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Article(id=1241322662316798855, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202307450, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1690214400000, receivedDateStr=2023-07-25, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773883985355, onlineDateStr=2026-03-19, pubDate=1706112000000, pubDateStr=2024-01-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773883985355, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773883985355, creator=13701087609, updateTime=1773883985355, updator=13701087609, issue=Issue{id=1241322661654098823, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='2', pageStart='193', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773883985198, creator=13701087609, updateTime=1773890256678, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241348966214849502, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241348966214849503, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=279, endPage=284, ext={EN=ArticleExt(id=1241322664032269194, articleId=1241322662316798855, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Gender differences of metabolic syndrome and influencing factors among elderly people in urban communities, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the prevalence and gender distinctions of metabolic syndrome in elder adults in urban communities and to provide targeted guidance on early intervention of metabolic syndrome.

Methods

The data were collected from the 2019 medical examination data of the elderly population aged 65 years or older in Qingyang District, Chengdu, China. Sociodemographic characteristics, health-related behavioral indicators, health self-assessment reports, and metabolic syndrome indicators were selected for the chi-square test and then multi-categorical logistic regression analysis using StataSE16.0 software.

Results

The prevalence of metabolic syndrome was 35.12% in total, with women (35.81%) having a higher rate compared to men (34.15%), and multifactorial regression analysis showed a higher risk for women, 70-79 years, smoking, and salt addiction. Model 2 and Model 3 regression analyses for men and women showed that partial mental partial physical labor, and maintaining exercise more than once a week were associated with a low risk of developing metabolic syndrome in old age in both male and female populations. Middle school (OR=1.27, 95% CI:1.12-1.44), High school (OR=1.26, 95% CI:1.10-1.45), smoking (OR=1.11, 95% CI:1.01-1.22), and alcohol occasionally (OR=1.15, 95%CI:1.04-1.27) were only associated with a high risk of developing metabolic syndrome in the male elderly population while education level at junior high school and above (OR=0.85, 95% CI:0.77-0.93), and satisfactory health self-assessment reports in older adults (OR=0.78, 95% CI:0.61-0.99) were only associated with a lower risk of the disease for women.

Conclusion

The prevalence of metabolic syndrome in older adults in urban communities is high, and there are significant gender differences. In the following prevention, control, and intervention work, we should strengthen personalized interventions, targeting and monitoring of key populations.

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目的

了解城市社区老年人代谢综合征现状及性别差异，为代谢综合征的防控重点及早期干预提供针对性指导。

方法

利用2019年成都市青羊区65岁及以上老年人群体检数据，选取社会人口学特征、健康相关行为指标、健康自我报告以及代谢综合征指标，按性别分组，运用StataSE16.0软件进行趋势χ2检验、χ2检验以及logistic多因素回归分析。

结果

代谢综合征总体患病率为35.12%。老年女性人群患病率(35.81%)高于男性(34.15%)，差异具有统计学意义，女性、70~79岁、吸烟以及嗜盐患病风险更高。模型2和模型3回归结果显示，部分脑力部分体力劳动者、保持每周一次以上锻炼与老年代谢综合征患病风险低相关。初中(OR=1.27，95% CI:1.12~1.44)、高中(OR=1.26，95% CI:1.10~1.45)、吸烟(OR=1.11，95% CI:1.01~1.22)、偶尔饮酒(OR=1.15，95% CI:1.04~1.27) 仅与男性老年人群患代谢综合征患病风险高相关(P<0.05)；教育水平在初中及以上(OR=0.85，95% CI:0.77~0.93)、老年人健康自评报告满意(OR=0.78，95% CI:0.61~0.99) 仅与女性患病风险低相关(P<0.05)。

结论

成都市社区老年人代谢综合征患病率较高，且具有显著的性别差异，在后续防控与干预工作中应加强个性化干预，提高针对性，加强重点人群监测。

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杨洋，E-mail：
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夏舟容（1997—），女，硕士在读，研究方向：社会医学与卫生事业管理

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Internal Medicine, 2018, 13(6): 823-826, 862., articleTitle=10-year follow-up study of lifestyle intervention on patients with metabolic syndrome, refAbstract=null)], funds=[Fund(id=1241322669585526870, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322662316798855, awardId=0040405502588, language=CN, fundingSource=成都市青羊区慢病干预研究(0040405502588), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241322664783049618, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322662316798855, xref=1., ext=[AuthorCompanyExt(id=1241322664787243923, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322662316798855, companyId=1241322664783049618, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1241322664795632533, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322662316798855, companyId=1241322664783049618, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.四川大学华西公共卫生学院/华西第四医院 健康行为与社会医学系，四川 成都 610041)]), AuthorCompany(id=1241322664854352790, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322662316798855, xref=2., ext=[AuthorCompanyExt(id=1241322664938238871, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322662316798855, companyId=1241322664854352790, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.成都市青羊区疾病预防控制中心)])], figs=[ArticleFig(id=1241322668717305887, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322662316798855, language=EN, label=Table 1, caption=

