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

1997年，在伦理委员会的批准下，我们开始了一项以现场为基础的队列研究，通过建立由每年健康检查数据和冠心病和中风事件组成的数据库，对1.1万人进行了研究。于1997年和2002年分别进行了生活方式问卷调查和保存冰冻血清标本用于胰岛素、瘦素、C反应蛋白等测定的问卷调查，结果表明：1)问卷调查前5年冠心病和卒中患者分别为52例和36例，其中心肌梗死15例，心绞痛14例等。就知情同意检查的病例而言，报告与其家庭医生的回答在心肌梗死、脑梗塞和蛛网膜下腔出血方面的一致性为100%。高血压、糖尿病、高脂血症、高尿酸血症的符合率均超过95%。2)20岁以后20~40岁的体重变异性为…在2000人中，与体重变化斜率或由此产生的BMI无关的更显著的预测因素是随后出现血清胰岛素和C反应蛋白水平升高以及代谢综合征(MS)，这表明从青年时期起保持恒定体重对预防动脉粥样硬化的重要性。3)尽管MS的发生与白细胞(WBC)计数和C反应蛋白的升高有关，但在3500人中，胰岛素水平与WBC计数无关。因此，胰岛素被认为通过MS的发展而导致低度炎症或动脉粥样硬化。瘦素与WBC计数的增加无关，与肥胖有关。(4)50岁及以上女性血压与咸味相似性的关联性增强，提示绝经对盐敏感性有影响。5)对2600人进行了37个月的随访，发现血清磷脂转运蛋白与血脂、体重指数呈正相关，与冠心病的发生呈负相关，与卒中无相关性。6)验证了本研究所使用的简易食物摄入量和饮食行为检查式问卷的重复性和效度。从20岁时自我报告的体重与测量的体重进行比较，证实了自我报告体重的可靠性。较少

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