Athyros Vasilios G, Mikhailidis Dimitri P, Papageorgiou Athanasios A, Didangelos Triandafillos P, Ganotakis Emmanuel S, Symeonidis Athanasios N, Daskalopoulou Stella S, Kakafika Anna I, Elisaf Moses
Atherosclerosis Unit, Aristotelian University, Hippocration Hospital, Thessaloniki, Greece.
Curr Med Res Opin. 2004 Nov;20(11):1691-1701. doi: 10.1185/030079904x5599.
To estimate the prevalence of vascular disease (coronary heart disease/stroke/peripheral arterial disease) in individuals with the metabolic syndrome (MetSyn) with or without diabetes mellitus (DM) when compared with subjects without the MetSyn.
A cross-sectional analysis of a representative sample of Greek adults (n = 4153), men and women (49% and 51%, respectively), living in urban, semi-urban and rural areas (54%, 25% and 21%, respectively). The National Cholesterol Education Program-Adult Treatment Panel III definition of the MetSyn was used.
The age-adjusted prevalence of the MetSyn was 23.6% [95% confidence interval (CI) = 22.4%-25.1%]; this was similar in men and women. The fully adjusted prevalence of vascular disease in those with the MetSyn (n = 984) was 29.4%, significantly higher than in those without (n = 3169, 9.6%, p < 0.0001), while subjects without both the MetSyn and DM had the lowest vascular disease prevalence (n = 3035, 8.9%). Subjects with the MetSyn but no DM (n = 674) had a vascular disease prevalence of 24.1% (p < 0.0001 vs. those without the MetSyn), which was similar to that in subjects with DM without the MetSyn (n = 134, 25.4%), but lower than in those with both the MetSyn and DM (n = 310, 40.7%, p < 0.0001 vs. all). In comparison to those without the MetSyn [odds ratio (OR) = 1], the ORs of prevalent vascular disease, after multivariate analysis for age, sex and components of the MetSyn, and antiatherosclerotic drugs were: all MetSyn = 1.94 (95% CI = 1.35-2.47), with both MetSyn and DM = 3.04 (95% CI = 1.98-4.11) and with MetSyn but no DM = 1.48 (95% CI = 1.12-1.92).
The prevalence of vascular disease was markedly increased in the presence of the MetSyn. Those with both the MetSyn and DM had the highest prevalence of vascular disease, followed by those with the MetSyn without DM. Probably MetSyn without DM should be considered as a coronary heart disease-risk equivalent in future guidelines. This initiative would reset treatment targets and potentially provide additional benefit in patients with the MetSyn.
评估患有或未患有糖尿病（DM）的代谢综合征（MetSyn）个体中血管疾病（冠心病/中风/外周动脉疾病）的患病率，并与无MetSyn的受试者进行比较。
对居住在城市、半城市和农村地区（分别占54%、25%和21%）的希腊成年人（n = 4153）的代表性样本进行横断面分析，其中男性和女性分别占49%和51%。采用美国国家胆固醇教育计划成人治疗小组第三次报告中对MetSyn的定义。
年龄调整后的MetSyn患病率为23.6%[95%置信区间（CI）= 22.4%-25.1%]；男性和女性患病率相似。患有MetSyn的患者（n = 984）经充分调整后的血管疾病患病率为29.4%，显著高于未患MetSyn的患者（n = 3169，9.6%，p < 0.0001），而既无MetSyn也无DM的受试者血管疾病患病率最低（n = 3035，8.9%）。患有MetSyn但无DM的患者（n = 674）血管疾病患病率为24.1%（与未患MetSyn的患者相比，p < 0.0001），与患有DM但无MetSyn的患者（n = 134，25.4%）相似，但低于同时患有MetSyn和DM的患者（n = 310，40.7%，与所有其他组相比，p < 0.0001）。与未患MetSyn的患者相比[比值比（OR）= 1]，在对年龄、性别、MetSyn各组分以及抗动脉粥样硬化药物进行多变量分析后，血管疾病的OR值为：所有MetSyn患者 = 1.94（95% CI = 1.35 - 2.47），同时患有MetSyn和DM的患者 = 3.04（95% CI = 1.98 - 4.11），患有MetSyn但无DM的患者 = 1.48（95% CI = 1.12 - 1.92）。
存在MetSyn时血管疾病患病率显著增加。同时患有MetSyn和DM的患者血管疾病患病率最高，其次是患有MetSyn但无DM的患者。在未来的指南中，或许应将无DM的MetSyn视为冠心病风险等同情况。这一举措将重新设定治疗目标，并可能为患有MetSyn的患者带来额外益处。
