Ninomiya Toshiharu, Kubo Michiaki, Doi Yasufumi, Yonemoto Koji, Tanizaki Yumihiro, Rahman Mahbubur, Arima Hisatomi, Tsuryuya Kazuhiko, Iida Mitsuo, Kiyohara Yutaka
Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Maidashi, Higashi-ku, Fukuoka, Japan.
Stroke. 2007 Jul;38(7):2063-9. doi: 10.1161/STROKEAHA.106.479642. Epub 2007 May 24.
The metabolic syndrome (MetS) is associated with an increased risk of cardiovascular disease (CVD) events in general populations. However, well-designed prospective studies in Asian populations are very limited.
We prospectively evaluated a total of 2452 community-dwelling Japanese individuals aged 40 years or older from 1988 to 2002 and examined the effects of MetS defined by the modified National Cholesterol Education Program Adult Treatment Panel III criteria on incident CVD.
The prevalence of the MetS was 21% in men and 30% in women at baseline. During the follow up, 307 CVD events occurred. Compared with those without MetS, the age-adjusted incidence of CVD (per 1000 person-years) was significantly higher in subjects with the MetS in both men (21.8 versus 11.6, P<0.01) and women (12.9 versus 6.5, P<0.01). The risk of CVD events was significantly higher even after adjusting for the following confounding factors: age, proteinuria, electrocardiographic abnormalities, serum total cholesterol, smoking habits, alcohol intake, and regular exercise (hazard ratio, 1.86; 95% CI, 1.32 to 2.62 in men and hazard ratio, 1.70; 95% CI, 1.22 to 2.36 in women). The risk of incident CVD was found to increase with the number of components of MetS and became significantly predictive when the number of components reached 3. Similar associations were also observed when CVD was divided into coronary heart disease and stroke.
Our findings suggest that MetS is a significant risk factor for the development of CVD in the Japanese middle-aged population.
代谢综合征（MetS）与一般人群中心血管疾病（CVD）事件风险增加相关。然而，针对亚洲人群的精心设计的前瞻性研究非常有限。
我们对1988年至2002年期间共2452名年龄在40岁及以上的日本社区居民进行了前瞻性评估，并研究了根据美国国家胆固醇教育计划成人治疗小组第三次修订标准定义的代谢综合征对新发CVD的影响。
基线时，男性MetS患病率为21%，女性为30%。随访期间，发生了307例CVD事件。与无MetS者相比，校正年龄后的CVD发病率（每1000人年）在男性MetS患者中显著更高（21.8对11.6，P<0.01），在女性中也显著更高（12.9对6.5，P<0.01）。即使在调整了以下混杂因素后，CVD事件风险仍显著更高：年龄、蛋白尿、心电图异常、血清总胆固醇、吸烟习惯、饮酒量和规律运动（风险比，1.86；95%CI，男性为1.32至2.62，女性为1.70；95%CI，1.22至2.36）。发现新发CVD风险随MetS组分数量增加而升高，当组分数量达到3个时具有显著预测性。当将CVD分为冠心病和中风时，也观察到类似关联。
我们的研究结果表明，MetS是日本中年人群发生CVD的重要危险因素。
