Florez Hermes, Silva Eglé, Fernández Virginia, Ryder Elena, Sulbarán Tulio, Campos Gilberto, Calmón Gustavo, Clavel Emilio, Castillo-Florez Sumaya, Goldberg Ronald
University of Miami Miller School of Medicine, 1450 NW 10th Avenue, Diabetes Research Institute #2054, Miami, FL 33136, USA.
Diabetes Res Clin Pract. 2005 Jul;69(1):63-77. doi: 10.1016/j.diabres.2004.11.018. Epub 2005 Feb 19.
Studies have highlighted the association between insulin resistance (IR) and several cardiovascular (CV) risk factors, including hypertension (HTN), obesity, dyslipidemia (i.e. high triglyceride and low HDL-cholesterol) and glucose intolerance, in a cluster known as the metabolic syndrome (MS). There are few data on the frequency of the MS and dyslipidemia in developing countries, and none in South America. To estimate the prevalence of the MS and its components in Zulia State, Venezuela, and to establish associated demographic and clinical factors, we evaluated 3108 Hispanic men and women aged 20 years or older from a cross-sectional survey of a random representative sample from each health district in Zulia State, Venezuela (1999-2001). Prevalence of the MS and dyslipidemia was defined according to the National Cholesterol Education Program (NCEP)/Adult Treatment Panel III (ATP III) criteria. The age-adjusted prevalence of MS and dyslipidemia was 31.2% and 24.1%, respectively, with higher rates in men than in women. Prevalence rates increased with age and with the degree of obesity. MS prevalence was lower in Amerindian (17.%) compared to Black (27.2%), White (33.3%) and Mixed (37.4%) men, but no differences were found among women. Overall, low HDL-cholesterol (65.3%), abdominal obesity (42.9%) and HTN (38.1%) were the most frequent MS components. After adjusting for age, sex and race groups, family history of diabetes, obesity and HTN were associated with the MS. Sedentary lifestyle also increased the risk of MS, event after adjusting for the same covariates, obesity and the degree of IR. These results suggest that MS is found in approximately one-third of the Venezuelan adult population in Zulia State, with higher prevalence in men related to the presence of dyslipidemia. Lifestyle interventions in MS subjects are needed in Venezuela to halt the burden of CV disease and diabetes.
研究强调了胰岛素抵抗（IR）与几种心血管（CV）危险因素之间的关联，这些危险因素包括高血压（HTN）、肥胖、血脂异常（即高甘油三酯和低高密度脂蛋白胆固醇）以及葡萄糖耐量异常，它们共同构成了代谢综合征（MS）。关于发展中国家MS和血脂异常的发生率数据很少，南美洲则尚无相关数据。为了估计委内瑞拉苏利亚州MS及其组成部分的患病率，并确定相关的人口统计学和临床因素，我们对委内瑞拉苏利亚州每个健康区的随机代表性样本进行了横断面调查，评估了3108名20岁及以上的西班牙裔男性和女性（1999 - 2001年）。MS和血脂异常的患病率根据美国国家胆固醇教育计划（NCEP）/成人治疗小组第三次报告（ATP III）标准定义。年龄调整后的MS和血脂异常患病率分别为31.2%和24.1%，男性患病率高于女性。患病率随年龄和肥胖程度增加而上升。与黑人（27.2%）、白人（33.3%）和混血（37.4%）男性相比，美洲印第安男性的MS患病率较低（17.%），但女性之间未发现差异。总体而言，低高密度脂蛋白胆固醇（65.3%）、腹型肥胖（42.9%）和高血压（38.1%）是最常见的MS组成部分。在对年龄、性别和种族群体、糖尿病家族史、肥胖和高血压进行调整后，这些因素与MS相关。久坐的生活方式也增加了患MS的风险，即使在对相同协变量、肥胖和IR程度进行调整后依然如此。这些结果表明，在委内瑞拉苏利亚州约三分之一的成年人口中发现了MS，男性患病率较高与血脂异常的存在有关。委内瑞拉需要对MS患者进行生活方式干预，以减轻心血管疾病和糖尿病的负担。
