Zabetian A, Hadaegh F, Azizi F
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Science, Shahid Beheshti University (M. C), Tehran, I. R. Iran.
Exp Clin Endocrinol Diabetes. 2008 Oct;116(9):525-31. doi: 10.1055/s-2008-1065332. Epub 2008 Apr 1.
Although metabolic syndrome (MetS) is receiving increased attention from physicians, data on the syndrome's association with coronary heart disease (CHD) in Iranian populations are limited.
To estimate the odds ratio (OR) of MetS defined by each of the International Diabetes Federation (IDF), the Adult Treatment Panel (ATPIII) and the WHO definitions for CHD, logistic regression analysis was used on 5981 subjects aged > or = 30 years, in both sexes in 3 models; model 1 an age adjusted model, model 2 adjusted for age, smoking status, premature history of CHD and LDL cholesterol and model 3 adjusted for mentioned variables plus the MetS components.
The MetS defined by all the three definitions was associated with CHD in models 1 and 2.The relatively highest odds ratio (95% CI) of the MetS for CHD was defined in model 2 by WHO definition in men (2.3 (1.8-3)) and the ATPIII definition in women (1.6 (1.3-2)). In model 3, MetS lost its association with CHD; in men however, high fasting plasma glucose and high blood pressure (plus obesity by the WHO definition) and in women, high blood pressure (plus high waist circumference by the ATPIII, obesity and glucose domain by the WHO definition) remained associated with CHD.
In Iranian men and women, all three definitions of MetS were associated with CHD when considering the conventional risk factors. After further adjusting MetS components, none of these definitions showed association with CHD and only high blood pressure remained related to CHD in both sexes in all definitions.
尽管代谢综合征(MetS)日益受到医生的关注,但关于该综合征与伊朗人群冠心病(CHD)关联的数据有限。
为估计国际糖尿病联盟(IDF)、成人治疗小组(ATPIII)和世界卫生组织(WHO)定义的MetS与CHD的比值比(OR),对5981名年龄≥30岁的受试者进行了逻辑回归分析,分析采用了3种模型,涵盖男女两性;模型1为年龄调整模型,模型2在模型1基础上调整了年龄、吸烟状况以及CHD家族史和低密度脂蛋白胆固醇水平,模型3在模型2基础上进一步调整了上述变量以及MetS各组分。
在模型1和模型2中,所有三种定义的MetS均与CHD相关。在模型2中,按WHO定义,男性MetS对CHD的比值比(95%可信区间)相对最高(2.3(1.8 - 3));按ATPIII定义,女性MetS对CHD的比值比(95%可信区间)相对最高(1.6(1.3 - 2))。在模型3中,MetS与CHD失去关联;然而,在男性中,空腹血糖升高和高血压(加上WHO定义的肥胖),在女性中,高血压(加上ATPIII定义的高腰围、WHO定义的肥胖和血糖异常)仍与CHD相关。
对于伊朗男性和女性,考虑传统危险因素时,所有三种MetS定义均与CHD相关。进一步调整MetS各组分后,这些定义均未显示与CHD相关,且在所有定义中,仅高血压在两性中仍与CHD相关。