Milionis Haralampos J, Kalantzi Kallirroi J, Papathanasiou Athanasios J, Kosovitsas Athanasios A, Doumas Michael T, Goudevenos John A
Department of Internal Medicine, School of Medicine, University of Ioannina, Greece.
Coron Artery Dis. 2007 Jun;18(4):247-52. doi: 10.1097/MCA.0b013e328035f8c4.
There is a paucity of data with regard to the association of the metabolic syndrome with cardiovascular risk in young adults. We investigated the association of the metabolic syndrome with acute coronary syndrome in adults aged 45 years or younger.
A total of 136 consecutive patients (128 men and eight women; mean age, 41.2+/-3.7 years) presenting with a first-ever acute coronary syndrome, and 136 age-matched and sex-matched controls were evaluated. The diagnosis of the metabolic syndrome was established according to the Adult Treatment Panel III criteria.
The prevalence of the metabolic syndrome was significantly higher in the patients' group compared with the control group (40.4 versus 23.5%; P=0.003). Multivariate logistic regression analysis showed that smoking, positive family history of premature coronary artery disease, and the metabolic syndrome were associated with odds ratios 4.46 (95% confidence interval, 2.30-8.66; P<0.001), 3.11 (95% confidence interval, 1.71-5.66; P<0.001), and 1.97 (95% confidence interval, 1.08-3.56; P=0.02) higher odds, respectively, of having an acute coronary syndrome, after taking into account the matching for age and sex and controlling for potential confounders. Moreover, a 10-mg/dl increase in total cholesterol was associated with 1.06 higher odds of having an acute coronary syndrome. Analysis of interaction showed that smoking and a positive family history of premature coronary artery disease in young individuals with metabolic syndrome had an incremental effect on the odds of suffering an acute coronary syndrome (odds ratio, 7.12; 95% confidence interval, 2.42-20.96; P<0.001).
The metabolic syndrome is highly associated with acute coronary syndrome in patients younger than 45 years of age, indicating the need for early and intensive preventive measures.
关于年轻成年人代谢综合征与心血管风险之间的关联，目前数据匮乏。我们调查了45岁及以下成年人代谢综合征与急性冠状动脉综合征之间的关联。
共评估了136例首次出现急性冠状动脉综合征的连续患者（128例男性和8例女性；平均年龄41.2±3.7岁），以及136例年龄和性别匹配的对照。根据成人治疗小组III标准确定代谢综合征的诊断。
患者组代谢综合征的患病率显著高于对照组（40.4%对23.5%；P = 0.003）。多因素逻辑回归分析显示，在考虑年龄和性别匹配并控制潜在混杂因素后，吸烟、早发冠状动脉疾病阳性家族史和代谢综合征与发生急性冠状动脉综合征的比值比分别高4.46（95%置信区间，2.30 - 8.66；P < 0.001）、3.11（95%置信区间，1.71 - 5.66；P < 0.001）和1.97（95%置信区间，1.08 - 3.56；P = 0.02）。此外，总胆固醇每升高10mg/dl与急性冠状动脉综合征发生几率高1.06相关。交互作用分析显示，代谢综合征的年轻个体中吸烟和早发冠状动脉疾病阳性家族史对发生急性冠状动脉综合征的几率有增量影响（比值比，7.12；95%置信区间，2.42 - 20.96；P < 0.001）。
代谢综合征与45岁以下患者的急性冠状动脉综合征高度相关，表明需要采取早期和强化的预防措施。
