采用改良的美国国家胆固醇教育计划成人治疗组第三次报告（NCEP-ATPIII）标准定义的代谢综合征对日本成年人颈动脉粥样硬化的临床影响
Clinical impact of metabolic syndrome by modified NCEP-ATPIII criteria on carotid atherosclerosis in Japanese adults.
作者信息
Teramura Megumi, Emoto Masanori, Araki Takahiro, Yokoyama Hisayo, Motoyama Koka, Shinohara Kayo, Mori Katsuhito, Koyama Hidenori, Shoji Tetsuo, Inaba Masaaki, Nishizawa Yoshiki
机构信息
Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
出版信息
J Atheroscler Thromb. 2007 Aug;14(4):172-8. doi: 10.5551/jat.e505. Epub 2007 Aug 14.
AIM
The present study aimed to clarify the clinical impact of modified NCEP-ATP III criteria for metabolic syndrome (MS) and Framingham Risk Score (FRS) on carotid atherosclerosis in 615 Japanese adults (319 men and 296 women) including 307 with type 2 diabetes.
METHODS
Waist circumference was the only component from the original NCEP-ATP III criteria based on Japanese criteria. The intima-medial thickness (IMT) and stiffness parameter beta of the carotid artery were measured by ultrasound.
RESULTS
Both IMT and stiffness parameter beta were significantly increased with the number of coexisting components of MS, and higher in subjects with MS than in those without MS (all Ps < 0.0001). In a logistic regression analysis with each component of MS as independent factors, hyperglycemia and hypertension had the highest odds ratio for progressors of IMT and stiffness parameter beta , respectively. Univariate odds ratios of MS for both IMT and stiffness parameter beta were comparable with that of an increase of 10% in 10-year coronary heart disease (CHD) risk by FRS (CHD risk/ 10%) but inferior to CHD risk by FRS >/= 20%.
CONCLUSION
The modified NCEP-ATP III criteria for MS revealed an additive predictive impact on carotid atherosclerosis but no superiority to FRS.
目的
本研究旨在阐明修改后的美国国家胆固醇教育计划成人治疗组第三次报告（NCEP-ATP III）代谢综合征（MS）标准和弗雷明汉风险评分（FRS）对615名日本成年人（319名男性和296名女性，其中307名患有2型糖尿病）颈动脉粥样硬化的临床影响。
方法
基于日本标准，腰围是原始NCEP-ATP III标准中唯一的组成部分。通过超声测量颈动脉内膜中层厚度（IMT）和硬度参数β。
结果
IMT和硬度参数β均随MS共存组分数量的增加而显著增加，且MS患者高于非MS患者（所有P<0.0001）。在以MS的各组分作为独立因素的逻辑回归分析中，高血糖和高血压分别对IMT进展者和硬度参数β具有最高的优势比。MS对IMT和硬度参数β的单变量优势比与FRS使10年冠心病（CHD）风险增加10%（CHD风险/10%）相当，但低于FRS≥20%时的CHD风险。
结论
修改后的NCEP-ATP III MS标准显示出对颈动脉粥样硬化有累加预测影响，但不优于FRS。
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