The Effects Of Individual Lifestyle-intervention On Overweight, Hypertension, Dyslipidemia, And Hyperglycemia

Objective: Firstly,1316subjects whose age ranged from20to79years-old were recruited in cross-sectional study of Shijiazhuang toanalyze the significance of BMI on evaluation the metabolic syndrome in2012. Then Dietary Approaches and Weight Approaches were given tothe857subjects at high risk of metabolic syndrome or overweight amongthem as interventions. The study was conducted to determine the feasibi-lity and effects of a program of individual lifestyle-intervention on over-weight, hypertension, dyslipidemia, and hyperglycemia.Methods:A cluster sampling was conducted in Physical Examination Centerof The Second Heibei Medical University from Octomber to December in2012.1316adults were recruited in and examed on weight, diastolic andsystolic blood pressure, total cholesterol, LDL-cholesterol, triacylglycerol,glucose and HDL-cholesterol. A series of satistical methods such as riskanalyses, bivariate correlations and ROC curve in SPSS13.0were perfor-med to evaluate the significance of BMI and metabolic syndrome. ThenDietary Approaches and Weight Approaches were given to the857subjects at high risk of metabolic syndrome or overweight as interven-tions. At last,we perform Chi-square test, risk analyses and Wilcoxonsigned-rank test to test whether overweight, hypertension, dyslipidemia,and hyperglycemia can be prevented by interventions that affect the life-style as follows.1cross-sectional study in20121.1We got rid of people who were pregnant, absent from data such asblood pressure, total cholesterol, LDL-cholesterol, triacylglycerol, gluco-se and HDL-cholesterol, BMI<15kg/㎡, BMI>40kg/㎡, or being treated with antihypertensive medications, for dyslipidemia, or the use of hypog-lycemic medications.At last,1316individuals completed the survey and examination.1.2Study DesignWe recruited1316adults and performed the following analyses：⑴search for various combinations of blood pressure, total cholesterol,LDL-cholesterol, triacylglycerol, glucose and HDL-cholesterol associa-ted with the risk of clustering metabolic abnormalities.⑵calculation ofoverweight, hypertension, dyslipidemia, and hyperglycemia associatedwith age, sex and BMI.⑶evaluation with receiver operating characteristiccurve for the risk and determination of an optimal BMI cutoff.1.3Statistical Methods:Data were given as the means and standard deviations (SD) forcontinuous variables or as percentages for dichotomous variables. Statist-ical table, statistical graph, risk analyses and Chi-square test were used inqualitative variables. Linear correlation was used in data of bivariatenormal distribution in binary variables. And we assessed the predictiveimpact of BMI using receiver operating characteristic (ROC) curves for acluster of metabolic abnormalities, from which optimal cutoff valueswere obtained.2Experimental Study2.1On the basis of standards in the Physical Examination Center of TheSecond Heibei Medical University, hypertension, dyslidsmia, and hyperg-lycemia were defined as follows. Hypertension was diagnosed whensystolic blood pressure was≥140mmHg or diastolic blood pressure was≥90mmHg. Dyslidsmia was determined as HDLcholesterol≤1.10mmol/L,LDL cholesterol≥4.00mmol/L, triglyceride≥1.70mmol/L or total cholest-erol≥5.80mmol/L. Hyperglycemia was defined as glucose≥6.10mmol/L.2.2Inclusion criteria of the population in experimental studyThere were857subjects who had overwheight, hypertension, dyslip-idemia, hyperglycemia or more than one of them. 2.2Intervention MeasuresEach subject receieved Dietary Approaches and Weight Approachesas intervention about weight,total intake of fat, and increasing intake offiber and physical activity (Table.1and Table.2).2.4Control Group:the subjects in20122.5Intervention Group: the subjects in20132.6Leading Indicator: height, weight, BMI, blood pressure, total chole-sterol, LDL-cholesterol, triacylglycerol, glucose and HDL-cholesterol.2.7Sample DesignDietary Approaches and Weight Approaches were given to the857subjects at high risk of metabolic syndrome or overweight as intervene-tions. At last, we perform Chi-square test and Wilcoxon signed-rank testto test whether overweight, hypertention, dyslipidemia, and diabetes canbe prevented by interventions that affect the lifestyle.Results:1Descriptive study of cross-sectional studyA total of784men and532women were recruited in cross-sectional.Their age ranged from20to79years, and291women and349men were20-36years, whereas,241women and435men were37-79years.349men and291women were recruited in the younger, whereas,435men and241women were recruited in the older.563men and131women in BMI≥24kg/㎡, and there were221men and401women inBMI<24kg/㎡.2The distribution of abnormal indicators2.1Abnormalities of BP, CH, TG, HDL, LDL or GLU2.1.1The crude sample number of abnormalities whose TG≥1.70mmol/L,hypertension, LDL≥4.00mmol/L, CH≥5.80mmol/L, HDL≤1.10mmol/Land GLU≥6.10mmol/L was394,326,223,219,133and79, respec-tively.The abnormalities of TG only had the most people, which was11times as much as the least one. 2.1.2The largest population of abnormalities in two of the indicators was149in TG+BP. It was thirteen times as much as the smallest one in HDL+GLU.2.1.3The largest population of abnormalities in three of the indicatorswas40in TG+BP+HDL. It was twenty times as much as the smallest onein HDL+GLU+LDL.2.2The distribution of hypertension, dyslipidemia and diabetes2.2.1The population of dyslipidemia were the most.2.2.2In the composition