Mellen Philip B, Cefalu William T, Herrington David M
Department of Internal Medicine/Cardiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Arterioscler Thromb Vasc Biol. 2006 Jan;26(1):189-93. doi: 10.1161/01.ATV.0000191656.71812.7c. Epub 2005 Oct 20.
Although the metabolic syndrome (MS) is associated with increased cardiovascular risk, its relationship with atherosclerotic progression is less well defined. We sought to determine whether the MS predicts angiographic progression of coronary heart disease in a cohort of postmenopausal women.
A total of 309 postmenopausal women entered the Estrogen Replacement and Atherosclerosis trial, of whom 248 underwent baseline angiography and completed follow-up angiography after an average of 3.2 years. Women were identified as having type 2 diabetes mellitus (T2DM) or the MS (National Cholesterol Education Panel diagnostic criteria). In adjusted models, participants with T2DM and the MS had greater angiographic progression [change in minimal diameter (DeltaMD): -0.15] than women without T2DM or the MS (DeltaMD: -0.08; P<0.05) or with MS alone (DeltaMD: -0.07; P<0.005); there was no difference in progression by MS status in women without T2DM (P=0.54)]. In adjusted logistic regression models, T2DM predicted coronary heart disease events [odds ratio, 2.79 (95% CI, 1.29 to 6.02)], and the MS demonstrated a similar trend [odds ratio, 1.98 (95% CI, 0.90 to 4.33)].
Among postmenopausal women with coronary heart disease, the presence of diabetes predicted disease progression, but the MS did not.
尽管代谢综合征（MS）与心血管风险增加相关，但其与动脉粥样硬化进展的关系尚不明确。我们试图确定MS是否能预测绝经后女性队列中冠心病的血管造影进展情况。
共有309名绝经后女性进入雌激素替代与动脉粥样硬化试验，其中248名接受了基线血管造影，并在平均3.2年后完成了随访血管造影。女性被确定患有2型糖尿病（T2DM）或MS（根据美国国家胆固醇教育计划诊断标准）。在调整模型中，患有T2DM和MS的参与者的血管造影进展更大[最小直径变化（ΔMD）：-0.15]，高于没有T2DM或MS的女性（ΔMD：-0.08；P<0.05）或仅患有MS的女性（ΔMD：-0.07；P<0.005）；在没有T2DM的女性中，根据MS状态的进展没有差异（P=0.54）。在调整的逻辑回归模型中，T2DM可预测冠心病事件[比值比，2.79（95%CI，1.29至6.02）]，而MS呈现出类似趋势[比值比，1.98（95%CI，0.90至4.33）]。
在患有冠心病的绝经后女性中，糖尿病的存在可预测疾病进展，但MS不能。
