting insulin, lipids, uric acid, and high-sensitivity C-reactive protein, insulin resistance, and systolic blood pressure were significant between the residents in MS group and NMS group, P<0.05or <0.001. There was no statistical difference in terms of age, diastolic blood pressure between the two groups (P>0.05). In aspect of the ECG, the heart rate, Pwd, QTc, QTd and QTcd of the residents in MS group were significantly higher than the residents in NMS group (P<0.05or<0.001), while the difference of QT interval in residents of the two groups was not statistically significant (P>0.05).Elderly residents suffering from metabolic syndrome exhibit significantly longer Pwd, QTc, QTd and QTcd. We should pay more attention to detecting this kinds of people with ECG and to preventing the arrhythmia.