of dyslipidemia, the number of dyslipidemiaonly was the largest accounted for61.8%. While the number of dyslipide-mia with hypertension and hyperglycemia was the least one accounted for5.54%.In the composition of hypertension, the number of hypertension withdyslipidemia was the most accounted for50.0%. While the number ofhypertension with hyperglycemia was the least accounted for3.07%.In the composition of diabetes, the number of dyslipidemia withhypertension and hyperglycemia was the most accounted for40.5%.While the number of hyperglycemia with hypertension was the leastaccounted for12.6%.2.2.3We subsequently intergrated men and women subgroup into onemodel. As a result, men had a higher risk than women in a cluster ofmetabolic abnormalities.2.2.4When BMI were categoriaed, the prevalence of MS was higher withhigher BMI for both men and women. The number of dyslipidemia, hype-rtension and hyperglycemia was578,326, and79, respecyively.The frequency of having a combination of two among hypertension,dyslipidemia and diabetes was the most.2.2.5We subsequently integrated men and women subgroups into onemodel and investigated OR for a cluster of metabolic abnormalities. As aresults, men had a higher risk than women with similar BMI.2.3For both men and women, mean blood pressure, total cholesterol, LDL-cholesterol, triacylglycerol, and glucose values were higher, where-as mean HDL-cholesterol values were lower with higher BMI. Likewise,the prevalence of hypertension, dyslipidemia and hyperglycemia werehigher with higher BMI for both men and women.3The association between BMI, age, sex and hypertension, dyslipidemia,and diabetes3.1Linear correlation was used in data of bivariate normal distribution inbinary variables. BMI, age and sex had relation with hypertension, dysli-pidemia, and hyperglycemia (r>0，P<0.05).3.2BMI levels had the relation with hypertension.3.3Age had the relation with hypertension, dyslipidemia, and hypergly-cemia. P<0.001，ORhypersention=2.30, ORdyslipidemia=1.73, ORhyperglycemia=1.89;95%CI were (1.77，2.99),(1.39，2.16) and (1.17，3.05), respectively.3.4Sex had the relation with hypertension, dyslipidemia, and hyper-glycemia. P<0.001，ORhypertension=6.84, ORdyslipidemia=4.25, ORhyperglycemia=1.74;95%CI were (4.82，9.71),(3.33，5.43) and (1.06，2.85), respectively.4BMI cutoffROC curves demonstrated that male cutoff values25.0kg/㎡werelarger than female’s(22.1kg/㎡and23.9kg/㎡) of the whole population.5Experimental Study5.1The baseline of experimental studyA total of1291subjects were recruited in experimental study.5.2Evaluation of intervention measuresThe influence of Weight Approaches in overweight, hypertension,dyslipidemia, and hyperglycemia was6.15%,42.1%,30.6%, and98.5%,respectively. The influence of Dietary Approaches in hypertension anddyslipidemia was50.0%and54.7%. The influence of Weight Approacheswith Dietary Approaches in overweight, hypertension and dyslipidemiawas75.8%,34.5%and35.3%, respectively.6Study of1291subjects6.1Qualitative study The proportion of subjects who were overweight, hypertension,dyslipidemia, and hyperglycemia but keep still in2013was30.7%,62.3%,60.4%and1.54%, respectively.6.2Quantitative studyThere was a signicicant difference in diastolic and systolic bloodpressure, total cholesterol, LDL-cholesterol, triacylglycerol and HDL-cholesterol between the control group and the intervention group.(p<0.05)7Corhort Study7.1IncidenceThe incidence of overweight in the control group and B group was10.6%and0.00%.The incidence of hypertension and dyslipidemia in the control groupand A, B,C group was4.15%,11.1%,9.24%,11.0%and23.7%,31.2%,32.1%and26.2%, respectively.7.2Evaluation of intervention measuresThe individual lifestyle-intervention could not prevent the occur-rence of hypertension and dyslipidemia in normalities.The intervention measures of only Dietary Approaches and WeightApproaches with Dietary Approaches could not prevent the occurrence ofhyperglycemia in normalities.The evaluation of Weight Approaches with Dietary Approaches wasmuch better than only Weight Approaches in overweight.The evaluation of only Dietary Approaches was the best than otherapproaches in hypertension and dyslipidemia.Conclusions:1The abnormalities of TG only had the most people, which was11ti-mes as much as the least GLU. While the largest population of abnor-malities in two of the indicators was720in TG+BP. It was twice as muchas the smallest one in HDL+GLU. And the largest population ofabnormalities in three of the indicators was40in TG+BP+HDL. It was twenty times as much as the smallest one in HDL+GLU+LDL.2The population of dyslipidemia were the most among hypertension,dyslipidemia and hyperglycemia.3The best cutofff of BMI was23.9kg/㎡,25.0kg/㎡and22.1kg/㎡inthe whole population, men and women, respectively, in ROC curve defi-nding obesity.4The influence of Weight Approaches in overweight, hypertension,dyslipidemia, and hyperglycemia was6.15%,42.1%,30.6%, and98.5%,respectively. The influence of Dietary Approaches in hypertension anddyslipidemia was50.0%and54.7%. The influence of Weight Approacheswith Dietary Approaches in overweight, hypertension and dyslipidemiawas75.8%,34.5%and35.3%, respectively.5Dietary Approaches and Weight Approaches with Dietary Approachescould not prevent the occurrence of hypertension.6The evaluation of Weight Approaches with Dietary Approaches wasmuch better than only Weight Approaches in overweight. What’s more,the evaluation of only Dietary Approaches was much better than WeightApproaches with Dietary Approaches in dyslipidemia.