The variable assignment

, figureFileSmall=null, figureFileBig=null, tableContent=
类型变量名称赋值
因变量MetS患病情况0=未患病，1=患病
自变量性别0=男性，1=女性
年龄(岁)1=65~69，2=70~74，3=75~79，4≥80
教育水平1=小学及以下，2=初中程度，3=高中程度，4=大专及以上
职业类型0=无业，1=脑力劳动者，2=部分脑力部分体力劳动者，3=体力劳动者，4=其它
婚姻状态0=不在婚，1=在婚
医疗费用支付方式0=全自费，1=城镇职工基本医疗保险，2=城镇居民基本医疗保险，3=新农合，4=商业保险及其它补充保险
老年人健康自我报告1=不满意，2=不太满意，3=基本满意，4=满意，5=说不清楚
吸烟情况0=不吸烟，1=吸烟/已戒烟
饮酒频率0=从不喝酒，1=偶尔喝酒，2=经常喝酒，3=每天喝酒
锻炼频率0=从不锻炼，1=偶尔锻炼，2=每周一次，3=每天锻炼
膳食习惯1=荤素均衡，2=素食为主，3=荤食为主
嗜糖0=否，1=是
嗜油0=否，1=是
嗜盐0=否，1=是
), ArticleFig(id=1241322668838940711, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322662316798855, language=CN, label=表1, caption=

变量赋值

, figureFileSmall=null, figureFileBig=null, tableContent=
类型变量名称赋值
因变量MetS患病情况0=未患病，1=患病
自变量性别0=男性，1=女性
年龄(岁)1=65~69，2=70~74，3=75~79，4≥80
教育水平1=小学及以下，2=初中程度，3=高中程度，4=大专及以上
职业类型0=无业，1=脑力劳动者，2=部分脑力部分体力劳动者，3=体力劳动者，4=其它
婚姻状态0=不在婚，1=在婚
医疗费用支付方式0=全自费，1=城镇职工基本医疗保险，2=城镇居民基本医疗保险，3=新农合，4=商业保险及其它补充保险
老年人健康自我报告1=不满意，2=不太满意，3=基本满意，4=满意，5=说不清楚
吸烟情况0=不吸烟，1=吸烟/已戒烟
饮酒频率0=从不喝酒，1=偶尔喝酒，2=经常喝酒，3=每天喝酒
锻炼频率0=从不锻炼，1=偶尔锻炼，2=每周一次，3=每天锻炼
膳食习惯1=荤素均衡，2=素食为主，3=荤食为主
嗜糖0=否，1=是
嗜油0=否，1=是
嗜盐0=否，1=是
), ArticleFig(id=1241322668939604016, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322662316798855, language=EN, label=Table 2, caption=

General Characteristics of the Study Population [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量性别合计
n=(23 410)		χ2值P值
男性(n=9 724)女性(n=13 686)
年龄组(岁)37.13aP<0.001
65~693 392(34.88)5 255(38.40)8 647(36.94)
70~742 969(30.53)4 131(30.18)7 100(30.33)
75~791 876(19.29)2 520(18.41)4 396(18.78)
≥801 487(15.29)1 780(13.01)3 267(13.96)
教育水平42.86aP<0.001
小学及以下2 124(21.84)5 053(36.92)7 177(30.66)
初中程度2 914(29.97)4 218(30.82)7 132(30.47)
高中程度2 199(22.61)2 976(21.74)5 175(22.11)
大专及以上2 487(25.58)1 439(10.51)3 926(16.77)
职业类型358.35P<0.001
无业487(5.01)1 086(7.94)1 573(6.72)
脑力劳动者3 052(31.39)3 133(22.89)6 185(26.42)
部分脑力与部分体力1 543(15.87)1 715(12.53)3 258(13.92)
体力劳动者4 642(47.74)7 752(56.64)12 394(52.94)
婚姻状态695.00P<0.001
不在婚641(6.59)3 665(26.78)4 306(18.39)
在婚9 083(93.41)10 021(73.22)19 104(81.61)
医疗费用支付方式217.12P<0.001
全自费70(0.72)106(0.77)176(0.75)
城镇职工基本医疗8 081(83.10)10 313(75.35)18 394(78.57)
城镇居民基本医疗1 036(10.65)2 308(16.86)3 344(14.28)
新农合525(5.40)942(6.88)1 467(6.27)
商业保险及其他12(0.12)17(0.12)29(0.12)
老年人健康自我报告3.91aP=0.048
不满意149(1.53)288(2.10)437(1.87)
不太满意155(1.59)287(2.10)442(1.89)
基本满意2 758(28.36)3 925(28.68)6 683(28.55)
满意6 527(67.12)8 914(65.13)15 441(65.96)
说不清楚135(1.39)272(1.99)407(1.74)
吸烟情况5767.62P<0.001
从不吸烟3 916(40.27)13 443(98.22)17 359(74.15)
吸烟/已戒烟5 808(59.73)243(1.78)6 051(25.85)
饮酒频率P<0.001
从不喝酒3 690(37.95)12 245(89.47)15 935(68.07)4744.00a
偶尔喝酒3 959(40.71)1 214(8.87)5 173(22.10)
经常喝酒449(4.62)50(0.37)499(2.13)
每天喝酒1 626(16.72)177(1.29)1 803(7.7)
锻炼频率6.71aP=0.001
从不锻炼1 121(11.53)1 670(12.20)2 791(11.92)
偶尔锻炼391(4.02)649(4.74)1 040(4.44)
每周一次329(3.38)560(4.09)889(3.80)
每天锻炼7 883(81.07)10 807(78.96)18 690(79.84)
膳食习惯113.04P<0.001
荤素均衡9 208(94.69)12 723(92.96)21 931(93.68)
素食为主328(3.37)820(5.99)1 148(4.90)
荤食为主188(1.93)143(1.04)331(1.41)
嗜糖94(0.97)74(0.54)168(0.72)14.47P<0.001
嗜油141(1.45)120(0.88)261(1.11)16.94P<0.001
嗜盐250(2.57)278(2.03)528(2.26)7.51P=0.006
), ArticleFig(id=1241322669044461624, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322662316798855, language=CN, label=表2, caption=

