Table 3.
The two-level final model for metabolic syndrome with the multilevel analysis method
| Parameter | β | Std | χ2 | P value | OR | 95% CI | Parameter | β | Std | χ2 | P value | OR | 95% CI |
| Fixed effect | |||||||||||||
| Intercept | −1.98 | 0.14 | 200.83 | 0.00 | |||||||||
| Level 2 variable | |||||||||||||
| Urbanisation rate | 0.01 | 0.00 | 5.44 | 0.02 | 1.01 | 1 to 1.01 | |||||||
| Number of doctors in healthcare institutions per 1000 population | −0.22 | 0.06 | 12.19 | 0.00 | 0.80 | 0.71 to 0.91 | |||||||
| Number of beds in medical institutions per 1000 population | 0.09 | 0.02 | 13.14 | 0.00 | 1.09 | 1.04 to 1.14 | |||||||
| Level 1 variable (the reference groups are in parentheses) | Level 1 variable (the reference groups are in parentheses) | ||||||||||||
| Year (2010） | Smoking of cigarettes (<20/day） | ||||||||||||
| 2013 | −0.04 | 0.06 | 0.40 | 0.52 | 0.97 | 0.87 to 1.08 | ≥20 /day | 0.09 | 0.06 | 2.80 | 0.09 | 1.10 | 0.98 to 1.22 |
| 2015 | −0.39 | 0.08 | 22.83 | 0.00 | 0.68 | 0.58 to 0.80 | Red meat intake (≤100 g/day) | ||||||
| 2018 | −0.30 | 0.10 | 9.57 | 0.00 | 0.74 | 0.62 to 0.90 | >100 g/day | 0.15 | 0.04 | 18.86 | 0.00 | 1.16 | 1.09 to 1.25 |
| Age, years (18–44） | Fruit or vegetable juice intake (every week) | ||||||||||||
| 45–59 | 0.69 | 0.05 | 223.70 | 0.00 | 1.99 | 1.82 to 2.18 | Intake but not every week | 0.17 | 0.08 | 4.45 | 0.03 | 1.19 | 1.01 to 1.40 |
| 60 and above | 0.69 | 0.05 | 180.40 | 0.00 | 1.98 | 1.80 to 2.19 | Never | 0.24 | 0.08 | 9.80 | 0.00 | 1.27 | 1.09 to 1.48 |
| Sex (males) | Consumption of carbonated soft drinks (every week) |
||||||||||||
| Females | 0.40 | 0.04 | 116.87 | 0.00 | 1.49 | 1.39 to 1.60 | Every month | −0.21 | 0.09 | 5.24 | 0.02 | 0.81 | 0.68 to 0.97 |
| Education (primary and lower) | Every year | −0.19 | 0.09 | 4.13 | 0.04 | 0.83 | 0.69 to 0.99 | ||||||
| Junior middle school | −0.03 | 0.04 | 0.60 | 0.44 | 0.97 | 0.90 to 1.05 | Never | −0.17 | 0.08 | 4.75 | 0.03 | 0.84 | 0.72 to 0.98 |
| Senior high school or technical (specialised) secondary school | −0.04 | 0.07 | 0.36 | 0.55 | 0.96 | 0.84 to 1.10 | Sedentary time outside of work (<1.2 hours） | ||||||
| College or above | −0.40 | 0.11 | 12.66 | 0.00 | 0.67 | 0.54 to 0.84 | 1st quartile–median, 1.2–2 | 0.01 | 0.07 | 0.01 | 0.92 | 1.01 | 0.88 to 1.15 |
| Marriage (divorced, widowed or separated) | Median–third quartile, 2–3.1 | 0.10 | 0.04 | 6.00 | 0.01 | 1.10 | 1.02 to 1.19 | ||||||
| Married or cohabiting | 0.00 | 0.06 | 0.00 | 0.96 | 1.00 | 0.90 to 1.11 | >3 rd quartile, ≥3.1 | 0.17 | 0.05 | 12.32 | 0.00 | 1.19 | 1.08 to 1.31 |
| Unmarried or single group | −0.67 | 0.12 | 32.86 | 0.00 | 0.51 | 0.41 to 0.65 | Physical activity (HEPA active) | ||||||
| Ethnicity (Han) | Minimally active | 0.21 | 0.04 | 29.83 | 0.00 | 1.24 | 1.15 to 1.34 | ||||||
| Yi | −0.06 | 0.10 | 0.34 | 0.56 | 0.94 | 0.77 to 1.15 | Insufficiently active | 0.30 | 0.04 | 50.68 | 0.00 | 1.35 | 1.24 to 1.46 |
| Other ethnic minorities | −0.32 | 0.12 | 6.58 | 0.01 | 0.73 | 0.57 to 0.93 | |||||||
| Random effect | β | Std | χ2 | P value | |||||||||
| Level 2 variance | 0.06 | 0.02 | 6.48 | 0.01 | |||||||||
| Level 1 scale parameter | 1.00 | 0.00 |
The random effect at level 2 and fixed effects at both levels were statistically significant. The results of the variables in level 2 suggested that people living in a place with relatively abundant prehospital and outpatient medical service resources, rather than places with more beds, had a relatively lower risk of metabolic syndrome (MS). The results at level 1 showed that a higher education level was an individual protective factor under the same external environmental situation. Age, female sex, excessive red meat intake, a higher frequency of carbonated soft drink consumption and longer time spent sedentarily elevated the risk of MS. Improving the human resources component of medical services, such as the number of doctors, increasing the availability of public sports facilities and E-health tools and improving individual dietary quality and education level might help prevent MS.
HEPA, health enhancing physical activity.