成人血清鐵蛋白與代謝綜合征之間的關聯性分析
發(fā)布時間：2018-08-03 14:40
【摘要】：目的本研究是基于大樣本體檢人群,進行的一項橫斷面和隊列研究。旨在全面評估性別特異的血清鐵蛋白水平與代謝綜合征(metabolic syndrome,MS)之間的真實關聯。方法本研究人群來源于天津人群慢性低度炎癥與健康促進隊列。主要包括2007-2015年間在天津醫(yī)科大學總醫(yī)院健康管理中心接受常規(guī)年度體檢的人群。所有參與者自愿參加研究并簽署知情同意書。通過相關納入及排除標準,最終橫斷面研究共納入23,952名研究對象。橫斷面基礎上排除基線患有MS的人群、只有2015年體檢的人群以及隨訪期間未完成隨訪的人群,最終隊列研究共納入7,545名研究對象,平均隨訪時間為2.58年(95%置信區(qū)間:2.54-2.62)。對研究對象進行體格檢查、問卷調查以及血液生化指標測定。采用標準測量方法對各變量進行測量。MS的診斷標準使用中華醫(yī)學會糖尿病學分會在2013年制定的我國最新的MS診斷標準。對于連續(xù)變量及分類變量,分別采用方差分析及Logistic回歸分析比較MS和非MS人群的基本特征差異。采用方差分析及Logistic回歸分析,比較不同鐵蛋白五分位的人群特征差異。在橫斷面研究中,以是否患MS為因變量,性別特異的鐵蛋白五分位水平作為自變量,運用多因素Logistic回歸分析評估血清鐵蛋白水平與MS患病率之間的關系。在隊列研究中,以是否發(fā)生MS為因變量,基線性別特異的鐵蛋白五分位水平作為自變量,使用Cox比例風險回歸模型評估血清鐵蛋白水平與MS發(fā)病率之間的關系。將每個五分位的中位數作為有序變量,進行五分位的趨勢性檢驗。結果橫斷面研究結果發(fā)現,本研究人群MS的患病率為34.0%,男性MS患病率為40.9%,高于女性患病率(23.1%)。調整潛在的混雜因素,如年齡、性別、體質指數、白細胞計數、吸煙情況、飲酒情況以及家族病史(心血管疾病、高血壓、高脂血癥和糖尿病)之后,最終的調整模型結果顯示,在研究人群中,隨著血清鐵蛋白水平的升高,MS患病率逐漸升高(各五分位的比值比以及95%置信區(qū)間),分別為1.00,1.18(1.06,1.31),1.37(1.24,1.52),1.72(1.56,1.91)和2.28(2.06,2.52)(趨勢性P0.0001)。男性和女性分別分析中也觀察到類似的結果。在隊列研究中發(fā)現,MS者與非MS者在基線上的年齡分布、體檢、血生化指標以及生活習慣等方面的差別有統(tǒng)計學意義(P0.05)。根據血清鐵蛋白五分位分組分析發(fā)現男性BMI、WC、TC、TG、FBG以及HDL-C與鐵蛋白五分位數組呈現明顯的線性關聯(趨勢性P0.05),女性人群中可以觀察到類似關聯。隨訪期間該人群男性MS發(fā)病率為125/1000人年,女性發(fā)病率為56/1000人年。研究人群中,經年齡、性別、體質指數、白細胞計數、吸煙情況、飲酒情況、家族病史(心血管疾病、高血壓、高脂血癥和糖尿病)、腰圍、血壓、血糖、高密度脂蛋白膽固醇以及甘油三酯進行調整后,在不同鐵蛋白五分位組,MS的風險比(95%置信區(qū)間)為1.00,0.91(0.78,1.06),1.00(0.86,1.16),0.99(0.85,1.15)和1.07(0.93,1.24)(趨勢性P=0.13)。血清鐵蛋白水平與MS的發(fā)病沒有統(tǒng)計學關聯,在男性和女性分別分析中也觀察到類似的結果。結論橫斷面研究結果顯示,成年人群血清鐵蛋白水平與MS患病率呈正相關,然而隊列研究中經過混雜因素調整,尤其是基線甘油三酯水平調整后發(fā)現,血清鐵蛋白水平與MS的發(fā)病未見統(tǒng)計學關聯。血清鐵蛋白尚不能預測成年人MS的發(fā)生情況。今后還需要更多的研究,去探索鐵蛋白與代謝綜合征的關聯。
[Abstract]:Objective this study was based on a cross-sectional and cohort study based on a large sample of physical examination. The purpose of this study was to assess the true association between the sex specific serum ferritin level and the metabolic syndrome (MS). Methods the population of this study was derived from the chronic low degree of inflammation and health promotion in the Tianjin population, mainly including 20 People who received regular annual physical examination at the health management center of General Hospital Affiliated to Tianjin Medical University during 07-2015. All participants volunteered to participate in the study and signed informed consent. Through the relevant inclusion and exclusion criteria, a total of 23952 subjects were included in the cross-sectional study. A population of MS was excluded from the baseline on a cross-sectional basis, only 2015. A total of 7545 subjects were included in the final cohort study. The average follow-up time was 2.58 years (95% confidence interval: 2.54-2.62). A physical examination, a questionnaire, and a measurement of blood biochemical indexes were carried out on the subjects. The standard measurement method was used to measure the.MS. The standard uses the latest MS diagnostic criteria in China established by the Chinese Medical Association for diabetes in 2013. For continuous and classified variables, variance analysis and Logistic regression analysis were used to compare the basic characteristics differences between the MS and non MS groups. The variance analysis and Logistic regression analysis were used to compare the different five fraction of the ferritin. In the cross-sectional study, the relationship between serum ferritin level and the prevalence of MS was assessed in the cross-sectional study using the MS dependent variable and the gender specific ferritin five division level as the independent variable. In the cohort study, the baseline sex specific ferritin five was found if the MS was generated as the dependent variable. The Cox proportional risk regression model was used to evaluate the relationship between serum ferritin level