研究对象的基本情况 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量性别合计
n=(23 410)		χ2值P值
男性(n=9 724)女性(n=13 686)
年龄组(岁)37.13aP<0.001
65~693 392(34.88)5 255(38.40)8 647(36.94)
70~742 969(30.53)4 131(30.18)7 100(30.33)
75~791 876(19.29)2 520(18.41)4 396(18.78)
≥801 487(15.29)1 780(13.01)3 267(13.96)
教育水平42.86aP<0.001
小学及以下2 124(21.84)5 053(36.92)7 177(30.66)
初中程度2 914(29.97)4 218(30.82)7 132(30.47)
高中程度2 199(22.61)2 976(21.74)5 175(22.11)
大专及以上2 487(25.58)1 439(10.51)3 926(16.77)
职业类型358.35P<0.001
无业487(5.01)1 086(7.94)1 573(6.72)
脑力劳动者3 052(31.39)3 133(22.89)6 185(26.42)
部分脑力与部分体力1 543(15.87)1 715(12.53)3 258(13.92)
体力劳动者4 642(47.74)7 752(56.64)12 394(52.94)
婚姻状态695.00P<0.001
不在婚641(6.59)3 665(26.78)4 306(18.39)
在婚9 083(93.41)10 021(73.22)19 104(81.61)
医疗费用支付方式217.12P<0.001
全自费70(0.72)106(0.77)176(0.75)
城镇职工基本医疗8 081(83.10)10 313(75.35)18 394(78.57)
城镇居民基本医疗1 036(10.65)2 308(16.86)3 344(14.28)
新农合525(5.40)942(6.88)1 467(6.27)
商业保险及其他12(0.12)17(0.12)29(0.12)
老年人健康自我报告3.91aP=0.048
不满意149(1.53)288(2.10)437(1.87)
不太满意155(1.59)287(2.10)442(1.89)
基本满意2 758(28.36)3 925(28.68)6 683(28.55)
满意6 527(67.12)8 914(65.13)15 441(65.96)
说不清楚135(1.39)272(1.99)407(1.74)
吸烟情况5767.62P<0.001
从不吸烟3 916(40.27)13 443(98.22)17 359(74.15)
吸烟/已戒烟5 808(59.73)243(1.78)6 051(25.85)
饮酒频率P<0.001
从不喝酒3 690(37.95)12 245(89.47)15 935(68.07)4744.00a
偶尔喝酒3 959(40.71)1 214(8.87)5 173(22.10)
经常喝酒449(4.62)50(0.37)499(2.13)
每天喝酒1 626(16.72)177(1.29)1 803(7.7)
锻炼频率6.71aP=0.001
从不锻炼1 121(11.53)1 670(12.20)2 791(11.92)
偶尔锻炼391(4.02)649(4.74)1 040(4.44)
每周一次329(3.38)560(4.09)889(3.80)
每天锻炼7 883(81.07)10 807(78.96)18 690(79.84)
膳食习惯113.04P<0.001
荤素均衡9 208(94.69)12 723(92.96)21 931(93.68)
素食为主328(3.37)820(5.99)1 148(4.90)
荤食为主188(1.93)143(1.04)331(1.41)
嗜糖94(0.97)74(0.54)168(0.72)14.47P<0.001
嗜油141(1.45)120(0.88)261(1.11)16.94P<0.001
嗜盐250(2.57)278(2.03)528(2.26)7.51P=0.006
), ArticleFig(id=1241322669128347709, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322662316798855, language=EN, label=Table 3, caption=

