Mancia Giuseppe, Bombelli Michele, Facchetti Rita, Madotto Fabiana, Corrao Giovanni, Trevano Fosca Quarti, Giannattasio Cristina, Grassi Guido, Sega Roberto
Clinica Medica, Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo, Monza, Italy.
J Hypertens. 2008 Aug;26(8):1602-11. doi: 10.1097/HJH.0b013e328302f10d.
Metabolic syndrome is accompanied by an increased risk of developing diabetes mellitus. Limited or no evidence exists on whether and to what extent metabolic syndrome increases the risk of developing office hypertension, daily-life hypertension and left ventricular hypertrophy.
In 1412 individuals representative of the population of Monza, plasma glucose, office, home and ambulatory blood pressure, and echocardiographic left ventricular mass index were measured between 1990 and 1992 and 10 years later. New onset diabetes mellitus, new onset office, home and ambulatory hypertension as well as new onset left ventricular hypertrophy were assessed in individuals with and without metabolic syndrome (Adult Treatment Panel criteria) at the first examination.
New onset diabetes mellitus, hypertension and left ventricular hypertrophy were all much more frequent in individuals with metabolic syndrome than in those without. In patients with metabolic syndrome, the adjusted risk of new onset diabetes mellitus was five to six times greater (P < 0.001), that of new onset office, home or ambulatory hypertension 3.5, 2.9 and 3.2 times greater (P < 0.001), respectively, and that of new onset left ventricular hypertrophy 2.6 times greater (P < 0.001). The most important predictors of new onset diabetes mellitus, hypertension and left ventricular hypertrophy were the baseline blood glucose, blood pressure and left ventricular mass index, respectively, with an independent contribution, in each condition, from other metabolic syndrome components. The metabolic syndrome as such did not have an additional predictive value.
In the general population, metabolic syndrome is associated with a marked increase in the risk not only of new onset diabetes mellitus but also of new onset office and daily-life hypertension, and left ventricular hypertrophy. This may account for the increased rate of cardiovascular morbidity and mortality exhibited with this condition in long-term studies.
代谢综合征会增加患糖尿病的风险。关于代谢综合征是否以及在何种程度上会增加患诊室高血压、日常生活高血压和左心室肥厚的风险，现有证据有限或几乎没有。
在1412名代表蒙扎人群的个体中，于1990年至1992年期间测量了血浆葡萄糖、诊室、家庭和动态血压以及超声心动图左心室质量指数，并在10年后再次测量。在首次检查时，对有和没有代谢综合征（成人治疗小组标准）的个体评估新发糖尿病、新发诊室、家庭和动态高血压以及新发左心室肥厚情况。
有代谢综合征的个体中，新发糖尿病、高血压和左心室肥厚的发生率均远高于无代谢综合征的个体。在患有代谢综合征的患者中，新发糖尿病的校正风险高五至六倍（P<0.001），新发诊室、家庭或动态高血压的校正风险分别高3.5倍、2.9倍和3.2倍（P<0.001），新发左心室肥厚的校正风险高2.6倍（P<0.001）。新发糖尿病、高血压和左心室肥厚的最重要预测因素分别是基线血糖、血压和左心室质量指数，在每种情况下，其他代谢综合征组分均有独立作用。代谢综合征本身并无额外的预测价值。
在一般人群中，代谢综合征不仅与新发糖尿病的风险显著增加有关，还与新发诊室和日常生活高血压以及左心室肥厚的风险显著增加有关。这可能解释了长期研究中该疾病所呈现的心血管发病率和死亡率增加的现象。
