Huang Kuo-Chin, Lee Long-Teng, Chen Ching-Yu, Sung Pei-Kun
Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Obesity (Silver Spring). 2008 Mar;16(3):684-9. doi: 10.1038/oby.2007.112. Epub 2008 Jan 17.
This study aimed to investigate the relationship between mortality and metabolic syndrome using the America Heart Association/National Heart Lung Blood Institute (AHA/NHLBI) and International Diabetes Federation (IDF) definitions in a Taiwanese cohort.
A total of 124,513 participants, aged 20-94 years, from four nationwide health centers in Taiwan were recruited from 1998 to 1999. Cox proportional hazard regression analyses were used to estimate the relative risks (RRs) for all-cause and cardiovascular disease (CVD) mortality for those with metabolic syndrome compared to those without metabolic syndrome over 8 years of follow-up.
The baseline prevalence of metabolic syndrome was 22.4% by the AHA/NHLBI and 13.9% by the IDF definition. A total of 2,762 deaths (527 CVD) occurred. Using the AHA/NHLBI definition, the RRs (95% confidence intervals) of all-cause and CVD mortality were 1.21 (1.09-1.34) and 1.77 (1.40-2.24), respectively, in men and 1.30 (1.12-1.49) and 1.69 (1.19-2.42), respectively, in women. The association between metabolic syndrome and mortality was attenuated when using the IDF definition. Excluding subjects with diabetes or CVD at baseline, the RRs for CVD mortality still remained significant using the two definitions.
Metabolic syndrome, using either the AHA/NHLBI or IDF definitions, is a common disorder in Taiwanese adults and is similarly associated with an increase in all-cause and CVD mortality as found in Western populations. Our study suggests that Asians with metabolic syndrome are also at higher risk for death.
本研究旨在采用美国心脏协会/美国国立心肺血液研究所(AHA/NHLBI)及国际糖尿病联盟(IDF)的定义,调查台湾队列中死亡率与代谢综合征之间的关系。
1998年至1999年,从台湾四个全国性健康中心招募了共计124,513名年龄在20 - 94岁的参与者。采用Cox比例风险回归分析,估计在8年随访期内,患有代谢综合征者与未患有代谢综合征者相比,全因死亡率和心血管疾病(CVD)死亡率的相对风险(RRs)。
根据AHA/NHLBI定义,代谢综合征的基线患病率为22.4%;根据IDF定义,为13.9%。共发生2762例死亡(527例CVD)。采用AHA/NHLBI定义时,男性全因死亡率和CVD死亡率的RRs(95%置信区间)分别为1.21(1.09 - 1.34)和1.77(1.40 - 2.24),女性分别为1.30(1.12 - 1.49)和1.69(1.19 - 2.42)。采用IDF定义时,代谢综合征与死亡率之间的关联减弱。排除基线时患有糖尿病或CVD的受试者后,使用这两种定义时CVD死亡率的RRs仍具有显著性。
采用AHA/NHLBI或IDF定义,代谢综合征在台湾成年人中是一种常见疾病,与西方人群一样,与全因死亡率和CVD死亡率的增加相关。我们的研究表明,患有代谢综合征的亚洲人死亡风险也更高。