The prevalence of metabolic syndrome and its components [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
MetS及其组分总体检出(%)男性检出(%)女性检出(%)χ2值P值
MetS8 222(35.12)3 321(34.15)4 901(35.81)6.86P=0.009
中心性肥胖10 197(43.56)3 834(39.43)6 363(46.49)115.40P<0.001
高甘油三酯8 250(35.24)2 954(30.38)5 296(38.70)172.35P<0.001
低HDL_C3 011(12.86)1 810(18.61)1 201(8.78)490.96P<0.001
血压异常17 181(73.39)7 127(73.29)10 054(73.46)0.08P=0.773
血糖异常9 340(39.90)3 992(41.05)5 348(39.08)9.26P=0.002
), ArticleFig(id=1241322669287731269, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322662316798855, language=CN, label=表3, caption=

不同性别MetS及其组分的患病率比较 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
MetS及其组分总体检出(%)男性检出(%)女性检出(%)χ2值P值
MetS8 222(35.12)3 321(34.15)4 901(35.81)6.86P=0.009
中心性肥胖10 197(43.56)3 834(39.43)6 363(46.49)115.40P<0.001
高甘油三酯8 250(35.24)2 954(30.38)5 296(38.70)172.35P<0.001
低HDL_C3 011(12.86)1 810(18.61)1 201(8.78)490.96P<0.001
血压异常17 181(73.39)7 127(73.29)10 054(73.46)0.08P=0.773
血糖异常9 340(39.90)3 992(41.05)5 348(39.08)9.26P=0.002
), ArticleFig(id=1241322669384200263, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322662316798855, language=EN, label=Table 4, caption=

Logistic regression analysis of Metabolic Syndrome among elderly people in urban communities

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人群(模型1)男性人群(模型2)女性人群(模型3)
OR(95% CI)P值OR(95% CI)P值OR(95% CI)P值
女性(参照组：男性)1.10(1.02,1.20)0.0151.001.00
年龄组(岁,参照组：65~69岁)1.001.001.00
70~741.17(1.09,1.25)P<0.0011.10(0.99,1.22)0.0851.22(1.12,1.33)P<0.001
75~791.21(1.12,1.31)P<0.0011.04(0.92,1.18)0.5201.35(1.22,1.50)P<0.001
≥801.08(0.98,1.18)0.1070.93(0.81,1.07)0.3311.21(1.07,1.36)0.002
教育水平(参照组：小学及以下)1.001.001.00
初中程度0.96(0.89,1.03)0.2281.27(1.12,1.44)P<0.0010.85(0.77,0.93)0.001
高中程度0.87(0.80,0.95)0.0011.26(1.10,1.45)0.0010.71(0.63,0.79)P<0.001
大专及以上0.84(0.76,0.92)P<0.0011.13(0.98,1.30)0.1010.68(0.59,0.78)P<0.001
职业类型(参照组：无业)1.001.001.00
脑力劳动者0.90(0.79,1.02)0.0910.78(0.63,0.97)0.0241.00(0.85,1.17)0.975
部分脑体0.81(0.71,0.93)0.0030.76(0.61,0.96)0.0190.83(0.70,0.99)0.034
体力劳动者1.03(0.92,1.15)0.5950.90(0.73,1.10)0.3011.12(0.98,1.28)0.109
婚姻状态(参照组：不在婚)1.001.001.00
在婚1.00(0.93,1.08)0.9480.97(0.81,1.15)0.6941.05(0.96,1.14)0.299
医疗费用支付方式(参照组：全自费)1.001.001.00
城镇职工基本医疗1.16(0.85,1.59)0.3581.16(0.70,1.94)0.5611.14(0.76,1.7)0.537
城镇居民基本医疗1.05(0.76,1.44)0.770.99(0.59,1.67)0.9681.05(0.70,1.58)0.812
新农合0.85(0.61,1.18)0.3230.59(0.34,1.02)0.0570.97(0.64,1.49)0.905
商业保险及其他0.63(0.26,1.57)0.3260.37(0.07,1.85)0.2280.85(0.28,2.63)0.784
老年人健康自我报告(参照组：不满意)1.001.001.00
不太满意1.18(0.90,1.54)0.2291.07(0.67,1.70)0.7761.27(0.91,1.77)0.160
基本满意0.82(0.67,1.00)0.0460.87(0.62,1.22)0.4130.79(0.62,1.01)0.061
满意0.78(0.64,0.95)0.0150.80(0.57,1.13)0.2050.78(0.61,0.99)0.043
说不清楚0.93(0.70,1.22)0.5951.13(0.70,1.83)0.6210.85(0.60,1.20)0.352
吸烟情况(参照组：从不吸烟)1.001.001.00
吸烟/已戒烟1.09(1.00,1.2)0.0441.11(1.01,1.22)0.0340.87(0.66,1.14)0.32
饮酒频率(参照组：从不喝酒)1.001.001.00
偶尔喝酒1.07(0.99,1.16)0.0831.15(1.04,1.27)0.0080.94(0.83,1.07)0.380
经常喝酒0.99(0.81,1.21)0.9301.06(0.86,1.31)0.5810.81(0.44,1.48)0.491
每天喝酒0.95(0.85,1.07)0.4161.02(0.89,1.17)0.7780.98(0.72,1.34)0.899
锻炼频率(参照组：从不锻炼)1.001.001.00
偶尔锻炼0.88(0.76,1.02)0.0980.96(0.76,1.22)0.7580.84(0.69,1.01)0.069
每周一次0.74(0.63,0.87)P<0.0010.74(0.57,0.96)0.0210.74(0.60,0.90)0.003
每天锻炼0.77(0.71,0.84)P<0.0010.75(0.66,0.86)P<0.0010.78(0.70,0.87)P<0.001
膳食习惯分组(参照组：荤素均衡)1.001.001.00
素食为主1.11(0.98,1.26)0.0891.02(0.80,1.29)0.8821.15(0.99,1.33)0.070
荤食为主1.02(0.81,1.28)0.8620.97(0.71,1.32)0.8251.10(0.78,1.55)0.586
是否嗜糖(参照组：否)1.001.001.00
是0.55(0.39,0.79)0.0010.47(0.28,0.77)0.0030.69(0.41,1.14)0.147
是否嗜油(参照组：否)1.001.001.00
是1.09(0.84,1.43)0.5071.09(0.75,1.59)0.6351.08(0.73,1.60)0.689
是否嗜盐(参照组：否)1.001.001.00
是1.45(1.20,1.75)P<0.0011.69(1.28,2.23)P<0.0011.31(1.01,1.68)0.039
), ArticleFig(id=1241322669472280652, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322662316798855, language=CN, label=表4, caption=

