Maggi Stefania, Noale Marianna, Zambon Alberto, Limongi Federica, Romanato Giovanna, Crepaldi Gaetano
National Research Council, Aging Branch, Institute of Neuroscience, Padova, Italy.
Atherosclerosis. 2008 Apr;197(2):877-82. doi: 10.1016/j.atherosclerosis.2007.08.002. Epub 2007 Sep 11.
The metabolic syndrome (MetS) is represented by the co-occurrence of multiple metabolic and physiologic risk factors for both type 2 diabetes mellitus and atherosclerotic cardiovascular diseases. In spite of its high frequency and association with morbidity and mortality in the adult population, very little is known about its magnitude in the elderly and about the validity of the diagnostic criteria commonly used. The objective of this paper is to assess the prevalence rate of MetS and the validity of the Adult Treatment Panel III (ATP III) diagnostic criteria in an elderly Caucasian cohort, considering data from the Italian Longitudinal Study on Aging (ILSA), a population-based study with a sample of 5632 individuals aged 65-84 years at baseline (1992). Logistic regression models and ROC curve were used to test the validity of the cut off levels proposed. The prevalence of MetS was 31.5% in men, and 59.8% in women. The cut off levels suggested for both men and women by the ATP III panel indicated a significant association with the MetS for all components. Actually, the ROC analysis would suggest lower levels for glycaemia (106 mg/dl) in men, and higher levels for blood pressure in both men and women (145/95 and 135/90, respectively). Concluding, MetS is very common in the aged Caucasians and the diagnostic criteria proposed by the ATP III panel seem to be appropriate in older individuals. Small adjustments in the cut off levels could be suggested for glycaemia (men) and in blood pressure (men and women).
代谢综合征(MetS)表现为同时出现多种2型糖尿病和动脉粥样硬化性心血管疾病的代谢及生理风险因素。尽管其在成年人群中发生率高且与发病率和死亡率相关,但对于其在老年人中的严重程度以及常用诊断标准的有效性却知之甚少。本文的目的是评估老年白种人队列中代谢综合征的患病率以及成人治疗小组第三次报告(ATP III)诊断标准的有效性,研究数据来自意大利纵向老龄化研究(ILSA),这是一项基于人群的研究,基线(1992年)时有5632名年龄在65 - 84岁的个体作为样本。使用逻辑回归模型和ROC曲线来检验所提议的临界值水平的有效性。男性代谢综合征的患病率为31.5%,女性为59.8%。ATP III小组针对男性和女性所建议的临界值水平表明,所有组分与代谢综合征均存在显著关联。实际上,ROC分析表明男性血糖水平的临界值较低(106毫克/分升),而男性和女性血压的临界值较高(分别为145/95和135/90)。总之,代谢综合征在老年白种人中非常常见,ATP III小组提议的诊断标准在老年人中似乎适用。对于血糖(男性)和血压(男性和女性)的临界值水平可建议进行小幅度调整。