Wang Jianjun, Ruotsalainen Sanna, Moilanen Leena, Lepistö Päivi, Laakso Markku, Kuusisto Johanna
Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
Diabetes Care. 2007 Dec;30(12):3099-104. doi: 10.2337/dc07-0985. Epub 2007 Sep 11.
We investigated the relationship of the metabolic syndrome and its single components, defined by four different criteria, with peripheral vascular disease (PVD) in a prospective population-based study.
The metabolic syndrome was defined according to the World Health Organization (WHO), the National Cholesterol Education Program (NCEP), the International Diabetes Federation (IDF), and the American Heart Association (updated NCEP) criteria. We investigated the relationship of the metabolic syndrome defined by the aforementioned four criteria with PVD (revacularization and amputation) by Cox regression analyses in a Finnish population of 1,212 subjects, aged 65-74 years, with and without diabetes during a 14-year follow-up.
The metabolic syndrome defined by the WHO, NCEP, and updated NCEP criteria was associated with a statistically significant risk for incident PVD (n = 57) with adjustment for all confounding variables except for prevalent diabetes (hazard ratios [HRs] from 1.91 to 2.62). After adjustment for prevalent diabetes or after the exclusion of subjects with prevalent diabetes, there was no association between the metabolic syndrome by any criteria and incident PVD. Of the single components of the metabolic syndrome, elevated fasting glucose by the WHO and NCEP criteria (HR 2.35) and microalbuminuria by the WHO definition (2.56) predicted PVD in multivariable models (prevalent diabetes included).
The metabolic syndrome defined by the WHO, NCEP, and updated NCEP criteria predicted incident end-stage PVD in elderly Finns but only when not adjusted for diabetes status. Two of the single components of the metabolic syndrome, elevated fasting plasma glucose and microalbuminuria, predicted PVD. We conclude that the metabolic syndrome predicts PVD but not above and beyond the risk associated with diabetes and microalbuminuria.
在一项基于人群的前瞻性研究中，我们调查了由四种不同标准定义的代谢综合征及其单一成分与外周血管疾病（PVD）之间的关系。
代谢综合征根据世界卫生组织（WHO）、美国国家胆固醇教育计划（NCEP）、国际糖尿病联盟（IDF）以及美国心脏协会（更新后的NCEP）标准进行定义。我们通过Cox回归分析，在1212名年龄在65至74岁之间、有或无糖尿病的芬兰人群中，对上述四种标准定义的代谢综合征与PVD（血管再通和截肢）之间的关系进行了14年的随访研究。
由WHO、NCEP和更新后的NCEP标准定义的代谢综合征与新发PVD（n = 57）的风险在统计学上显著相关，在对除糖尿病患病率之外的所有混杂变量进行调整后（风险比[HRs]为1.91至2.62）。在对糖尿病患病率进行调整后或排除患有糖尿病的受试者后，任何标准定义的代谢综合征与新发PVD之间均无关联。在代谢综合征的单一成分中，根据WHO和NCEP标准空腹血糖升高（HR 2.35）以及根据WHO定义的微量白蛋白尿（2.56）在多变量模型中（包括糖尿病患病率）可预测PVD。
由WHO、NCEP和更新后的NCEP标准定义的代谢综合征可预测老年芬兰人新发终末期PVD，但仅在未对糖尿病状态进行调整时。代谢综合征的两个单一成分，空腹血糖升高和微量白蛋白尿，可预测PVD。我们得出结论，代谢综合征可预测PVD，但并不超过与糖尿病和微量白蛋白尿相关的风险。
