Cankurtaran Mustafa, Halil Meltem, Yavuz Burcu Balam, Dagli Neslihan, Oyan Başak, Ariogul Servet
Hacettepe University, Medical Faculty, Department of Internal Medicine, Division of Geriatric Medicine, Sihhiye, 06100 Ankara, Turkey.
Arch Gerontol Geriatr. 2006 Jan-Feb;42(1):35-45. doi: 10.1016/j.archger.2005.05.004. Epub 2005 Jul 25.
Metabolic syndrome (MS) is known to increase risks for cardiovascular disease. Risks for cardiovascular disease also increase with aging. The aim of the study was to describe prevalence and correlates of MS in older adults. Patients aged 65 years and over without any acute illness that were referred to our geriatrics unite for comprehensive geriatric assessment were included in this cross-sectional study. MS was defined by using the WHO and the National Cholesterol Education Program (NCEP) definitions. The correlates were age, gender, low-grade inflammation as assessed by C-reactive protein (CRP) levels, high-homocysteine, total and LDL cholesterol, lipoprotein-a (Lip-a), apolipoprotein-A (Apo-A), apolipoprotein-B (Apo-B), nutrition point, coronary artery disease (CAD) and cerebrovascular event history. Total 1255 patients, 789 (62.9%) females, 466 (37.1%) males with a mean age of 71.8+/-6.3 years were included in our study. MS prevalence was 16.2% with WHO definition and 23.8% with NCEP definition. Prevalence of CAD in MS and non-metabolic syndrome (non-MS) patients was 38.4% versus 29.5% (p=0.010) in WHO and 35.3% versus 29.6% (p=0.066) in NCEP group, respectively. Prevalence of cerebrovascular event history was 11.3% versus 6.2% in WHO (p=0.008) and 9.9% versus 6.1% (p=0.026) in NCEP group, respectively. Multiple logistic regression analysis was performed to investigate the independent association of variables with the MS. Female sex, high-homocysteine, low-grade inflammation, CAD and cerebrovascular event history was found to be associated with both modified WHO and NCEP MS groups in the multivariate analysis. This study has shown that MS is common in elderly patients with strongly related to CAD and cerebrovascular events. Low grade inflammation as assessed by CRP and high-homocysteine level is strongly related to MS.
众所周知,代谢综合征(MS)会增加心血管疾病的风险。心血管疾病的风险也会随着年龄的增长而增加。本研究的目的是描述老年人中MS的患病率及其相关因素。本横断面研究纳入了65岁及以上、无任何急性疾病且被转诊至我们老年科进行综合老年评估的患者。MS采用世界卫生组织(WHO)和美国国家胆固醇教育计划(NCEP)的定义。相关因素包括年龄、性别、通过C反应蛋白(CRP)水平评估的低度炎症、高同型半胱氨酸、总胆固醇和低密度脂蛋白胆固醇、脂蛋白a(Lip-a)、载脂蛋白A(Apo-A)、载脂蛋白B(Apo-B)、营养评分、冠状动脉疾病(CAD)和脑血管事件史。本研究共纳入1255例患者,其中女性789例(62.9%),男性466例(37.1%),平均年龄为71.8±6.3岁。根据WHO定义,MS患病率为16.2%;根据NCEP定义,患病率为23.8%。在WHO组中,MS患者和非代谢综合征(非MS)患者的CAD患病率分别为38.4%和29.5%(p=0.010);在NCEP组中,分别为35.3%和29.6%(p=0.066)。脑血管事件史的患病率在WHO组中分别为11.3%和6.2%(p=0.008),在NCEP组中分别为9.9%和6.1%(p=0.026)。进行多因素logistic回归分析以研究各变量与MS的独立关联。在多变量分析中,发现女性、高同型半胱氨酸、低度炎症、CAD和脑血管事件史与修订后的WHO和NCEP MS组均相关。本研究表明,MS在老年患者中很常见,且与CAD和脑血管事件密切相关。通过CRP评估的低度炎症和高同型半胱氨酸水平与MS密切相关。