Associations Between Dynamic Changes Of Blood Indicators And Metabolic Syndrome

Objective: The objective of this study was to research the influnce of the dynamic change in blood lipid indicators and the occurrence of metabolic syndrome(MetS).These findings provided a basis for using the dynamic changes in blood lipid indicators levels to predict the development of MetS.Methods: We analysed the associations between the changes of blood lipid indicators level trends and MetS among the participants who underwent consecutive annual health check-ups during 2010~2013 and divided the subjects into two groups,people who occoured MetS and without MetS,based on whether they developed MetS during the follow-up period.The average annual changes in the blood lipid indicators TC(Total Cholesterol),TG(Triglyceride),HDL(High Density Lipoprotein),LDL(Low Density Lipoprotein)levels was compared in the two groups.To analyse the associations with the changes of blood lipid indicators level trends between people who occoured MetS and without MetS,we used a linear mixed-effects model and implemented by R.Single factor and multiple factors Logistic regression were established by SPSS17.0 to analyse the association between the average annual changes in the blood lipid indicators levels and the occurrence of MetS.Results: 1.Data Description: This study finally recruited 1070 participants,70subjects(6.54%,men 42,women 28)were diagnosed with MetS during the follow-up period.The baseline age of the 1000 subjects without MetS ranged from 21 to 70 years with a median age of 37.00(29.00,44.00)years;the baseline age of the 70 subjects with MetS ranged from 21 to 70 years with a median age of 45.00(31.00,53.00)years.TheMetS group had higher annual rates of change in the blood lipid indicators except HDL than did the group without MetS(TC P=0.041,TG P=0.001,LDL P=0.013 and HDL P=0.380).The participants who developed MetS in the different years had significantly greater annual rates of change than did members of the group without MetS.The annual rates of change of TC and TG who developed MetS in 2010 and 2011 was significantly different from the group without(TC P=0.000,TG P=0.003).2.Longitudinal Changes in blood lipid indicators:(1)A linear mixed-effect model of LLTC.The average level of LLTC was 0.929mmol/L for a 37(the median of the baseline age)year old subject without Met S and it was similar to a MetS subject with same age at baseline.The LLTC value of the subjects without MetS increased by2.11E-03mmol/L per 1-year increase in baseline age.The interaction between MetS status and baseline age was statistically significant,the LLTC value of subjects who had developed MetS decreased by 1.67E-03mmol/L per 1-year increase than the subjects without MetS in baseline age due to this interaction.Consequently,the LLTC level of older subjects who developed MetS was higher than that of younger subjects at baseline.In addition,the level of LLTC significantly increased by an average of 2.72E-03mmol/L with each additional measured time-point for subjects without Met S,but the change rate of LLTC among subjects who developed MetS was greater by an average of 5.96E-03mmol/L although interaction effect between measured time points and MetS status were not significant.(2)A linear mixed-effect model of LLTG.The mean value of LLTG was0.774mmol/L for a 37 year old subject in the group wihtout MetS at baseline.The LLTG value of subjects who developed MetS was 0.214mmol/L higher than that of the subjects wihtout Met S.The LLTG level for subjects wihtout MetS increased by an average of 5.07E-03mmol/L per 1-year increase in baseline age.The significant interaction effect between baseline age and MetS status resulted in a decrease of approximately 4.34E-03mmol/L in the LLTG level when baseline age increased by 1year among the subjects developed MetS than the subjects without MetS,the LLTG level of older subjects who developed MetS was still little higher than that of younger subjects.And for interaction term,the level of LLTG among subjects who developedMetS increased by an average of 0.036mmol/L with each additional measured time-point.(3)A linear mixed-effect model of LLDL.The average level of LLDL was1.298mmol/L for a 37 year old subject without MetS at baseline.The average level of LLDL among subjects developed MetS was 0.048mmol/L higher than that of subjects without MetS but the difference was not significant statistically.The LLDL value of the subjects without MetS increased by 5.76E-03mmol/L per 1-year increase in baseline age.The interaction between Met S status and baseline age was statistically significant,and the LLDL value of subjects who had developed MetS decreased by 5.27E-03mmol/L per 1-year increase than the subjects without MetS in baseline age due to this interaction.Moreover,in the subjects without MetS,the level of LLDL increased 8.32E-03mmol/L with the passage of each follow-up time point.Between measured time points and MetS status were also identified a significant interaction effect and for this interaction term,the level of LLDL among subjects who developed MetS increased with 0.022mmol/L greater change rate relative to subjects without MetS.(4)In the method used for a constructing linear mixed-effects model for LHDL the mean value of LHDL was 2.478mmol/L for a 37 year old male subject in the group without MetS at baseline,moreover,the LHDL level for female Met S-free subjects was 0.191mmol/L higher than male..The LHDL value of subjects who developed MetS was 0.164mmol/L lower than that of the subjects without MetS regardless of gender.The LHDL value for all subjects did not change with baseline age increasing regardless of gender.The LHDL level for male subject did not change during the follow-up period regardless of MetS status,but famle subject showed a slight increasing thrend with the change rate 8.72E-03mmol/L.The result of the equation the standardized logarithm indicators showed,LLDL levels were most changed in the baseline age and following measured time points.Both of the interaction of State and the baseline age and the interaction between State and following measured time points,LLTG levels were changed greatest.Conclusion:1.The levels of TG and LDL from the physical examination people is on rise year by year,which growing more faster in the subjects with MetS.An increase average annual change rate of TG is the significant risk factor of MetS.2.The levels of TC,TG and LDL were increasing with baseline age.But the subjects with MetS shows the higher the indicators withe the younger baseline age.In particular,the younger people should be paid more attention to the indicators and their dynamic tendency.3.The levels of HDL was not affected by the baseline age and follow-up time point.We should pay more attention to the influence on genetic factor.4.In the health management,we should not only focus on the blood indicators of one physical examination,but also take more care on the dynamic change of the indicators.Although the indicators did not exceed the normal reference interval,we should also watch out the occurrence of MetS.