Ding Qun-Fang, Hayashi Toshio, Zhang Xin-Jun, Funami Jan, Ge Ling, Li Jun, Huang Xiao-Li, Cao Li, Zhang Jun, Akihisa Iguchi
Department of Geriatrics, Medicine in Growth and Aging, Program in Health and Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
J Diabetes Complications. 2007 Sep-Oct;21(5):315-9. doi: 10.1016/j.jdiacomp.2006.03.005.
The objective of this study was to assess the capacity of different criteria of metabolic syndrome (MetS) to identify risks of coronary heart diseases (CHDs) and related changes of adipocytokines in postmenopausal women. A cross-sectional study was carried out in 225 community-dwelling, elderly postmenopausal Chinese women (age, 66.77+/-5.09 years) without hormone replacement therapy (HRT). Baseline data such as blood pressure, body mass index (BMI), serum lipid profiles, and fasting glucose were analyzed, and insulin sensitivity was estimated via the homeostasis model assessment for insulin resistance. Serum tumor necrosis factor alpha (TNFalpha), interleukin-6 (IL-6), and adiponectin were measured simultaneously. The prevalence of MetS identified by the Third Report of the National Cholesterol Education Programme Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, the International Diabetes Federation (IDF), the Chinese Diabetes Society (CDS), and the Japanese Society of Internal Medicine (JPN) were 27.31%, 37.34%, 23.29%, and 13.65%, respectively. No significant differences of baseline data were found among different MetS groups, except for a significant higher waist circumference in the JPN-MetS group as compared with other MetS groups. The prevalence of confirmed CHD in the four MetS groups were 26.2%, 18.6%, 26.9%, and 32%, respectively. Odds ratios for CHD were 1.905 (95% CI=1.273-2.851), 1.208 (95% CI=0.778-1.876), 1.997 (95% CI=1.238-3.221), and 2.336 (95% CI=1.119-4.876), respectively. The JPN-MetS group had higher levels of TNFalpha and IL-6, whereas the CDS-MetS group correlated better with lower adiponectin levels. The IDF definition for MetS is the most sensitive one with regard to metabolic disorders, whereas JPN and CDS definitions correlate better with CHD and changes of adipocytokines among the four criteria studied.
本研究的目的是评估不同代谢综合征（MetS）标准对识别绝经后女性冠心病（CHD）风险及相关脂肪细胞因子变化的能力。对225名居住在社区、未接受激素替代疗法（HRT）的老年绝经后中国女性（年龄66.77±5.09岁）进行了一项横断面研究。分析了血压、体重指数（BMI）、血脂谱和空腹血糖等基线数据，并通过稳态模型评估胰岛素抵抗来估计胰岛素敏感性。同时测量血清肿瘤坏死因子α（TNFα）、白细胞介素-6（IL-6）和脂联素。根据美国国家胆固醇教育计划成人高血胆固醇检测、评估和治疗专家小组第三次报告、国际糖尿病联盟（IDF）、中国糖尿病学会（CDS）和日本内科医学会（JPN）确定的MetS患病率分别为27.31%、37.34%、23.29%和13.65%。除JPN-MetS组的腰围显著高于其他MetS组外，不同MetS组之间的基线数据无显著差异。四个MetS组中确诊冠心病的患病率分别为26.2%、18.6%、26.9%和32%。冠心病的比值比分别为1.905（95%CI=1.273-2.851）、1.208（95%CI=0.778-1.876）、1.997（95%CI=1.238-3.221）和2.336（95%CI=1.119-4.876）。JPN-MetS组的TNFα和IL-6水平较高，而CDS-MetS组与较低的脂联素水平相关性更好。在研究的四个标准中，IDF对MetS的定义在代谢紊乱方面最敏感，而JPN和CDS的定义与冠心病及脂肪细胞因子变化的相关性更好。
