Worksite cohort study for evaluation of lifestyle-related diseases risk : effect of lifestyle modification on the insulin level and the manifestation of metabolic syndrome

我们于1997年经伦理委员会批准，建立了由年度健康检查数据和冠心病（CHD）和脑卒中事件组成的数据库，开始了11,000人的基于工作地点的队列研究。1997年和2002年对调查对象的生活方式和血清冻存情况进行问卷调查，结果发现：1）调查对象前5年内自报冠心病和脑卒中分别为52例和36例，其中心肌梗死15例，心绞痛等14例;只要是在知情同意下检查的病例，心肌梗死、脑梗死和蛛网膜下腔出血的报告与家庭医生的回答一致性为100%。高血压、糖尿病、高脂血症和高尿酸血症的一致性均超过95%。2)从20岁起的20至40年间的体重变异性是一个 ...更多信息 在2，000人中，血清胰岛素和CRP水平升高以及代谢综合征（MS）的后续出现的显著预测因素，与体重变化斜率或由此产生的BMI无关，这表明从年轻时起保持恒定体重对预防动脉粥样硬化的重要性。3)虽然MS的发展与白色血细胞（WBC）计数和CRP的增加有关，但胰岛素水平与3,500人的WBC计数无关。因此，胰岛素被认为是通过MS的发展引起低度炎症或动脉粥样硬化。瘦素与独立于肥胖的WBC计数增加相关。4)在50岁或以上的女性中，血压与咸味相似性的关系加强，这表明绝经对盐敏感性的影响。5)在对2,600人进行的37个月随访中，血清磷脂转运蛋白与血脂、BMI呈强相关，与冠心病的发生呈负相关，而与脑卒中无相关性。6)本研究采用的食物摄入量和饮食行为简易检查表式问卷的重复性和效度得到证实。通过比较20岁时自我报告的体重和测量的体重，证实了自我报告的体重的可靠性。少

We started a worksite-based cohort study of 11,000 people in 1997 by constructing database consisting of annual health check-up data and affairs of coronary heart disease(CHD) and stroke under the approval of ethical committee. In 1997 and 2002,questionnaire survey on lifestyle and storage of frozen serum samples for later determination of insulin, leptin, CRP, etc was done.The following results were obtained, 1)Self-reported incident cases of CHD and stroke during the first 5 years accounted 52 and 36,respectively, including 15 myocardial infarctions, 14 angina pectoris, etc according to questionnaire survey. Consistency of the report with the answers from their family doctors was 100% for myocardial infarction, cerebral infarction and subarachnoid hemorrhage as long as cases examined under informed consent were concerned. Consistency for hypertension, diabetes, hyperlipidemia, and hyperuricemia all exceeded 95%. 2)The weight variability during 20 to 40 years since the age of 20 was a … More significant predictor of subsequent appearance of elevated serum insulin and CRP levels and metabolic syndrome(MS) independent of weight change slope or resultant BMI in 2,000 people, suggesting the importance of maintaining constant weight since the youth to prevent atherosclerosis. 3)Although the development of MS was associated with the increase in white blood cell(WBC) counts and CRP, insulin levels was not associated with the WBC counts in 3,500 people. Insulin, hence, was supposed to cause low grade inflammation or atherosclerosis through development of MS. Leptin was associated with the increase of WBC counts independently of obesity. 4)The association of blood pressure with likeness of salty taste was intensified in females aged 50 years or older, suggesting the effects of menopause on the salt sensitivity. 5)Serum phospholipids transfer protein showed strong correlations with serum lipids and BMI and an inverse correlation with the development of CHD but no correlation with that of stroke during 37 months' follow up of 2,600 people. 6)The reproducibility and validity of simple check-list type questionnaire of food intake and dietary behavior used in this study was confirmed. From the comparison of self-reported and measured weights at age 20,reliability of self-reported weights was confirmed. Less