Sadeghian Saeed, Darvish Soodabeh, Salimi Shabnam, Esfehani Farah Ayatollahzadeh, Fallah Nader, Mahmoodian Mehran, Salarifar Mojtaba, Karimi Abbasali
Research Department Tehran Heart Center, Tehran University of Medical Sciences, Shahed University, Tehran, Iran.
Coron Artery Dis. 2007 May;18(3):163-8. doi: 10.1097/MCA.0b013e328012a94f.
Being overweight, a constituent of the metabolic syndrome, is also an important contributing factor to the development of coronary artery disease in younger patients, compared with the older patient population. Owing to the above-mentioned fact, we sought to assess the association of the metabolic syndrome with premature coronary artery disease.
In an analytic cross-sectional study, 940 patients (553 women<or=55 years and 387 men<or=45 years), 637 with coronary artery disease and 303 without coronary artery disease, were evaluated. The extent of atherosclerosis was assessed with a clinical vessel score. Besides established coronary artery disease risk factors, all patients were evaluated for the presence of metabolic syndrome based on the National Cholesterol Education Program Adult Treatment Panel III criteria.
The overall prevalences of metabolic syndrome and coronary artery disease were 56 and 67.8%, respectively. Metabolic syndrome prevalence was higher in women than in men (69.6 vs. 36.4%, P<0.001). The odds ratio of metabolic syndrome for premature coronary artery disease was 1.82 (95% confidence interval 1.17-2.82) after adjusting for age and multiple established coronary artery disease risk factors; the strength of this association varied by sex (2.17 in men vs. 1.22 in women).
This study revealed a stronger association between metabolic syndrome and coronary artery disease in men<or=45 years than in women<or=55 years. It seems that endogenous estrogens may play a role in reducing the effects of metabolic syndrome-related risk and therefore in spite of higher prevalence of metabolic syndrome in young women, the effect of this syndrome on coronary artery disease is more dominant in young men.
超重作为代谢综合征的一个组成部分，与老年患者群体相比，也是年轻患者发生冠状动脉疾病的一个重要促成因素。基于上述事实，我们试图评估代谢综合征与早发性冠状动脉疾病之间的关联。
在一项分析性横断面研究中，对940例患者（553例年龄≤55岁的女性和387例年龄≤45岁的男性）进行了评估，其中637例患有冠状动脉疾病，303例无冠状动脉疾病。采用临床血管评分评估动脉粥样硬化的程度。除了既定的冠状动脉疾病危险因素外，所有患者均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评估代谢综合征的存在情况。
代谢综合征和冠状动脉疾病的总体患病率分别为56%和67.8%。代谢综合征的患病率女性高于男性（69.6%对36.4%，P<0.001）。在调整年龄和多种既定的冠状动脉疾病危险因素后，早发性冠状动脉疾病患者代谢综合征的比值比为1.82（95%置信区间为1.17 - 2.82）；这种关联的强度因性别而异（男性为2.17，女性为1.22）。
本研究显示，年龄≤45岁的男性中代谢综合征与冠状动脉疾病之间的关联比年龄≤55岁的女性更强。内源性雌激素似乎可能在降低代谢综合征相关风险的影响方面发挥作用，因此尽管年轻女性中代谢综合征的患病率较高，但该综合征对冠状动脉疾病的影响在年轻男性中更为显著。
