Gimeno-Orna José A, Molinero-Herguedas Edmundo, Lou-Arnal Luis M, Boned-Juliani Beatriz, Labrador-Fuster Tomás, Guiu-Campos Miguel
Sección de Medicina Interna, Hospital Comarcal de Alcañiz, Teruel, España.
Rev Esp Cardiol. 2007 Nov;60(11):1202-5.
The aim of this study was to determine the impact of the metabolic syndrome on vascular disease risk in patients with type-2 diabetes. A prospective cohort study was carried out. The main dependent variable was the combination of coronary disease, stroke and lower leg amputation. Cox regression modeling was used. In total, 317 patients were followed for a mean of 7.7 years. The prevalence of metabolic syndrome was 87%. Multivariate analysis identified the following as predictors of incident vascular disease: age (relative risk [RR] =1.06, 95% confidence interval [CI], 1.02-1.1; P=.0003), baseline cardiovascular disease (RR=1.8; 95% CI, 1.1-3.0; P=.017), and the simultaneous presence of four metabolic risk factors (RR=5.8; 95% CI, 1.8-18; P=.003). The most predictive factor was microalbuminuria (chi2=5.9; P=.015). Microalbuminuria accounts for the increased risk of vascular disease in patients with metabolic syndrome. In evaluating vascular disease risk in patients with type-2 diabetes, it is more important to consider the total number of metabolic risk factors than the presence of metabolic syndrome alone.
本研究的目的是确定代谢综合征对2型糖尿病患者血管疾病风险的影响。开展了一项前瞻性队列研究。主要因变量是冠心病、中风和小腿截肢的综合情况。采用Cox回归模型。总共对317名患者进行了平均7.7年的随访。代谢综合征的患病率为87%。多变量分析确定以下因素为血管疾病发病的预测因素：年龄（相对风险[RR]=1.06，95%置信区间[CI]，1.02 - 1.1；P = 0.0003）、基线心血管疾病（RR = 1.8；95% CI，1.1 - 3.0；P = 0.017）以及同时存在四种代谢危险因素（RR = 5.8；95% CI，1.8 - 18；P = 0.003）。最具预测性的因素是微量白蛋白尿（χ2 = 5.9；P = 0.015）。微量白蛋白尿导致代谢综合征患者血管疾病风险增加。在评估2型糖尿病患者的血管疾病风险时，考虑代谢危险因素的总数比单纯考虑代谢综合征的存在更为重要。
