Moon Jae-Youn, Park Sungha, Rhee Ji-Hyuk, Jee Sun Ha, Park Chan Mi, Choi Dae-Sik, Park Hyun-Young, Ko Young-Guk, Choi Donghoon, Jang Yangsoo, Chung Namsik
Division of Cardiology, Yonsei University College of Medicine Cardiovascular Center, Seoul, Korea.
Int J Cardiol. 2007 Jan 2;114(1):83-9. doi: 10.1016/j.ijcard.2005.12.008. Epub 2006 May 8.
We compared the metabolic profiles and risk of coronary artery disease (CAD) in Koreans with non-diabetic metabolic syndrome (MetS). [We applied four criteria of MetS: the NCEP criteria, the Asian modified NCEP (a-NCEP) criteria, the WHO criteria and the Asian modified WHO (a-WHO).]
The study group composed of 2724 subjects enrolled in the cardiovascular genome center. There were 728 patients with significant CAD. The different criteria of the MetS were applied for the study population.
Among the 2724 participants, 522 (19.2%) met the NCEP criteria, 796 (29.2%) met the a-NCEP criteria, 361 (13.3%) met the WHO criteria and 576 (21.1%) met the a-WHO criteria. The clinical parameters, lipid profile, apoA1 and apoB level were not different between the participants classified as MetS by using the different criteria. The odds ratio for CAD prediction were not significantly different according to the metabolic criteria (odd ratio: 1.755 [95% CI: 1.423-2.163] in NCEP criteria, 2.120 [1.763-2.549] in a-NCEP criteria, 1.854 [1.466-2.343] in WHO criteria, 2.205 [1.810-2.687] in a-WHO criteria). The serum level of apoA1 and apoB showed strong correlations with MetS classified by all criteria and the HOMA index and insulin level showed better correlations with WHO-MetS criteria.
All the MetS criteria showed similar metabolic profiles and all four criteria had similar predictive value for CAD. Conventional MetS criteria, applied to the non-diabetic Asian population, may underestimate the population at risk. Our data suggests that the Asian modified criteria will decrease the risk for underdiagnosis while demonstrating similar metabolic profiles and CAD risk compared to the conventional criteria.
我们比较了患有非糖尿病性代谢综合征（MetS）的韩国人的代谢谱和冠状动脉疾病（CAD）风险。[我们应用了四种MetS标准：美国国家胆固醇教育计划（NCEP）标准、亚洲改良NCEP（a-NCEP）标准、世界卫生组织（WHO）标准和亚洲改良WHO（a-WHO）标准。]
研究组由心血管基因组中心招募的2724名受试者组成。其中有728例患有严重CAD的患者。对研究人群应用了不同的MetS标准。
在2724名参与者中，522人（19.2%）符合NCEP标准，796人（29.2%）符合a-NCEP标准，361人（13.3%）符合WHO标准，576人（21.1%）符合a-WHO标准。使用不同标准分类为MetS的参与者之间的临床参数、血脂谱、载脂蛋白A1和载脂蛋白B水平没有差异。根据代谢标准，CAD预测的比值比没有显著差异（比值比：NCEP标准下为1.755[95%可信区间：1.423 - 2.163]，a-NCEP标准下为2.120[1.763 - 2.549]，WHO标准下为1.854[1.466 - 2.343]，a-WHO标准下为2.205[1.810 - 2.687]）。载脂蛋白A1和载脂蛋白B的血清水平与所有标准分类的MetS均显示出强相关性，而稳态模型评估（HOMA）指数和胰岛素水平与WHO-MetS标准显示出更好的相关性。
所有MetS标准均显示出相似的代谢谱，且所有四种标准对CAD均具有相似的预测价值。应用于非糖尿病亚洲人群的传统MetS标准可能会低估风险人群。我们的数据表明，与传统标准相比，亚洲改良标准在显示相似代谢谱和CAD风险的同时，将降低漏诊风险。