城市社区老年人MetS的多因素logistic分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人群(模型1)男性人群(模型2)女性人群(模型3)
OR(95% CI)P值OR(95% CI)P值OR(95% CI)P值
女性(参照组：男性)1.10(1.02,1.20)0.0151.001.00
年龄组(岁,参照组：65~69岁)1.001.001.00
70~741.17(1.09,1.25)P<0.0011.10(0.99,1.22)0.0851.22(1.12,1.33)P<0.001
75~791.21(1.12,1.31)P<0.0011.04(0.92,1.18)0.5201.35(1.22,1.50)P<0.001
≥801.08(0.98,1.18)0.1070.93(0.81,1.07)0.3311.21(1.07,1.36)0.002
教育水平(参照组：小学及以下)1.001.001.00
初中程度0.96(0.89,1.03)0.2281.27(1.12,1.44)P<0.0010.85(0.77,0.93)0.001
高中程度0.87(0.80,0.95)0.0011.26(1.10,1.45)0.0010.71(0.63,0.79)P<0.001
大专及以上0.84(0.76,0.92)P<0.0011.13(0.98,1.30)0.1010.68(0.59,0.78)P<0.001
职业类型(参照组：无业)1.001.001.00
脑力劳动者0.90(0.79,1.02)0.0910.78(0.63,0.97)0.0241.00(0.85,1.17)0.975
部分脑体0.81(0.71,0.93)0.0030.76(0.61,0.96)0.0190.83(0.70,0.99)0.034
体力劳动者1.03(0.92,1.15)0.5950.90(0.73,1.10)0.3011.12(0.98,1.28)0.109
婚姻状态(参照组：不在婚)1.001.001.00
在婚1.00(0.93,1.08)0.9480.97(0.81,1.15)0.6941.05(0.96,1.14)0.299
医疗费用支付方式(参照组：全自费)1.001.001.00
城镇职工基本医疗1.16(0.85,1.59)0.3581.16(0.70,1.94)0.5611.14(0.76,1.7)0.537
城镇居民基本医疗1.05(0.76,1.44)0.770.99(0.59,1.67)0.9681.05(0.70,1.58)0.812
新农合0.85(0.61,1.18)0.3230.59(0.34,1.02)0.0570.97(0.64,1.49)0.905
商业保险及其他0.63(0.26,1.57)0.3260.37(0.07,1.85)0.2280.85(0.28,2.63)0.784
老年人健康自我报告(参照组：不满意)1.001.001.00
不太满意1.18(0.90,1.54)0.2291.07(0.67,1.70)0.7761.27(0.91,1.77)0.160
基本满意0.82(0.67,1.00)0.0460.87(0.62,1.22)0.4130.79(0.62,1.01)0.061
满意0.78(0.64,0.95)0.0150.80(0.57,1.13)0.2050.78(0.61,0.99)0.043
说不清楚0.93(0.70,1.22)0.5951.13(0.70,1.83)0.6210.85(0.60,1.20)0.352
吸烟情况(参照组：从不吸烟)1.001.001.00
吸烟/已戒烟1.09(1.00,1.2)0.0441.11(1.01,1.22)0.0340.87(0.66,1.14)0.32
饮酒频率(参照组：从不喝酒)1.001.001.00
偶尔喝酒1.07(0.99,1.16)0.0831.15(1.04,1.27)0.0080.94(0.83,1.07)0.380
经常喝酒0.99(0.81,1.21)0.9301.06(0.86,1.31)0.5810.81(0.44,1.48)0.491
每天喝酒0.95(0.85,1.07)0.4161.02(0.89,1.17)0.7780.98(0.72,1.34)0.899
锻炼频率(参照组：从不锻炼)1.001.001.00
偶尔锻炼0.88(0.76,1.02)0.0980.96(0.76,1.22)0.7580.84(0.69,1.01)0.069
每周一次0.74(0.63,0.87)P<0.0010.74(0.57,0.96)0.0210.74(0.60,0.90)0.003
每天锻炼0.77(0.71,0.84)P<0.0010.75(0.66,0.86)P<0.0010.78(0.70,0.87)P<0.001
膳食习惯分组(参照组：荤素均衡)1.001.001.00
素食为主1.11(0.98,1.26)0.0891.02(0.80,1.29)0.8821.15(0.99,1.33)0.070
荤食为主1.02(0.81,1.28)0.8620.97(0.71,1.32)0.8251.10(0.78,1.55)0.586
是否嗜糖(参照组：否)1.001.001.00
是0.55(0.39,0.79)0.0010.47(0.28,0.77)0.0030.69(0.41,1.14)0.147
是否嗜油(参照组：否)1.001.001.00
是1.09(0.84,1.43)0.5071.09(0.75,1.59)0.6351.08(0.73,1.60)0.689
是否嗜盐(参照组：否)1.001.001.00
是1.45(1.20,1.75)P<0.0011.69(1.28,2.23)P<0.0011.31(1.01,1.68)0.039
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成都市社区老年人代谢综合征现状及影响因素的性别差异研究
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夏舟容 1 , 付林 1 , 蔡鹏 2 , 彭长燕 2 , 杨洋 1
现代预防医学 | 基层卫生服务 2024,51(2): 279-284
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现代预防医学 | 基层卫生服务 2024, 51(2): 279-284
成都市社区老年人代谢综合征现状及影响因素的性别差异研究
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夏舟容1, 付林1, 蔡鹏2, 彭长燕2, 杨洋1
作者信息
  • 1.四川大学华西公共卫生学院/华西第四医院 健康行为与社会医学系，四川 成都 610041
  • 2.成都市青羊区疾病预防控制中心

