本文選題：代謝綜合征 + 患病率�。� 參考：《吉林大學(xué)》2015年博士論文

【摘要】：代謝綜合征是由機(jī)體脂肪、蛋白質(zhì)及碳水化合物等代謝異常聚集而成的復(fù)雜的代謝紊亂癥候群,包括中心性肥胖、血脂代謝異常、血壓異常升高及血糖異常升高。代謝綜合征的發(fā)生與遺傳因素、生活方式、飲食習(xí)慣等密切相關(guān)�；加写x綜合征的人群,有更高的風(fēng)險(xiǎn)罹患2型糖尿病、心血管疾病、癌癥、痛風(fēng)、非酒精性脂肪肝、多囊卵巢綜合征、睡眠呼吸暫停綜合征和癡呆等疾病。目的：了解吉林省成人代謝綜合征的患病率及分布特征,分析影響代謝綜合征患病的環(huán)境危險(xiǎn)因素；探討APOA1-APOC3-APOA4-APOA5基因簇基因多態(tài)性與代謝綜合征的關(guān)聯(lián)；分析環(huán)境危險(xiǎn)因素和APOA1-APOC3-APOA4-APOA5基因簇基因的交互作用對(duì)代謝綜合征發(fā)病的影響,為探討代謝綜合征的病因?qū)W研究、制定代謝綜合征的防治策略提供依據(jù)。方法：①代謝綜合征的患病率與影響因素分析數(shù)據(jù)來(lái)源于2012年吉林省成人慢性病及其危險(xiǎn)因素調(diào)查研究。從該調(diào)查21435例有效樣本中選擇可以進(jìn)行代謝綜合征診斷的16831名常住居民作為本研究的研究對(duì)象,結(jié)合身體測(cè)量和實(shí)驗(yàn)室檢測(cè)進(jìn)行代謝綜合征的診斷及環(huán)境危險(xiǎn)因素的收集。按2010年全國(guó)第六次人口普查,吉林省人口分布情況進(jìn)行加權(quán)調(diào)整,計(jì)算吉林省代謝綜合征患病率,應(yīng)用單因素、多因素logistic回歸探討代謝綜合征相關(guān)環(huán)境危險(xiǎn)因素。②APOA1-APOC3-APOA4-APOA5基因簇基因多態(tài)性與代謝綜合征的關(guān)聯(lián)分析以第一部分研究中隨機(jī)抽取的1807名代謝綜合征患者為病例組,以排除其他代謝系統(tǒng)疾病及惡性腫瘤等嚴(yán)重軀體疾病的匹配健康人作為對(duì)照；采用飛行質(zhì)譜方法檢測(cè)基因組DNA中APOA1-APOC3-APOA4-APOA5基因簇7個(gè)SNPs的多態(tài)性,利用基于散發(fā)病例-對(duì)照研究的關(guān)聯(lián)分析方法探討APOA1-APOC3-APOA4-APOA5基因簇基因多態(tài)性與代謝綜合征的關(guān)聯(lián)。③采用多因素Logistic回歸模型分析APOA1-APOC3-APOA4-APOA5基因與環(huán)境危險(xiǎn)因素交互作用對(duì)代謝綜合征發(fā)病的影響。結(jié)果：①本研究中可進(jìn)行代謝綜合征相關(guān)診斷的有效調(diào)查問(wèn)卷共計(jì)16831份,占2012年吉林省成人慢性病及其危險(xiǎn)因素調(diào)查研究全部完訪問(wèn)卷的78.52%。經(jīng)復(fù)雜加權(quán)吉林省成人代謝綜合征的患病率為32.86%,其中男性患病率為36.64%,女性患病率為29.66%,男性高于女性(P0.05)。城市患病率為33.86%,農(nóng)村患病率為31.80%,城市高于農(nóng)村(P0.05)。②調(diào)查對(duì)象中,中心性肥胖陽(yáng)性率50.81%；血壓升高陽(yáng)性率52.18%；甘油三酯水平升高陽(yáng)性率41.18%；高密度脂蛋白膽固醇降低陽(yáng)性率31.06%；血糖水平升高陽(yáng)性率30.22%。③影響代謝綜合征患病的危險(xiǎn)因素包括高齡(OR=8.621,95%CI=6.594-11.272),從事腦力勞動(dòng)(OR:1.098,95%CI=1.008.1.195),心腦血管疾病家族史(OR=1.297, 95%CI=1.211-1.389),糖尿病家族史(OR=1.630,95%CI=1.484.1.791),現(xiàn)在吸煙(OR=1.259,95%CI=1.108-1.429),高鹽飲食(OR=1.252,95%CI=1.149-1.363),以及飲酒(OR=1.217,95%CI=1.116-1.327)等,保護(hù)因素包括女性(OR=0.723, 95%CI=0.663-0.789),水果及乳制品攝入每周超過(guò)2次等(P0.001)。④攜帶APOAlrs5072位點(diǎn)T等位基因的人群較攜帶C等位基因的人群患代謝綜合征的危險(xiǎn)性更高(ORT/C=1.617,95%CI=1.478-1.770),超顯性遺傳模式下,攜帶TC基因型人群較攜帶CC+TT基因型人群,患代謝綜合征的危險(xiǎn)性更高(ORTC/TT+CC=1.617,95%CI=1.478-1.770).APOC3rs5128位點(diǎn)的最優(yōu)遺傳模式為超顯性遺傳模式,該模式下攜帶GC基因型的人群患代謝綜合征的危險(xiǎn)性是攜帶GG+CC基因型人群的1.238倍(95%CI=1.089-1.407)。rs2854117位點(diǎn)等位基因與基因型與代謝綜合征不相關(guān)(P0.05).APOA4rs5128位點(diǎn)的最優(yōu)遺傳模式為超顯性遺傳模式,該模式下攜帶GA基因型的人群患代謝綜合征的危險(xiǎn)性是攜帶GG+AA基因型人群的1.168倍(95%CI=1.025-1.331)。攜帶APOA5rs662799位點(diǎn)G等位基因的人群較攜帶A等位基因的人群患代謝綜合征的危險(xiǎn)性更高(ORG/A=1.450,95%CI=1.312-1.602),共顯性遺傳模式下,攜帶GG基因型及攜帶GA基因型人群較攜帶AA基因型人群,患代謝綜合征的危險(xiǎn)性更高(ORGG/AA=1.232,95%CI=1.746-2.852,ORGA/AA=1.392,95%CI=1.217-1.592).