Novo G, Corrado E, Muratori I, Tantillo R, Bellia A, Galluzzo A, Vitale G, Novo S
Division of Cardiology, Department of Internal Medicine and Cardiovascular Disease, University of Palermo, Palermo, Italy.
Int Angiol. 2007 Dec;26(4):312-7.
The aim of this study was to determine the prevalence of carotid atherosclerosis and coronary heart disease and cerebrovascular disease in subjects with metabolic syndrome and to investigate the relationship between atherosclerosis and C-reactive protein (CRP) levels.
We studied 568 ambulatory subjects, referred to our Center for the study of atherosclerosis and cardiovascular prevention by general practitioner, for the presence of traditional cardiovascular risk factors. Subjects were divided in two groups: those with metabolic syndrome (n=163), and those with 0-2 metabolic abnormalities (n=405). All subjects underwent carotid artery ultrasound and blood tests including high sensitivity-CRP measurement.
Prevalence of carotid lesions, previous cardiac or cerebrovascular events was higher in patients with metabolic syndrome. CRP levels were higher in patients with metabolic syndrome (0.6+/-0.23 vs 0.42+/-0.2, P<0.01). An increased relative risk for carotid atherosclerosis, coronary heart disease and cerebrovascular disease was not associated with each single component of the metabolic syndrome, but it was significantly associated with the coexistence of three or more of these. Patients with the metabolic syndrome had a higher incidence of carotid and coronary disease, if CRP levels were above 0.3 mg/dL.
Patients with metabolic syndrome are at increased risk for cardiovascular events. Strategy to treat these patients is not well clarified. Life style changes are mandatory, but in very high-risk subgroups secondary prevention strategies may be advisable. These may be identified by using CRP levels as a marker.
本研究旨在确定代谢综合征患者中颈动脉粥样硬化、冠心病和脑血管疾病的患病率，并探讨动脉粥样硬化与C反应蛋白（CRP）水平之间的关系。
我们研究了568名门诊患者，这些患者由全科医生转至我们中心进行动脉粥样硬化和心血管疾病预防研究，以确定是否存在传统心血管危险因素。受试者分为两组：代谢综合征患者（n = 163）和有0 - 2项代谢异常的患者（n = 405）。所有受试者均接受颈动脉超声检查和血液检测，包括高敏CRP测量。
代谢综合征患者的颈动脉病变、既往心脏或脑血管事件的患病率更高。代谢综合征患者的CRP水平更高（0.6±0.23 vs 0.42±0.2，P<0.01）。颈动脉粥样硬化、冠心病和脑血管疾病相对风险的增加与代谢综合征的单一成分无关，但与其中三种或更多种成分同时存在显著相关。如果CRP水平高于0.3mg/dL，代谢综合征患者的颈动脉和冠心病发病率更高。
代谢综合征患者发生心血管事件的风险增加。治疗这些患者的策略尚不清楚。生活方式改变是必要的，但在高危亚组中，二级预防策略可能是可取的。可将CRP水平作为标志物来识别这些亚组。
