Hoang Khiet C, Ghandehari Heli, Lopez Victor A, Barboza Michael G, Wong Nathan D
Heart Disease Prevention Program, Division of Cardiology, Department of Medicine, University of California, Irvine, California, USA.
Diabetes Care. 2008 Jul;31(7):1405-9. doi: 10.2337/dc07-2087. Epub 2008 Mar 28.
Although metabolic syndrome is related to an increased risk of coronary heart disease (CHD) events, individuals with metabolic syndrome encompass a wide range of CHD risk levels. This study describes the distribution of 10-year CHD risk among U.S. adults with metabolic syndrome.
Metabolic syndrome was defined by the modified National Cholesterol Education Program (NCEP)/Third Adult Treatment Panel (ATP III) definition among 4,293 U.S. adults aged 20-79 years in the National Health and Nutrition Examination Survey 2003-2004. Low-, moderate-, moderately high-, and high-risk statuses were defined as <6, 6 to <10, 10-20, and >20% probability of CHD in 10 years (based on NCEP/ATP III Framingham risk score algorithms), respectively; those with diabetes or preexisting cardiovascular disease were assigned to high-risk status.
The weighted prevalence of metabolic syndrome by NCEP criteria in our study was 29.0% overall (30.0% in men and 27.9% in women, P = 0.28): 38.5% (30.7% men and 46.9% women) were classified as low risk, 8.5% (7.9% men and 9.1% women) were classified as moderate risk, 15.8% (23.4% men and 7.6% women) were classified as moderately high risk, and 37.3% (38.0% men and 36.5% women) were classified as high risk. The proportion at high risk increased with age but was similar among Hispanics, non-Hispanic whites, and non-Hispanic blacks.
Although many subjects with metabolic syndrome have a low calculated risk for CHD, about half have a moderately high or high risk, reinforcing the need for global risk assessment in individuals with metabolic syndrome to appropriately target intensity of treatment for underlying CHD risk factors.
尽管代谢综合征与冠心病（CHD）事件风险增加相关，但患有代谢综合征的个体的冠心病风险水平范围很广。本研究描述了美国患有代谢综合征的成年人中10年冠心病风险的分布情况。
采用改良的美国国家胆固醇教育计划（NCEP）/成人治疗专家组第三次报告（ATP III）定义，对2003 - 2004年美国国家健康和营养检查调查中4293名年龄在20 - 79岁的成年人进行代谢综合征的定义。低、中、中度高和高风险状态分别定义为10年内冠心病发生概率<6%、6%至<10%、10% - 20%和>20%（基于NCEP/ATP III弗明汉风险评分算法）；患有糖尿病或已患心血管疾病的患者被归为高风险状态。
根据NCEP标准，本研究中代谢综合征的加权总体患病率为29.0%（男性为30.0%，女性为27.9%，P = 0.28）：38.5%（男性为30.7%，女性为46.9%）被归类为低风险，8.5%（男性为7.9%，女性为9.1%）被归类为中度风险，15.8%（男性为23.4%，女性为7.6%）被归类为中度高风险，37.3%（男性为38.0%，女性为36.5%）被归类为高风险。高风险比例随年龄增加而升高，但在西班牙裔、非西班牙裔白人和非西班牙裔黑人中相似。
尽管许多患有代谢综合征的受试者计算出的冠心病风险较低，但约一半受试者具有中度高风险或高风险，这进一步强调了对患有代谢综合征的个体进行全面风险评估的必要性，以便针对潜在的冠心病风险因素适当确定治疗强度。