攜帶APOA5rs651821位點(diǎn)C等位基因的人群較攜帶T等位基因的人群患代謝綜合征的危險(xiǎn)性更高(ORC/T=1.443,95%CI=1.306-1.594),共顯性遺傳模式下,攜帶CC基因型及攜帶TC基因型人群較攜帶TT基因型人群,患代謝綜合征的危險(xiǎn)性更高(ORCC/TT=2.253,95%CI=1.746-2.883, ORTC/TT=1.375,95%CI=1.203-1.572)。攜帶APOA5rs2075291位點(diǎn)T等位基因的人群較攜帶G等位基因的人群患代謝綜合征的危險(xiǎn)性更高(ORT/G=1.424,95%CI=1.170-1.732),顯性遺傳模式下,攜帶GT+TT基因型人群較攜帶GG基因型人群,患代謝綜合征的危險(xiǎn)性更高(ORGT+TT/GG=2.253,95%CI=1.168-1.760).⑤與甘油三酯異常升高相關(guān)的各位點(diǎn)等位基因包括rs5072位點(diǎn)T等位基因,rs5128 C等位基因,rs5104A等位基因,rs662799 G等位基因,rs651821 C等位基因和rs2075291 T等位基因(P0.05)。與甘油三酯異常升高相關(guān)的基因型包括：rs5072 TC+TT基因型,rs5128 GC+CC基因型,rs2854117 GA+AA基因型,rs5104 GA+GG基因型,rs662799 AA基因型和GA基因型,rs651821 CC基因型和TC基因型,rs2075291 GT+TT基因型(P0.05)。與高密度脂蛋白膽固醇異常降低相關(guān)的等位基因包括rs662799 G等位基因,rs651821 C等位基因,rs2075291 T等位基因(P0.05)。與高密度脂蛋白膽固醇異常降低相關(guān)的基因型包括rs5072 TC+TT基因型,rs662799 AA或GA基因型,rs651821 CC或TC基因型(P0.05)。與血壓異常升高相關(guān)的等位基因包括rs2854117 A等位基因,rs662799 G等位基因,rs651821 C等位基因和rs2075291 T等位基因(P0.05)。與血壓異常升高相關(guān)的基因型包括rs5128 GC基因型,rs5104GA基因型,rs662799 AA或GA基因型,rs651821 CC或TC基因型,rs2075291 GT+TT基因型(P0.05)。與中心性肥胖相關(guān)的等位基因包括rs662799 G等位基因,rs651821 C等位基因和rs2075291 T等位基因(P0.05),與中心性肥胖相關(guān)的相關(guān)的基因型包括rs5072 TC基因型,rs5128GC基因型,rs662799 AA或GA基因型,rs651821 CC或TC基因型,rs2075291 GT+TT基因型(P0.05)。與血糖異常升高相關(guān)的等位基因包括rs662799 G等位基因,rs651821C等位基因和rs2075291 T等位基因(P0.05)。與中心性肥胖相關(guān)的相關(guān)的基因型包括rs5072 TC基因型,rs5128GC基因型,rs5104 GA基因型,rs662799 AA或GA基因型,rs651821 CC或TC基因型和rs2075291 GT+TT基因型(P0.05)。⑥POA5rs662799位點(diǎn)與吸煙,飲酒狀況存在交互作用(PGE0.05),其它位點(diǎn)與環(huán)境因素間未見(jiàn)交互作用(PGE0.05)。結(jié)論：①吉林省代謝綜合征加權(quán)調(diào)整患病率為32.86%；男性患病率為36.64%,女性患病率為29.66%；城市患病率為33.86%,農(nóng)村患病率為31.80%。②影響代謝綜合征患病的危險(xiǎn)因素包括男性,高齡,從事腦力勞動(dòng),心腦血管疾病家族史,糖尿病家族史,現(xiàn)在吸煙,高鹽飲食,水果及乳制品攝入少以及飲酒等。③APOA1, APOC3, APOA4, APOA5基因可能是代謝綜合征的易感基因,APOA1-APOC3-APOA4-APOA5基因簇可能與代謝綜合征發(fā)病相關(guān)聯(lián)④APOA1, APOC3, APOA4, APOA5基因與代謝綜合征各異常因子存在關(guān)聯(lián),APOA1-APOC3-APOA4-APOA5基因簇可能與代謝綜合征各異常因子相關(guān)。⑤APOA5rs662799位點(diǎn)與吸煙、飲酒對(duì)代謝綜合征的發(fā)病的影響存在交互作用。
[Abstract]:Metabolic syndrome is a complex metabolic disorder syndrome characterized by abnormal metabolism of body fat , protein and carbohydrate , including central obesity , abnormal blood lipid metabolism , abnormal elevation of blood pressure and abnormal blood sugar . The occurrence of metabolic syndrome is closely related to genetic factors , lifestyle , eating habits and so on . The aim of this study is to understand the prevalence and distribution of metabolic syndrome in Jilin Province .
