Butler Javed, Rodondi Nicolas, Zhu Yuwei, Figaro Kathleen, Fazio Sergio, Vaughan Douglas E, Satterfield Suzanne, Newman Anne B, Goodpaster Bret, Bauer Douglas C, Holvoet Paul, Harris Tamara B, de Rekeneire Nathalie, Rubin Susan, Ding Jingzhong, Kritchevsky Stephen B
Division of Cardiovascular Medicine, Vanderbilt University, Nashville, Tennessee, USA.
J Am Coll Cardiol. 2006 Apr 18;47(8):1595-602. doi: 10.1016/j.jacc.2005.12.046. Epub 2006 Mar 27.
The purpose of this study was to assess whether metabolic syndrome (MetSyn) predicts a higher risk for cardiovascular events in older adults.
The importance of MetSyn as a risk factor has not previously focused on older adults and deserves further study.
We studied the impact of MetSyn (38% prevalence) on outcomes in 3,035 participants in the Health, Aging, and Body Composition (Health ABC) study (51% women, 42% black, ages 70 to 79 years).
During a 6-year follow-up, there were 434 deaths overall, 472 coronary events (CE), 213 myocardial infarctions (MI), and 231 heart failure (HF) hospital stays; 59% of the subjects had at least one hospital stay. Coronary events, MI, HF, and overall hospital stays occurred significantly more in subjects with MetSyn (19.9% vs. 12.9% for CE, 9.1% vs. 5.7% for MI, 10.0% vs. 6.1% for HF, and 63.1% vs. 56.1% for overall hospital stay; all p < 0.001). No significant differences in overall mortality was seen; however, there was a trend toward higher cardiovascular mortality (5.1% vs. 3.8%, p = 0.067) and coronary mortality (4.5% vs. 3.2%, p = 0.051) in patients with MetSyn. After adjusting for baseline characteristics, patients with MetSyn were at a significantly higher risk for CE (hazard ratio [HR] 1.56, 95% confidence interval [CI] 1.28 to 1.91), MI (HR 1.51, 95% CI 1.12 to 2.05), and HF hospital stay (HR 1.49, 95% CI 1.10 to 2.00). Women and whites with MetSyn had a higher coronary mortality rate. The CE rate was higher among subjects with diabetes and with MetSyn; those with both had the highest risk.
Overall, subjects over 70 years are at high risk for cardiovascular events; MetSyn in this group is associated with a significantly greater risk.
本研究旨在评估代谢综合征（MetSyn）是否能预测老年人发生心血管事件的更高风险。
MetSyn作为一种风险因素的重要性此前尚未聚焦于老年人，值得进一步研究。
我们在健康、衰老与身体成分研究（Health ABC）中，对3035名参与者（51%为女性，42%为黑人，年龄在70至79岁之间）研究了MetSyn（患病率为38%）对结局的影响。
在6年的随访期间，总共有434人死亡，472例冠心病事件（CE），213例心肌梗死（MI），以及231次因心力衰竭（HF）住院；59%的受试者至少有一次住院。患有MetSyn的受试者发生冠心病事件、心肌梗死、心力衰竭和总体住院的情况明显更多（冠心病事件：19.9%对12.9%，心肌梗死：9.1%对5.7%，心力衰竭：10.0%对6.1%，总体住院：63.1%对56.1%；所有p<0.001）。总体死亡率未见显著差异；然而，患有MetSyn的患者心血管死亡率有升高趋势（5.1%对3.8%，p = 0.067），冠心病死亡率也有升高趋势（4.5%对3.2%，p = 0.051）。在调整基线特征后，患有MetSyn的患者发生冠心病事件的风险显著更高（风险比[HR] 1.56，95%置信区间[CI] 1.28至1.91），心肌梗死（HR 1.51，95% CI 1.12至2.05），以及因心力衰竭住院（HR 1.49，95% CI 1.10至2.00）。患有MetSyn的女性和白人冠心病死亡率更高。患有糖尿病且患有MetSyn的受试者冠心病事件发生率更高；两者都有的风险最高。
总体而言，70岁以上的受试者心血管事件风险较高；该组中的MetSyn与显著更高的风险相关。
