Nakanishi Noriyuki, Takatorige Toshio, Fukuda Hideki, Shirai Kokoro, Li Wenjuan, Okamoto Mitsuharu, Yoshida Hiroshi, Matsuo Yoshio, Suzuki Kenji, Tatara Kozo
Department of Social and Environmental Medicine, Course of Social Medicine, Osaka University Graduate School of Medicine F2, 2-2 Yamada-oka, Suita-shi, Osaka 565-0871, Japan.
Diabetes Res Clin Pract. 2004 Apr;64(1):59-70. doi: 10.1016/j.diabres.2003.10.001.
To determine whether the clustered features of the metabolic syndrome precede the 7 year incidence of cardiovascular disease (CVD) and type 2 diabetes, we examined 6182 Japanese male office workers aged 35-59 years without any history of CVD. The 5588 subjects without type 2 diabetes also constituted the nondiabetic cohort, and were re-examined over seven successive years. Components of the metabolic syndrome included glycemic disorder (type 2 diabetes for the risk of CVD and impaired fasting glucose for the risk of type 2 diabetes), systemic obesity, hypertension, dyslipidemia, proteinuria, and elevated white blood cell (WBC) count. After controlling for age, family history of diabetes, alcohol intake, and cigarette smoking, the multivariate-adjusted relative risk of incidence of CVD compared with absence of components was 3.18, 3.48, 12.55, and 14.15 (P for trend <0.001), for the presence of 1,2,3, and > or =4 components, respectively. The corresponding relative risks of incidence of type 2 diabetes were 1.92, 4.36, 6.44, and 15.08 (P for trend <0.001). In both non-smokers and current smokers, the multivariate-adjusted relative risks of incidence of CVD and type 2 diabetes increased as the number of components increased (P for trend <0.001 for all). Our findings indicate that clustered features of the metabolic syndrome are closely associated with development of CVD and type 2 diabetes in middle-aged Japanese.
为了确定代谢综合征的聚集特征是否先于心血管疾病（CVD）和2型糖尿病的7年发病率，我们对6182名年龄在35 - 59岁、无CVD病史的日本男性上班族进行了检查。5588名无2型糖尿病的受试者也构成了非糖尿病队列，并连续7年接受复查。代谢综合征的组成部分包括血糖紊乱（CVD风险为2型糖尿病，2型糖尿病风险为空腹血糖受损）、全身性肥胖、高血压、血脂异常、蛋白尿和白细胞（WBC）计数升高。在控制了年龄、糖尿病家族史、饮酒量和吸烟情况后，与无这些组分相比，存在1、2、3和≥4个组分时，CVD发病的多变量调整相对风险分别为3.18、3.48、12.55和14.15（趋势P<0.001）。2型糖尿病发病的相应相对风险分别为1.92、4.36、6.44和15.08（趋势P<0.001）。在不吸烟者和当前吸烟者中，CVD和2型糖尿病发病的多变量调整相对风险均随着组分数量的增加而增加（所有趋势P<0.001）。我们的研究结果表明，代谢综合征的聚集特征与中年日本人CVD和2型糖尿病的发生密切相关。