and the incidence of MS. The median of each five Division was used as an orderly variable and a trend test was conducted in the five Division. The results of the cross-sectional study found that the prevalence rate of MS in this study was 34%, and the prevalence rate of male MS was 40.9%, Higher than female prevalence (23.1%). Adjustment of potential confounding factors, such as age, sex, body mass index, leukocyte count, smoking, drinking, and family history (cardiovascular disease, hypertension, hyperlipidemia, and diabetes), the final adjustment model showed that in the study population, with the increase of serum ferritin level, MS The prevalence rate increased gradually (the ratio of five points and 95% confidence intervals), 1.00,1.18 (1.06,1.31), 1.37 (1.24,1.52), 1.72 (1.56,1.91) and 2.28 (2.06,2.52) (trend P0.0001). Similar results were observed in the analysis of men and women. The age distribution of MS and non MS in the cohort study was found in the cohort study. The differences in blood biochemical indexes and living habits were statistically significant (P0.05). According to the group analysis of serum ferritin five subdivision, male BMI, WC, TC, TG, FBG, and HDL-C had a significant linear association with the five subarray of ferritin (trend P0.05), and a similar association could be observed in female population. During the follow-up period, the population was followed up. The incidence of male MS was 125/1000 year, and the incidence of female was 56/1000 year. The study population was adjusted by age, sex, body mass index, white blood cell count, smoking, drinking, family history (cardiovascular disease, hypertension, hyperlipidemia and diabetes), waist circumference, blood pressure, blood glucose, high density lipoprotein cholesterol and triglyceride After that, the risk ratio of MS (95% confidence interval) was 1.00,0.91 (0.78,1.06), 1 (0.86,1.16), 0.99 (0.85,1.15) and 1.07 (0.93,1.24) (trend P=0.13). The level of serum ferritin was not statistically associated with the incidence of MS, and similar results were also observed in the analysis of male sex and women. Conclusion the cross-sectional study was concluded. The results showed that serum ferritin levels were positively correlated with the prevalence of MS in the adult population. However, in the cohort study, the serum ferritin level was not statistically associated with the incidence of MS after a mix adjustment, especially the baseline triglyceride level adjustment. Serum ferritin did not yet predict the occurrence of MS in adults. More studies are needed to explore the association between ferritin and metabolic syndrome.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R589
本文編號：2162066
[Abstract]:Objective this study was based on a cross-sectional and cohort study based on a large sample of physical examination. The purpose of this study was to assess the true association between the sex specific serum ferritin level and the metabolic syndrome (MS). Methods the population of this study was derived from the chronic low degree of inflammation and health promotion in the Tianjin population, mainly including 20 People who received regular annual physical examination at the health management center of General Hospital Affiliated to Tianjin Medical University during 07-2015. All participants volunteered to participate in the study and signed informed consent. Through the relevant inclusion and exclusion criteria, a total of 23952 subjects were included in the cross-sectional study. A population of MS was excluded from the baseline on a cross-sectional basis, only 2015. A total of 7545 subjects were included in the final cohort study. The average follow-up time was 2.58 years (95% confidence interval: 2.54-2.62). A physical examination, a questionnaire, and a measurement