    • 夏舟容（1997—），女，硕士在读，研究方向：社会医学与卫生事业管理

通讯作者:

杨洋，E-mail：
Gender differences of metabolic syndrome and influencing factors among elderly people in urban communities
Zhou-rong XIA1, Lin FU1, Peng CAI2, Chang-yan PENG2, Yang YANG1
Affiliations
  • Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2024-01-25 doi: 10.20043/j.cnki.MPM.202307450
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摘要
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目的

了解城市社区老年人代谢综合征现状及性别差异，为代谢综合征的防控重点及早期干预提供针对性指导。

方法

利用2019年成都市青羊区65岁及以上老年人群体检数据，选取社会人口学特征、健康相关行为指标、健康自我报告以及代谢综合征指标，按性别分组，运用StataSE16.0软件进行趋势χ2检验、χ2检验以及logistic多因素回归分析。

结果

代谢综合征总体患病率为35.12%。老年女性人群患病率(35.81%)高于男性(34.15%)，差异具有统计学意义，女性、70~79岁、吸烟以及嗜盐患病风险更高。模型2和模型3回归结果显示，部分脑力部分体力劳动者、保持每周一次以上锻炼与老年代谢综合征患病风险低相关。初中(OR=1.27，95% CI:1.12~1.44)、高中(OR=1.26，95% CI:1.10~1.45)、吸烟(OR=1.11，95% CI:1.01~1.22)、偶尔饮酒(OR=1.15，95% CI:1.04~1.27) 仅与男性老年人群患代谢综合征患病风险高相关(P<0.05)；教育水平在初中及以上(OR=0.85，95% CI:0.77~0.93)、老年人健康自评报告满意(OR=0.78，95% CI:0.61~0.99) 仅与女性患病风险低相关(P<0.05)。

结论

成都市社区老年人代谢综合征患病率较高，且具有显著的性别差异，在后续防控与干预工作中应加强个性化干预，提高针对性，加强重点人群监测。

城市社区  /  代谢综合征  /  老年人  /  性别差异；
Objective

To explore the prevalence and gender distinctions of metabolic syndrome in elder adults in urban communities and to provide targeted guidance on early intervention of metabolic syndrome.

Methods

The data were collected from the 2019 medical examination data of the elderly population aged 65 years or older in Qingyang District, Chengdu, China. Sociodemographic characteristics, health-related behavioral indicators, health self-assessment reports, and metabolic syndrome indicators were selected for the chi-square test and then multi-categorical logistic regression analysis using StataSE16.0 software.

