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刘璐, 孙纪新, 曹亚景, 史卫卫, 唐丽娟, 崔泽. 河北省成年女性绝经前后代谢综合征患病情况及其危险因素构成[J]. 中国公共卫生, 2018, 34(11): 1511-1515. DOI: 10.11847/zgggws1119464
引用本文: 刘璐, 孙纪新, 曹亚景, 史卫卫, 唐丽娟, 崔泽. 河北省成年女性绝经前后代谢综合征患病情况及其危险因素构成[J]. 中国公共卫生, 2018, 34(11): 1511-1515. DOI: 10.11847/zgggws1119464
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Lu LIU, Ji-xin SUN, Ya-jing CAO, . Prevalence and risk factors of metabolic syndrome among pre-menopausal and post-menopausal women in Hebei province[J]. Chinese Journal of Public Health, 2018, 34(11): 1511-1515. DOI: 10.11847/zgggws1119464
Citation: Lu LIU, Ji-xin SUN, Ya-jing CAO, . Prevalence and risk factors of metabolic syndrome among pre-menopausal and post-menopausal women in Hebei province[J]. Chinese Journal of Public Health, 2018, 34(11): 1511-1515. DOI: 10.11847/zgggws1119464
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河北省成年女性绝经前后代谢综合征患病情况及其危险因素构成

Prevalence and risk factors of metabolic syndrome among pre-menopausal and post-menopausal women in Hebei province

    摘要
  • 摘要:
      目的  了解河北省成年女性绝经前、后代谢综合征（MS）的患病情况及其危险因素构成，为慢性病防控人员制定相应的综合防治措施提供参考依据。
      方法  采用多阶段随机整群抽样方法，于2015年10 — 12月在河北省13个监测点抽取3 751名≥18岁成年女性进行问卷调查、体格检查和实验室检测；应用Amos 21.0构建MS的4种因子模型，采用验证性因子分析方法对绝经前、后2组成年女性人群进行拟合评价，得出适合2组人群的危险因素模式。
      结果  河北省绝经后成年女性年龄、腰围、体质指数、腰高比、收缩压、舒张压、平均动脉压（MAP）、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和TG/HDL-C均较绝经前成年女性升高，身高较绝经前成年女性降低，差异均有统计学意义（均P < 0.05）。河北省成年女性MS患病率为26.55 %，绝经前患病率为17.63 %，绝经后患病率为45.53 %，绝经后成年女性MS患病率高于绝经前，差异有统计学意义（χ2 = 188.926，P < 0.001）。验证性因子分析结果显示，模型2与绝经前成年女性适配程度较好χ2 = 11.271，P = 0.004，残差均方和平方根（RMR）= 0.001，渐进残差均方和平方根（RMSEA）= 0.049，适配度指数（GFI）= 0.997，Akaike讯息效标（AIC）= 27.271，Bayes讯息效标（BIC）= 71.106，AIC指标调整值（CAIC）= 79.106，期望跨效度指数（ECVI）= 0.015，90 % CI ECVI = 0.011～0.024，模型1与绝经后成年女性适配程度较好（χ2 = 4.312，P = 0.116，RMR = 0.043，RMSEA = 0.024，GFI = 0.999，AIC = 20.312，BIC = 65.038，CAIC = 73.038，ECVI = 0.010，90 % CI ECVI = 0.009～0.015）。多因素分析结果显示，腰高比、TG、FPG、收缩压4个因素的单因子模型为绝经前成年女性危险因素的主要构成，其中TG因素负荷量为0.62（> 0.50），能解释模型的主要特征；腰围、TG/HDL-C、FPG和MAP 4个因素的单因子模型为绝经后成年女性危险因素的主要构成，其中腰围因素负荷量为0.56（ > 0.50），能解释模型的主要特征。
      结论  河北省绝经后成年女性MS患病率较高，且绝经前、后2组成年女性人群适用于不同因子构成的单因素模型，应根据2个人群MS患病的不同特征及早采取预防和干预措施。

     

    Abstract:
      Objective  To examine the prevalence and risk factors of metabolic syndrome (MS) among pre-menopausal and post-menopausal adult women in Hebei province and to provide references for developing comprehensive measures on chronic disease prevention and control.
      Methods  Using multistage random cluster sampling, we recruited 3 751 female residents aged 18 years and older and living in 13 counties or districts across Hebei province at least 6 months during previous one year; then we conducted a questionnaire survey, physical examination, and laboratory test among the women between October and December 2015. Four factor models of MS were firstly constructed by Amos 21.0 and then the four models were evaluated with confirmatory factor analysis (CFA) to obtain risk factor models applicable in the pre-menopausal (less than 50 years old) and post-menopausal (50 years old and older) women.
      Results  Significantly higher waist circumference (WC), body mass index (BMI), waist/height ratio (WHtR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), and high density lipoprotein cholesterol (HDL-C) but significantly lower density lipoprotein cholesterol(LDL-C) and height were observed among the post-menopausal women than among the pre-menopausal women (all P < 0.05). The MS prevalence rate was 26.55% among all the women and the prevalence rate was significantly higher among the post-menopausal women than among the pre-menopausal women (45.53% vs. 17.63% , χ2 = 188.926; P < 0.001). Confirmatory factor analysis revealed that the established model B had a better fit for pre-menopausal women (χ2 = 11.271, P = 0.004, root mean square residual RMR = 0.001, root mean square error of approximation RMSEA = 0.049, goodness-of-fit index GFI = 0.997, Akaike information criteria AIC = 27.271, Bayes information criteria BIC = 71.106, consistent Akaike information criteria CAIC = 79.106, expected cross-validation index ECVI = 0.015 and its 95% confidence interval 90% CI ECVI: 0.011 – 0.024); while the model A had a better fit for post-menopausal women (χ2 = 4.312, P = 0.11, RMR = 0.043, RMSEA = 0.024, GFI = 0.999, AIC = 20.312, BIC = 65.038, CAIC = 73.038, ECVI = 0.010 90% CI: 0.009 – 0.015). Multivariate analysis results demonstrated that WHtR, TG, FPG, and SBP were main components of MS risk factors model for pre-menopausal women, with TG as a major factor (factor loadings: 0.62 > 0.50) reflecting main characteristics of the model; whereas, WC, TG/HDL-C, FPG, and MAP were main components of MS risk factors model for post-menopausal adult women, with WC as a major factor (factor loadings: 0.56 >0.50) reflecting the main characteristics of the model.
      Conclusion  The MS prevalence is relatively high among post-menopausal women in Hebei province and different single factor models composed of different factors are applicable for pre-menopause and post-menopause women separately, suggesting that specific intervention measures on MS should be taken according to risk factor characteristics of the two population groups.

     

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