Katz Ronit, Wong Nathan D, Kronmal Richard, Takasu Junichiro, Shavelle David M, Probstfield Jeffrey L, Bertoni Alain G, Budoff Matthew J, O'Brien Kevin D
University of Washington, Seattle, WA, USA.
Circulation. 2006 May 2;113(17):2113-9. doi: 10.1161/CIRCULATIONAHA.105.598086. Epub 2006 Apr 24.
Calcific aortic valve disease is common in the elderly, is correlated with common cardiovascular risk factors, and is associated with increased cardiovascular event risk; however, whether metabolic syndrome is associated with an increased prevalence of aortic valve calcium (AVC) is not known.
The prevalence of AVC, as assessed by computed tomography, was compared in 6780 Multi-Ethnic Study of Atherosclerosis (MESA) participants with metabolic syndrome (n=1550; National Cholesterol Education Program's Adult Treatment Panel III [ATP III] criteria), diabetes mellitus (n=1016), or neither condition (n=4024). The prevalence of AVC for those with neither condition, metabolic syndrome, or diabetes mellitus was, respectively, 8%, 12%, and 17% in women (P<0.001) and 14%, 22%, and 24% in men (P<0.001). Compared with those with neither condition, the adjusted relative risks for the presence of AVC were 1.45 (95% CI 1.11 to 1.90) for metabolic syndrome and 2.12 (95% CI 1.54 to 2.92) for diabetes mellitus in women and 1.70 (95% CI 1.32 to 2.19) for metabolic syndrome and 1.73 (95% CI 1.33 to 2.25) for diabetes mellitus in men. There was a graded, linear relationship between AVC prevalence and the number of metabolic syndrome components in both women and men (both P<0.001). Similar results were obtained when the International Diabetes Federation metabolic syndrome definition was used.
In the MESA cohort, the metabolic syndrome and diabetes mellitus are associated with increased risk of AVC, and AVC prevalence is increased with increasing number of metabolic syndrome components.
钙化性主动脉瓣疾病在老年人中常见，与常见心血管危险因素相关，且与心血管事件风险增加有关；然而，代谢综合征是否与主动脉瓣钙化（AVC）患病率增加相关尚不清楚。
在6780名动脉粥样硬化多族裔研究（MESA）参与者中，比较了符合代谢综合征（n = 1550；根据美国国家胆固醇教育计划成人治疗小组第三次报告[ATP III]标准）、糖尿病（n = 1016）或两者均不符合（n = 4024）的参与者经计算机断层扫描评估的AVC患病率。在女性中，两者均不符合、患有代谢综合征或糖尿病的参与者的AVC患病率分别为8%、12%和17%（P<0.001），在男性中分别为14%、22%和24%（P<0.001）。与两者均不符合的参与者相比，女性中代谢综合征存在AVC的校正相对风险为1.45（95%CI 1.11至1.90），糖尿病为2.12（95%CI 1.54至2.92）；男性中代谢综合征为1.70（95%CI 1.32至2.19），糖尿病为1.73（95%CI 1.33至2.25）。在女性和男性中，AVC患病率与代谢综合征组分数量之间均存在分级线性关系（均P<0.001）。使用国际糖尿病联盟代谢综合征定义时也获得了类似结果。
在MESA队列中，代谢综合征和糖尿病与AVC风险增加相关，且AVC患病率随代谢综合征组分数量增加而升高。
