[The prevalence and associated factors of metabolic syndrome among Tibetan pastoralists in transition from nomadic to settled urban environment].

Objective: To study the prevalence and associated factors of metabolic syndrome (MS) among Tibetan pastoralists in transition from high altitude nomadic to settled urbanized environment, especially dietary factors. Methods: The community-based cross-sectional study included 920 Tibetan adults (men 419, women 501). Data were collected using questionnaires, anthropometric measurements, and biomarker tests. Questionnaires included socio-economic, lifestyle characteristics and food consumption. Principal component analysis was used to identify dietary patterns. The risk factors of MS and its components were analyzed by logistic regression model. Results: The prevalence rates of MS and its components were 32.8% (MS), 83.7% (decreased HDL-C), 62.1% (central obesity), 36.7% (elevated blood pressure), 11.8% (elevated TG), and 7.9% (elevated blood glucose), respectively. The prevalence of overweight was 31.2%, obesity 30.3%. Multivariate analysis showed smoking was associated factor for both of decreased HDL-C (OR=1.239, 95%CI: 1.025-1.496) and elevated TG (OR=1.277, 95%CI: 1.038-1.571). Alcohol drinking appeared as associated factor of elevated TG (OR=1.426, 95%CI: 1.055-1.927). However, physical activity showed as a protective factor for central obesity, decreased HDL-C, and elevated TG. With the increase of age, the adherence to the urban and western dietary patterns decreased, and that to the pastoral dietary pattern increased. By quintiles of dietary pattern scores, the urban dietary pattern was significantly associated with MS (trend test P=0.016). Conclusions: Tibetan pastoralists had high prevalence of both MS and obesity. Smoking, alcohol drinking, the transition from pastoral dietary pattern to urban dietary pattern and inadequate physical activity served as associated factors for MS and its components.目的： 研究青海省从高海拔牧区搬迁定居城镇的藏族牧民中MS的流行状况及相关因素，尤其是膳食因素。 方法： 采用横断面研究，纳入920名藏族成年人（男性419名，女性501名），进行一般情况问卷调查、膳食频率调查、体格检查和生化检测。问卷调查包括社会经济、生活方式和食物消费指标。采用主成分分析鉴定膳食模式，采用logistic回归分析MS及其组分的相关因素。 结果： MS及组分的患病率分别为32.8%（MS）、83.7%（HDL-C降低）、62.1%（中心性肥胖）、36.7%（血压升高）、11.8%（TG升高）和7.9%（血糖升高）。超重率为31.2%，肥胖率为30.3%。吸烟是HDL-C降低（OR=1.239，95%CI：1.025~1.496）及TG升高（OR=1.277，95%CI：1.038~1.571）的相关因素；饮酒是TG升高（OR=1.426，95%CI：1.055~1.927）的相关因素；体力活动是中心性肥胖、HDL-C降低和TG升高的相关因素。城镇膳食和西方膳食模式依从性随年龄增长而下降，牧区传统膳食模式随年龄增长而上升。按膳食模式得分五分位数分类，城镇膳食和MS显著相关（趋势检验P=0.016）。 结论： 藏族牧民中MS及肥胖高发。吸烟、饮酒、城镇膳食模式、体力活动不足是MS及其组分的相关因素。.