of blood biochemical indexes were carried out on the subjects. The standard measurement method was used to measure the.MS. The standard uses the latest MS diagnostic criteria in China established by the Chinese Medical Association for diabetes in 2013. For continuous and classified variables, variance analysis and Logistic regression analysis were used to compare the basic characteristics differences between the MS and non MS groups. The variance analysis and Logistic regression analysis were used to compare the different five fraction of the ferritin. In the cross-sectional study, the relationship between serum ferritin level and the prevalence of MS was assessed in the cross-sectional study using the MS dependent variable and the gender specific ferritin five division level as the independent variable. In the cohort study, the baseline sex specific ferritin five was found if the MS was generated as the dependent variable. The Cox proportional risk regression model was used to evaluate the relationship between serum ferritin level and the incidence of MS. The median of each five Division was used as an orderly variable and a trend test was conducted in the five Division. The results of the cross-sectional study found that the prevalence rate of MS in this study was 34%, and the prevalence rate of male MS was 40.9%, Higher than female prevalence (23.1%). Adjustment of potential confounding factors, such as age, sex, body mass index, leukocyte count, smoking, drinking, and family history (cardiovascular disease, hypertension, hyperlipidemia, and diabetes), the final adjustment model showed that in the study population, with the increase of serum ferritin level, MS The prevalence rate increased gradually (the ratio of five points and 95% confidence intervals), 1.00,1.18 (1.06,1.31), 1.37 (1.24,1.52), 1.72 (1.56,1.91) and 2.28 (2.06,2.52) (trend P0.0001). Similar results were observed in the analysis of men and women. The age distribution of MS and non MS in the cohort study was found in the cohort study. The differences in blood biochemical indexes and living habits were statistically significant (P0.05). According to the group analysis of serum ferritin five subdivision, male BMI, WC, TC, TG, FBG, and HDL-C had a significant linear association with the five subarray of ferritin (trend P0.05), and a similar association could be observed in female population. During the follow-up period, the population was followed up. The incidence of male MS was 125/1000 year, and the incidence of female was 56/1000 year. The study population was adjusted by age, sex, body mass index, white blood cell count, smoking, drinking, family history (cardiovascular disease, hypertension, hyperlipidemia and diabetes), waist circumference, blood pressure, blood glucose, high density lipoprotein cholesterol and triglyceride After that, the risk ratio of MS (95% confidence interval) was 1.00,0.91 (0.78,1.06), 1 (0.86,1.16), 0.99 (0.85,1.15) and 1.07 (0.93,1.24) (trend P=0.13). The level of serum ferritin was not statistically associated with the incidence of MS, and similar results were also observed in the analysis of male sex and women. Conclusion the cross-sectional study was concluded. The results showed that serum ferritin levels were positively correlated with the prevalence of MS in the adult population. However, in the cohort study, the serum ferritin level was not statistically associated with the incidence of MS after a mix adjustment, especially the baseline triglyceride level adjustment. Serum ferritin did not yet predict the occurrence of MS in adults. More studies are needed to explore the association between ferritin and metabolic syndrome.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R589
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