Study On The Clinical Characteristics,Prevention,Treatment And Gene Polymorphism Of Metabolic Syndrome In Aircrew

Metabolic syndrome(MS) is a pathological state aggregated of multiple metabolic abnormality, including hyperglycemia, hypertension, hyperlipidemia and central obesity. And it is considered to be the alarm of type2diabetes and cardiovascular and cerebrovascular diseases. Researches showed that the prevalence of MS in different races, countries, gender, and age group was about10%～50%, generally about25%. A large cross-sectional survey showed that the prevalence of MS was13.7%in mainland of China after the age standardized. Prevalence of MS in aircrew is increasing yearly. The mechanism of MS is very complicated. It is originated from the insulin resistance(IR), but research shows that it is a syndrome influenced by many factors. Because the characteristics of the occupation, aircrew are uaually high-load, high-pressure and etc., MS is common in this crowd. But the clinical characteristics, treatment and early warning mechanism of MS in aircrew so far have not been studied systematically. This study made a survey of the prevalence and clinical characteristics, prevention and treatment and correlation of MS in aircrew. It will provide the basis for early warning, prevention and treatment and the future application of gene screening in screening pilot.In this study, we used the MS diagnostic criteria formulated by the International Diabetes Federation as diagnostic basis.Clinical characteristics of MS in aircrew:We progressed a survey of124aircrew of air-force in Beijing, including the investigation of the basic situation of the individual and some biochemical indexes detection etc.. Finally, the data was on statistics and analysis. The results show that the prevalence of metabolic syndrome in this crowd was12.90%. The value of waist circumference(WC), diastolic blood pressure(DBP), triglyceride(TG) in MS group were significantly higher than those of non-MS group(P<0.05), and high-density lipoprotein cholesterol(HDL-C) in MS group were significantly lower than those of non-MS group(P<0.05).Observation on the therapeutic effect of rosuvastatin on MS in aircrew: We assessed the aircrew coming to our hospital and in the army of Beijing by the MS diagnostic criteria. After eliminating the aircrew who had interference factors and could not participate in the experiment, finally23aircrew were chosen and randomly divided into two groups (10in treatment group and13in control group). The two groups were given intervention in changing lifestyle and were given rosuvastatin or placebo respectively. Fasting blood sugar (FBS), fasting insulin(Fins), blood lipids, high sensitive C reactive protein(hs-CRP), carotid artery intima-media thickness(CAIMT), liver and renal function were detected before the treatment and at the30th days of the treatment. The homeostasis model assessment-insulin resistance index (HOMA-IR) were calculated, and the indexes before and after treatment were compared. The results showed that the value of total cholesterol(TC), TG, low-density lipoprotein cholesterol (LDL-C), FBS, Fins and HOMA-IR after the treatment was lower than that before the treatment in treatment group(P<0.05); but there were no significant differences in blood urea nitrogen(BUN), serum creatinine(Scr), glutamic pyruvic transaminase (GPT) and glutamic oxalacetic transaminase (GOT) before and after treatment(P>0.05). The value of TG after the treatment was lower than that before the treatment in control group(P<0.05), but there were no significant differences in the value of TC, LDL-C, FBS, Fins, HOMA-IR, hs-CRP, CAIMT before and after treatment(P>0.05). The correlation between the polymorphism of insulin receptor(INSR) gene exon8Nsi I site and peroxisome proliferators activated receptor y coactivator-la(PGC-1αa) Gly482Ser site and MS in aircrew:We chose42aircrew with MS as MS group,50healthy aircrew as control group. Venous blood was drawn and genomic DNA was extracted. After adding the primer set, the INSR gene eighth exon Nsi Ⅰ site and PGC-1α gene Gly482Ser site was amplified by PCR. Then we used the restriction enzyme Nsi I and Hpa II to carry out restriction enzyme digestion of the amplified product. And then all product was separated by2%agarose gel electrophoresis to determine the genotype. And the amplified product was sent to the biotechnological company for gene sequencing. The results showed that there were significant differences in the genotypes constituent ratio of the two genes between MS group and control group(P<0.05). N2allele frequence of INSR gene and A allele frequence of PGC-1α gene of MS group were higher than that of control group (P<0.05). N2allele and A allele were influenced factors of MS in aircrem(P<0.05).So we draw the conclusion:(1) In this group of aircrew, the prevalence of MS is12.9%, and the main clinical characteristics are central obesity, DBP increased, elevated TG and HDL-C decreased. We should pay much attention to the MS in aircrew.(2) In this group of aircrew, rosuvastatin can reduce TC and LDL-C, improve IR, and not influence on liver and kidney function. Rosuvastatin is the optional medicine for aircrew with MS.(3) N2allele of INSR gene exon8Nsi I site and A allele of PGC-1α gene Gly482Ser site maybe related genes of MS in this group of aircrew. This will provide the basis for individual prevention and early warning of MS in aircrew.