史秀忠
青島阜外心血管病医院 内科
OBJECTIVE:To determine whether educational level and overweight/obesity was associated with the development of diabetes among Chinese adult men and women.METHODS:A cohort (2000-2011) of 10 704 participants aged 18-59 years (8 238 men, 2 466 women) in Qingdao Port Health Study (QPHS) were recruited in this study. The personal lifestyle, height, weight, waist circumference, resting heart rate, blood pressure, fasting blood glucose, total cholesterol, triglycerides and plasma uric acid were collected annually in a comprehensive health checkup program. Cox proportional hazards regression models were used to estimate the association of factors and incidence of diabetes.RESULTS:During 110 825 person-years of follow-up, 1 056 new onset cases (9.5 per 1 000 person-years) of diabetes were identified. With normal weight as reference, the multiple-adjusted hazard ratio (HR) (95%CI) of diabetes was 1.69(1.38-2.09) for overweight and 2.24(1.66-3.02) for obesity among men, which was 1.81(1.12-2.92) and 2.58(1.37-4.86) among women, respectively. Compared with the participants with high educational level, those with low educational level had a higher risk of diabetes (multiple-adjusted HR (95%CI): 1.43(1.11-1.86)) among men. The association was not found among women and the adjusted HR (95%CI) of diabetes was 1.56(0.89-2.76). The increased risks of low educational level were independent of mediators among men, through normal weight (P for trend = 0.0313) and overweight (P for trend = 0.0212) group but not obesity group (P for trend = 0.0957).CONCLUSION:Baseline overweight/obesity was an independent risk factor for diabetes for both men and women. Low educational level was adversely associated with incidence of diabetes through normal weight, overweight and obesity groups, with the association being substantially attenuated by mediating factors only in the obesity group among men. The association was not found among women.
PloS one 2013
OBJECTIVE:To explore the association between metabolic syndrome and atherosclerosis.METHODS:Carotid intima-media thickness (IMT) was detected and the atherosclerotic plaque was classified, graded, and scored in 358 retired males, aged 55 approximately 74, including 95 (26.6%) with metabolic syndrome (metabolic syndrome group) and 263 (73.5%) without metabolic syndrome (non-metabolic syndrome group). The correlation of IMT with every characteristic of metabolic syndrome diagnostic criteria was studied.RESULTS:The metabolic syndrome group had higher carotid IMT (0.90 mm +/- 0.12 mm versus 0.84 mm +/- 0.11 mm, P < 0.05), plaque score (3.58 mm +/- 0.44 mm vs 2.45 mm +/- 0.25 mm, P < 0.05), plaque occurrence rate (64.2% vs 47.5%, P < 0.05) and cardiovascular event morbidity (20.0% versus 12.2%, P < 0.05) compared with the non-metabolic syndrome group. IMT was significantly but weakly positively correlated with systolic blood pressure, diastolic blood pressure, glucose, and waistline (r = 0.27, r = 0.17, r = 0.17 and r = 0.12 respectively, all P < 0.05).CONCLUSION:Metabolic syndrome accelerates the course of atherosclerosis. Detecting carotid artery as early as possible by vascular ultrasound is helpful to primary prevention of cardiovascular events in the patients with metabolic syndrome.
Zhonghua yi xue za zhi 2003