Tsangalis G, Papaconstantinou S, Kosmadakis G, Valis D, Zerefos N
Renal Unit, Ygia Hospital, Athens, Greece.
Int J Artif Organs. 2007 Feb;30(2):118-23. doi: 10.1177/039139880703000206.
Recently, the concept of the metabolic syndrome (MS) has emerged in an effort to group and study as a whole several cardiovascular risk factors. The definition of the metabolic syndrome requires the presence of 3 or more of the following parameters: high blood pressure (>/= 130/85), waist circumference >102 cm in men and >88 cm in women, HDL<50 mg/dL in men and <40 mg/dL in women, serum triglycerides >150 mg/dL and fasting blood glucose >/= 110 mg/dL.
To investigate the prevalence of the MS and the specific patient characteristics in a cohort of hemodialysis patients.
102 stable patients on maintenance hemodialysis (63 male/39 female with a mean time on dialysis of 57.19 +/- 47.16 months) were studied for 12 months.
The prevalence of the MS is high (56.25%) during the first year on dialysis and gradually declines (44.8% from 2-5 years and 29.7% for >5 years). In total 41/102 patients had MS (40.19%); 28/41 were men (68.29%) and 13/41 women (31.7%). The prevalence of MS in males was 44.4% (28/63) and 33.3% (13/39) in females, while the most frequent combination of risk factors in MS patients was high blood pressure-high waist circumference-high levels of serum triglycerides (36.58%). Serum triglycerides >150 mg/dL is the most frequent component of the MS both in well-nourished patients and according to the duration of dialysis (58.53% for 0-5 years and 19.51% for >5 years on dialysis). MS patients had a better nutritional status and were on dialysis for less time than their non-MS (NMS) counterparts. Actual or anamnestic cardiovascular events and infections did not differ between the 2 groups.
Our study provides new data concerning the prevalence of the MS and the specific patient characteristics in a hemodialysis population. The prevalence of MS in hemodialysis patients is high (40.19%) and seems to reflect a state of good nutrition compared to patients without the MS. Furthermore, the MS is more common in the first years of dialysis (42.46+/-34.29 months) than later on (67.25+/-52.15 months) probably reflecting the long term consequences of the hemodialysis treatment. Our results also indicate that although patients in the MS group were well-nourished and for a shorter time on dialysis, they were not protected from cardiovascular disease and infections. Our study provides new data concerning both the prevalence of the MS and a variety of patient characteristics in a hemodialysis population. Further research and a larger number of patients are required in order to clarify the precise role of this syndrome in patients on MHD.
最近，代谢综合征（MS）的概念应运而生，旨在将多种心血管危险因素作为一个整体进行归类和研究。代谢综合征的定义要求具备以下3项或更多参数：高血压（收缩压≥130mmHg和/或舒张压≥85mmHg），男性腰围>102cm，女性腰围>88cm，男性高密度脂蛋白（HDL）<50mg/dL，女性HDL<40mg/dL，血清甘油三酯>150mg/dL，空腹血糖≥110mg/dL。
调查一组血液透析患者中代谢综合征的患病率及特定患者特征。
对102例维持性血液透析稳定患者（63例男性/39例女性，平均透析时间57.19±47.16个月）进行了为期12个月的研究。
透析第一年代谢综合征的患病率较高（56.25%），随后逐渐下降（2至5年为44.8%，5年以上为29.7%）。102例患者中共有41例（40.19%）患有代谢综合征；其中28/41为男性（68.29%），13/41为女性（31.7%）。男性代谢综合征患病率为44.4%（28/63），女性为33.3%（13/39），代谢综合征患者中最常见的危险因素组合是高血压-高腰围-高血清甘油三酯水平（36.58%）。血清甘油三酯>150mg/dL是代谢综合征最常见的组成部分，无论营养状况良好的患者还是根据透析时间来看（透析0至5年为58.53%，透析5年以上为19.51%）。与非代谢综合征（NMS）患者相比，代谢综合征患者营养状况更好，透析时间更短。两组间实际发生的或既往的心血管事件及感染情况并无差异。
我们的研究提供了有关血液透析人群中代谢综合征患病率及特定患者特征的新数据。血液透析患者中代谢综合征的患病率较高（40.19%），与无代谢综合征的患者相比，似乎反映出营养良好的状态。此外，代谢综合征在透析最初几年（42.46±34.29个月）比之后（67.25±52.15个月）更为常见，这可能反映了血液透析治疗的长期后果。我们的结果还表明，尽管代谢综合征组患者营养良好且透析时间较短，但他们并未免受心血管疾病和感染的影响。我们的研究提供了有关血液透析人群中代谢综合征患病率及多种患者特征的新数据。需要进一步研究和纳入更多患者，以阐明该综合征在维持性血液透析患者中的精确作用。
