Altitude and metabolic syndrome in China: Beneficial effects of healthy diet and physical activity

作者：Junmin Zhou, Ruifeng He, Zhuozhi Shen, Yan Zhang, Xufang Gao, Dejiquzong, Xiong Xiao, Tao Zhang, Dan Yang, Yufei Wang, Huan Song, Yuming Guo, Shanshan Li, Gongbo Chen, Jianzhong Yin, Xing Zhao, China Multi-Ethnic Cohort (CMEC) collaborative group · 发表于：Journal of Global Health · 年份：2023 · DOI：10.7189/jogh.13.04061 · 被引用次数：13 · 研究领域：High Altitude and Hypoxia、Diabetes, Cardiovascular Risks, and Lipoproteins、Cardiovascular Health and Risk Factors

Background: The correlation between altitude and metabolic syndrome has not been extensively studied, and the mediation effects of diet and physical activity remain unclear. We evaluated the cross-sectional correlations between altitude and metabolic syndrome and the possible mediation effects of diet and physical activity in China. Methods: We included 89 485 participants from the China Multi-Ethnic Cohort. We extracted their altitude information from their residential addresses and determined if they had metabolic syndrome by the presence of three or more of the following components: abdominal obesity, reduced high-density lipoprotein cholesterol (HDL-C), elevated triglycerides, elevated glucose, and high blood pressure at recruitment. We conducted multivariable logistic regression and mediation analyses for all and separately for Han ethnic participants. Results: The participants had a mean age of 51.67 years and 60.56% were female. The risk difference of metabolic syndrome was -3.54% (95% confidence interval (CI) = -4.24, -2.86) between middle and low altitudes, -1.53% (95%CI = -2.53, -0.46) between high and low altitudes, and 2.01% (95% CI = 0.92, 3.09) between high and middle altitudes. Of the total estimated effect between middle and low altitude, the effect mediated by increased physical activity was -0.94% (95% CI = -1.04, -0.86). Compared to low altitude, the effects mediated by a healthier diet were -0.40% (95% CI = -0.47, -0.32) for middle altitude and -0.72% (95%...