To investigate the association of APOA1 - APOC3 - APOA4 - APOA5 gene cluster gene polymorphism with metabolic syndrome ;
The effects of environmental risk factors and the interaction of APOA1 - APOC3 - APOA4 - APOA5 gene cluster gene on the pathogenesis of metabolic syndrome were analyzed .
The polymorphism of APOA1 - APOC3 - APOA4 - APOA5 gene cluster in genomic DNA was detected by flight mass spectrometry . The association between APOA1 - APOC3 - APOA4 - APOA5 gene cluster and metabolic syndrome was investigated by using the association analysis method based on sporadic case - control study .
The positive rate of blood pressure was 52.18 % .
The positive rate of triglyceride was 41.18 % .
The positive rate of high density lipoprotein cholesterol was 31.06 % .
There was a higher risk of metabolic syndrome ( OR = 1.259 , 95 % CI = 1.107 , 95 % CI = 1.478 - 1.770 ) . There was a higher risk of metabolic syndrome ( OR = 1.259 , 95 % CI = 1.107 , 95 % CI = 1.478 - 1.770 ) . The genotype including rs5072 TC + TT genotype , rs662799 AA or GA genotype , rs651821 CC or TC genotype , rs651821 CC or TC genotype , rs2075291 GT + TT genotype ( P0.05 ) . The genotype associated with abnormal elevation of triglyceride included rs5072 TC + TT genotype , rs651821 CC or TC genotype , rs2075291 GT + TT genotype ( P0.05 ) . The alleles associated with abnormal elevation of triglyceride include rs5072 TC + TT genotype , rs651821 CC or TC genotype , rs2075291 GT + TT genotype ( P0.05 ) . The alleles associated with abnormal elevation of blood sugar include rs662799 G allele , rs651821 CC or TC genotype , rs2075291 GT + TT genotype ( P0.05 ) . The alleles associated with abnormal elevation of blood sugar include rs662799 G allele , rs651821 CC or TC genotype , rs2075291 GT + TT genotype ( P0.05 ) . The alleles associated with abnormal elevation of blood sugar include rs662799 G allele , rs651821 CC or TC genotype , rs2075291 GT + TT genotype ( P0.05 ) . The alleles associated with abnormal elevation of blood sugar include rs662799 G allele , rs651821 CC or TC genotype , rs2075291 GT + TT genotype ( P0.05 ) . The alleles associated with abnormal elevation of blood sugar include rs662799 G allele , rs651821 CC or TC genotype , rs2075291 GT + TT genotype ( P0.05 ) . The alleles associated with abnormal elevation of blood sugar include rs662799 G allele , rs651821 CC or TC genotype , rs2075291 GT + TT genotype ( P0.05 ) . The alleles associated with abnormal elevation of blood sugar include rs662799 G allele , rs651821 CC or TC genotype , rs2075291 GT + TT genotype ( P0.05 ) . The alleles associated with abnormal elevated blood glucose levels include rs662799 G allele , rs651821 CC or TC genotype , rs2075291 GT + TT genotype ( P0.05 ) . rs651821C allele and rs2075291 T allele ( P0.05 ) . The genotype associated with central obesity included rs5072 TC genotype , rs5128GC genotype , rs5104 GA genotype , rs662799 AA or GA genotype , rs651821 CC or TC genotype and rs2075291 GT + TT genotype ( P0.05 ) .
The prevalence of male was 36.64 % and the prevalence rate was 29.66 % .
The prevalence of APOA1 , APOC3 , APOA4 and APOA5 may be associated with abnormal factors of metabolic syndrome . APOA1 , APOC3 , APOA4 and APOA5 may be associated with abnormal factors of metabolic syndrome . APOA1 - APOC3 - APOA4 - APOA5 gene cluster may be associated with abnormal factors of metabolic syndrome .

【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R589
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本文編號(hào)：1821463