Montalcini Tiziana, Gorgone Gaetano, Gazzaruso Carmine, Sesti Giorgio, Perticone Francesco, Pujia Arturo
Department of Medicina Sperimentale e Clinica G Salvatore, University of Catanzaro Magna Graecia, Viale Europa Germaneto, Catanzaro, Italy.
Diabetes Res Clin Pract. 2007 Jun;76(3):378-82. doi: 10.1016/j.diabres.2006.09.014. Epub 2006 Oct 10.
Obesity and the metabolic syndrome (MS) frequently coexist. Both are apparently associated to cardiovascular disease. However, the contribution of obesity to cardiovascular risk, independent of the presence of the metabolic syndrome, remains controversial. The purpose of this study was to investigate whether the subclinical carotid atherosclerosis prevalence is different in obese postmenopausal women with and without the metabolic syndrome.
On the basis of consecutive recruitment, 313 postmenopausal women underwent a clinical, biochemical and ultrasound characterization. Women affected by cardiovascular disease or diabetes were excluded from the study.
Among enrolled women the metabolic syndrome and body mass index (BMI) resulted strongly associated, but only metabolic syndrome was associated with carotid atherosclerosis, a well-known marker of cardiovascular disease. Similarly, increases in BMI unit (normal to overweight to obese) were not associated with carotid atherosclerosis whereas metabolic status (normal to metabolic syndrome) conferred an approximate three-fold adjusted odds of carotid atherosclerosis.
The metabolic syndrome but not obesity is associated to carotid atherosclerosis in postmenopausal women. Although it remains prudent to recommend weight loss in overweight and obese women, evaluation and control of metabolic risk factors should be considered the main goal to prevent cardiovascular and cerebrovascular disease.
肥胖与代谢综合征（MS）常常并存。二者均明显与心血管疾病相关。然而，肥胖对心血管风险的影响，独立于代谢综合征的存在，仍存在争议。本研究的目的是调查有或无代谢综合征的肥胖绝经后女性亚临床颈动脉粥样硬化患病率是否存在差异。
基于连续招募，313名绝经后女性接受了临床、生化及超声检查。患有心血管疾病或糖尿病的女性被排除在研究之外。
在入选女性中，代谢综合征与体重指数（BMI）密切相关，但只有代谢综合征与颈动脉粥样硬化相关，颈动脉粥样硬化是心血管疾病的一个众所周知的标志物。同样，BMI单位的增加（从正常到超重再到肥胖）与颈动脉粥样硬化无关，而代谢状态（从正常到代谢综合征）使颈动脉粥样硬化的校正后几率增加了约三倍。
在绝经后女性中，与颈动脉粥样硬化相关的是代谢综合征而非肥胖。尽管建议超重和肥胖女性减肥仍然是谨慎之举，但应将评估和控制代谢危险因素视为预防心血管和脑血管疾病的主要目标。