Results

The prevalence of metabolic syndrome was 35.12% in total, with women (35.81%) having a higher rate compared to men (34.15%), and multifactorial regression analysis showed a higher risk for women, 70-79 years, smoking, and salt addiction. Model 2 and Model 3 regression analyses for men and women showed that partial mental partial physical labor, and maintaining exercise more than once a week were associated with a low risk of developing metabolic syndrome in old age in both male and female populations. Middle school (OR=1.27, 95% CI:1.12-1.44), High school (OR=1.26, 95% CI:1.10-1.45), smoking (OR=1.11, 95% CI:1.01-1.22), and alcohol occasionally (OR=1.15, 95%CI:1.04-1.27) were only associated with a high risk of developing metabolic syndrome in the male elderly population while education level at junior high school and above (OR=0.85, 95% CI:0.77-0.93), and satisfactory health self-assessment reports in older adults (OR=0.78, 95% CI:0.61-0.99) were only associated with a lower risk of the disease for women.

Conclusion

The prevalence of metabolic syndrome in older adults in urban communities is high, and there are significant gender differences. In the following prevention, control, and intervention work, we should strengthen personalized interventions, targeting and monitoring of key populations.

Urban community  /  Metabolic Syndrome  /  Elderly people  /  Sexual disparity
夏舟容, 付林, 蔡鹏, 彭长燕, 杨洋. 成都市社区老年人代谢综合征现状及影响因素的性别差异研究. 现代预防医学, 2024 , 51 (2) : 279 -284 . DOI: 10.20043/j.cnki.MPM.202307450
Zhou-rong XIA, Lin FU, Peng CAI, Chang-yan PENG, Yang YANG. Gender differences of metabolic syndrome and influencing factors among elderly people in urban communities[J]. Modern Preventive Medicine, 2024 , 51 (2) : 279 -284 . DOI: 10.20043/j.cnki.MPM.202307450
正文
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代谢综合征(Metabolic Syndrome, MetS)诊断标准[1]在各国各地区各有不同，但通常具有以下共识：腹型肥胖、高甘油三酯、低高密度脂蛋白(HDL-C)、血压以及血糖异常。
既往研究更多关注MetS的流行现状及危险因素分析[2]，本研究发现不同国家发表的报告对MetS的性别分布情况存在差异[3]，与男性相比，女性MetS患病率与年龄相关的增加幅度更大[4]。但少有研究进一步分析原因。本研究基于成都市青羊区开展的国家基本公共卫生服务，深入探讨MetS性别差异及其影响因素，为改善老年人群MetS状况提供精准防控的科学依据，促进健康老龄化。
1　对象与方法
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1.1　研究对象
本研究数据来自于参加2019年成都市青羊区国家公共卫生服务项目体检的老年人群，删除关键指标缺失即缺少MetS五项诊断标准任一条目的样本10 284例，共纳入65岁及以上研究对象23 410例，男性对象9 724人，女性对象13 686人。该体检数据主要收集研究对象的一般状况、生活方式、体格检查、实验室检查以及健康评价与指导等内容。本研究经四川大学华西第四医院/华西公共卫生学院伦理委员会审批通过(批件号：Gwll2021065)。
1.2　诊断标准
本研究的MetS诊断标准参照中华医学会糖尿病学分会发布的《中国2型糖尿病防治指南(2020年版)》[5-6]：以下五项标准达到三项及以上即可诊断为MetS：(1)腹型肥胖(即中心型肥胖)：腰围男性≥90 cm，女性≥85 cm；(2)高血糖：空腹血糖≥ 6.1 mmol/L或糖负荷后2h血糖≥7.8mmol/L和(或)已确诊为糖尿病并治疗者；(3)高血压：血压≥130/85 mmHg(1 mmHg=0.133 kPa)和(或)已确认为高血压并治疗者；(4)空腹TG≥ 1.70 mmol/L；(5)空腹HDL-C<1.04 mmol/L。
1.3　变量筛选
纳入模型的变量包括(1)社会人口学特征：性别、年龄、教育水平、职业类型、婚姻状态和医疗费用的支付方式等。(2)老年人健康自我报告(3)健康行为，包括吸烟情况、饮酒频率、锻炼频率、膳食习惯、是否嗜糖、是否嗜油、是否嗜盐。变量赋值见表1。
