Empana Jean-Philippe, Zureik Mahmoud, Gariepy Jerome, Courbon Dominique, Dartigues Jean Francois, Ritchie Karen, Tzourio Christophe, Alperovitch Annick, Ducimetiere Pierre
INSERM U780, Cardiovascular Team, Paris XI University, Hôpital Paul Brousse, Villejuif cedex, France.
Stroke. 2007 Mar;38(3):893-9. doi: 10.1161/01.STR.0000257983.62530.75. Epub 2007 Feb 1.
In contrast to the young adult population, limited data are presently available regarding the epidemiology of the metabolic syndrome (MetS) and its relationship with cardiovascular disease risk in the elderly. We have investigated the frequency of the MetS and its association with the carotid artery structure in an elderly free-living population.
The study population consists of 5585 French noninstitutionalized elderly men and women aged 65 to 85 years, free of diabetes, who participated in the multicenter Three City Study and who underwent ultrasound examination of the carotid arteries at baseline examination between March 1999 and March 2001. The MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria.
The MetS was present in 12.1% of the study participants, with slightly higher rates in men. Subjects with the MetS had higher frequency of carotid plaques (odds ratio, 1.30; 95% CI, 1.09 to 1.55), higher intima-media thickness of the common carotid artery (odds ratio, 1.81; 95% CI, 1.37 to 2.41), and higher lumen diameter (odds ratio, 2.17; 95% CI, 1.61 to 2.94) (upper quintiles) after adjustment for other cardiovascular risk factors. This association was observed in both genders and in subjects without prevalent cardiovascular disease. Elevated blood pressure as defined in the MetS was the main determinant of the relations between the MetS and the carotid parameters, especially the lumen diameter.
The present data suggest that noninstitutionalized elderly subjects with the MetS have altered structure of the carotid arteries.
与年轻成年人相比,目前关于代谢综合征(MetS)的流行病学及其与老年人心血管疾病风险关系的数据有限。我们在一个自由生活的老年人群中调查了MetS的发生率及其与颈动脉结构的关联。
研究人群包括5585名年龄在65至85岁之间、无糖尿病的法国非机构化老年男性和女性,他们参与了多中心三城市研究,并在1999年3月至2001年3月的基线检查中接受了颈动脉超声检查。MetS根据美国国家胆固醇教育计划成人治疗专家组第三次报告的标准进行定义。
12.1%的研究参与者患有MetS,男性患病率略高。在调整了其他心血管危险因素后,患有MetS的受试者颈动脉斑块的发生率更高(优势比,1.30;95%可信区间,1.09至1.55),颈总动脉内膜中层厚度更高(优势比,1.81;95%可信区间,1.37至2.41),管腔直径更大(优势比,2.17;95%可信区间,1.61至2.94)(上五分位数)。这种关联在男女两性以及无心血管疾病病史的受试者中均有观察到。MetS定义中的血压升高是MetS与颈动脉参数之间关系的主要决定因素,尤其是管腔直径。
目前的数据表明,患有MetS的非机构化老年受试者的颈动脉结构发生了改变。