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在一个基于法国人群的样本中,代谢综合征与亚临床动脉粥样硬化标志物相关。

Metabolic syndrome is associated with markers of subclinical atherosclerosis in a French population-based sample.

作者信息

Ahluwalia N, Drouet L, Ruidavets J-B, Perret B, Amar J, Boccalon H, Hanaire-Broutin H, Ferrières J

机构信息

Department of Nutritional Sciences, Pennsylvania State University, USA.

出版信息

Atherosclerosis. 2006 Jun;186(2):345-53. doi: 10.1016/j.atherosclerosis.2005.07.021. Epub 2005 Aug 29.

Abstract

Metabolic syndrome (MetS) is associated with increased risk of cardiovascular disease (CVD). The relation of MetS with early stages of atherosclerosis, more important from a prevention perspective, has not been evaluated extensively. We examined the association of MetS, using WHO and NCEP definitions, with number of carotid and femoral plaques; carotid intima-media thickness (IMT); pulse wave velocity (PWV) in a random population-based sample of 1153 French adults (35-65 year). Impact of inflammatory factors (C-reactive protein and soluble intercellular adhesion molecule-1) on these parameters was also evaluated. Prevalence of MetS was 14.5 (CI: 12.3-16.0) and 17.5 (CI: 15.1-20.2)%, using NCEP and WHO definitions, respectively. MetS significantly predicted number of plaques, IMT, and PWV after adjustment for traditional risk factors (P<0.05). Inflammatory factors predicted peripheral plaques only. The risk of subclinical atherosclerosis was considerably increased with MetS (P<0.05); odds ratios ranged 1.80-2.15 with NCEP definition, and 1.48-1.97 with WHO definition. Individuals meeting both NCEP and WHO definitions had slightly greater risk of increased plaques, IMT, and PWV. MetS was strongly associated with subclinical atherosclerosis and aortic stiffness, and can be used as a surrogate marker for high CVD risk, deserving aggressive treatment.

摘要

代谢综合征(MetS)与心血管疾病(CVD)风险增加相关。从预防角度来看,MetS与动脉粥样硬化早期阶段的关系尚未得到广泛评估。我们在一个基于人群的随机样本中,对1153名法国成年人(35 - 65岁)进行研究,使用世界卫生组织(WHO)和美国国家胆固醇教育计划(NCEP)的定义,考察了MetS与颈动脉和股动脉斑块数量、颈动脉内膜中层厚度(IMT)、脉搏波速度(PWV)之间的关联。还评估了炎症因子(C反应蛋白和可溶性细胞间黏附分子 - 1)对这些参数的影响。使用NCEP和WHO定义时,MetS的患病率分别为14.5(95%置信区间:12.3 - 16.0)和17.5(95%置信区间:15.1 - 20.2)%。在对传统危险因素进行校正后,MetS显著预测了斑块数量、IMT和PWV(P < 0.05)。炎症因子仅预测外周斑块。MetS使亚临床动脉粥样硬化风险显著增加(P < 0.05);使用NCEP定义时,比值比范围为1.80 - 2.15,使用WHO定义时为1.48 - 1.97。同时符合NCEP和WHO定义的个体,斑块数量增加、IMT增加和PWV增加的风险略高。MetS与亚临床动脉粥样硬化和主动脉僵硬度密切相关,可作为高CVD风险的替代标志物,值得积极治疗。

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