1.4　统计分析
采用StataSE 16.0统计分析软件。趋势χ2检验、χ2检验作组间比较分析，logistic多因素回归分析影响因素。
2　结果
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2.1　研究对象的一般情况
本次研究中共有23 410名调查对象，男性9 724人，占41.54%，女性13 686人，占58.46%。男性与女性的年龄、教育程度、职业类型、婚姻状态、医疗费用支付方式、健康自我报告报告以及健康行为方面的构成比差异均具有统计学意义(P<0.05)。健康行为上，男性人群中吸烟、饮酒、每天锻炼者的比例高于女性(P<0.001)；饮食情况上，男性人群中膳食习惯为荤素均衡、荤食为主、嗜糖、嗜油以及嗜盐者构成比高于女性，且差异具有统计学意义(P<0.01)。具体见表2。
2.2　老年MetS及其组分患病情况
本研究，MetS总人群患病率为35.12%，MetS女性检出人数为4 901(35.81%)高于男性检出人数3 321人(34.15%)，差异具有统计学意义(P=0.009)。
MetS各组分患病情况如下：男性的中心性肥胖率为39.43%低于女性46.48%(P<0.001)、男性高甘油三酯率30.48%低于女性的38.7%(P<0.001)，低HDL_C率18.61%高于女性的8.78%(P<0.001)，男性血糖异常率41.05%显著高于女性39.08%(P=0.002)，血压异常率方面，两组差异无统计学意义(P=0.773)。具体见表3。
2.3　年人MetS影响因素的多因素回归分析
模型1分析总人群MetS的患病风险，结果显示，女性(OR=1.10)、70-79岁(OR=1.17、1.21)、吸烟(OR=1.09) 以及嗜盐(OR=1.45)患病风险更高，差异具有统计学意义(P<0.05)。模型2和模型3分别对男性和女性进行分组回归分析，结果显示，职业类型为部分脑力劳动部分体力劳动(男性OR=0.76，女性OR=0.83)、保持每周一次以上锻炼(男性OR=0.74、0.75，女性OR=0.74、0.78)都与其老年MetS患病风险低相关，差异具有统计学意义(P<0.05)。两组差异主要在：教育水平为初中(OR=1.27)以及高中(OR=1.26)、吸烟(OR=1.11)、偶尔饮酒(OR=1.15)仅与男性老年人群患MetS风险高相关(P<0.05)，相较于65~69岁的老年人，年龄在70岁以上(OR=1.22、1.35、1.21)对女性来说，其患MetS的风险更高(P<0.01)，教育水平在初中及以上(OR=0.85、0.71、0.68)、老年人健康自我报告报告满意(OR=0.78)仅与女性患病风险低相关(P<0.05)。见表4。
3　讨论
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MetS其组分既是危险因素又是疾病[4]，而男性与女性之间生理上的差异以及明显不同的生活方式等都对MetS的精准防控提出了更高的要求。
本研究结果显示，在社会人口学因素方面，女性人群与男性人群相比，教育水平偏低、无业更多、不在婚的比例更高、在医疗费用支付方式上全自费以及参加城镇居民基本医疗保险的比例更高、健康自我报告偏向不满意的比例更高，这可能反映了女性社会经济水平相较于男性更低，而健康意识差，患病的风险更大。从健康相关行为来看，吸烟与饮酒仅与男性老年人群患MetS患病风险高相关，有研究认为[7]，男性与女性社会分工不同会对其行为方式产生影响，例如男性人群在吸烟与饮酒方面的比例远高于女性，这也可能是在回归分析中男性人群回归模型对总模型的影响更明显的原因。
该区65岁老年人群中MetS的患病率为35.1%，与其他研究相比偏高[8-14],这一差异除了受地域、经济因素等影响，可能也与本文参照选用的MetS诊断标准有关。分组结果显示，随着年龄增长，女性患MetS风险逐渐上升，男性患病风险并无明显差异。在本研究中女性中心性肥胖率、高甘油三酯以及血糖异常率明显高于男性，这与大多数研究结果一致。出现这一性别差异，有研究认为[15]随着年龄增长，与男性相比，女性尤其是围绝经期女性体内雌激素水平变化会影响身体脂肪的分布，例如腹部脂肪堆积，腰围增长导致MetS的发生。这提示性激素水平变化导致的血脂异常[16-17]可能与女性MetS患病率随年龄增长而增加幅度更大有关。
综上所述，MetS发病复杂隐匿，且老年人群本身存在不同程度的机体功能退化，因此除了膳食营养[18-19]、运动以及生活方式[20]指导等传统干预以外，综合性别差异，应该针对不同人群个性化干预[21]。例如重点人群监测与综合化措施相结合，重点关注女性人群尤其是高龄女性的中心性肥胖问题，开展社区体育锻炼活动，推出女性雌激素检测提早发现风险；多种途径加强对老年男性人群的健康教育，提高其健康认知，改善生活方式，加大对血压、血糖、血脂的管理宣传与防控力度；以及完善社区老年人群的健康档案，加强多团队多学科联合的综合性指导，最大程度实现个性化干预。
基金
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  • 成都市青羊区慢病干预研究(0040405502588)
文献
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2024年第51卷第2期
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doi: 10.20043/j.cnki.MPM.202307450
  • 接收时间：2023-07-25
  • 首发时间：2026-03-19
  • 出版时间：2024-01-25
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  • 收稿日期：2023-07-25
基金
成都市青羊区慢病干预研究(0040405502588)
作者信息
    1.四川大学华西公共卫生学院/华西第四医院 健康行为与社会医学系，四川 成都 610041
    2.成都市青羊区疾病预防控制中心

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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