Zaliūnas Remigijus, Slapikas Rimvydas, Babarskiene Rūta, Slapikiene Birute, Luksiene Dalia, Milvidaite Irena, Laukaitiene Jolanta
Institute of Cardiology, Kaunas University of Medicine, Kaunas, Lithuania.
Medicina (Kaunas). 2008;44(7):521-8.
During the last decade, it has been shown that the metabolic syndrome and its different components--arterial hypertension (AH), abdominal obesity (AO), diabetes mellitus (DM), atherogenic hypertriglyceridemia (HTG), and/or low concentration of high-density lipoprotein cholesterol (HDL-C))--increase the risk of cardiovascular diseases. There is increasing evidence that the incidence of the metabolic syndrome and the distribution of its components in combinations in the general male and female population differ. The aim of our study was to determine the incidence of the metabolic syndrome in men and women with acute ischemic syndromes and to evaluate the distribution of the metabolic syndrome component combinations in the presence of the metabolic syndrome. Contingent and methods. The study included 2756 patients (1670 males and 1086 females) with acute ischemic syndromes (1997 with myocardial infarction and 759 with unstable angina pectoris), in whom all five components of the metabolic syndrome were assessed. Women were significantly older than men (68.1+/-9.5 vs. 60.2+/-11.8 years, P<0.001). The metabolic syndrome was found (according to modified NCEP III) in 1641 (59.5%) patients (in 70.2% of females and in 52.6% of males, P<0.001). The most common components in both men and women were AH and AO (94.0% vs. 95.9% and 86.4% vs. 84.5%, respectively). HTG was significantly more common in men than in women (80.0% vs. 73.0%, P<0.001), while decreased HDL-C concentration was more common in women (82.8% and 59.2%, P<0.001). The DM component, detected in more than one-third of patients with acute ischemic syndromes, was significantly more common in women than in men (39.2% vs. 33.1%, P<0.05). Combinations of three components were significantly more common in men than in women, while combinations of four-five components were more common in women (55.6% vs. 41.4%, P<0.001; and 58.6% vs. 44.4%, P<0.01). The most common combination of three components in men was AH+AO+HTG and in women--AH+AO+low HDL-C; the most common combination of four components in both men and women was AH+AO+HTG+low HDL-C. CONCLUSION. In the metabolic syndrome, the differences between the components of atherogenic dyslipidemia in patients with acute ischemic syndromes were related to the patients' gender: men significantly more frequently had increased TG concentration and women--decreased HDL-C concentration; this is the problem to be addressed in further studies of dyslipidemia.
在过去十年中，研究表明代谢综合征及其不同组分——动脉高血压（AH）、腹型肥胖（AO）、糖尿病（DM）、致动脉粥样硬化性高甘油三酯血症（HTG）和/或低浓度高密度脂蛋白胆固醇（HDL-C）——会增加心血管疾病风险。越来越多的证据表明，代谢综合征的发病率及其组分在普通男性和女性人群中的组合分布存在差异。我们研究的目的是确定急性缺血综合征男性和女性患者中代谢综合征的发病率，并评估存在代谢综合征时代谢综合征组分组合的分布情况。研究对象与方法。该研究纳入了2756例急性缺血综合征患者（1670例男性和1086例女性）（1997例心肌梗死患者和759例不稳定型心绞痛患者），对其代谢综合征的所有五个组分进行了评估。女性明显比男性年龄大（68.1±9.5岁对60.2±11.8岁，P<0.001）。根据改良的NCEP III标准，在1641例（59.5%）患者中发现了代谢综合征（女性为70.2%，男性为52.6%，P<0.001）。男性和女性中最常见的组分都是AH和AO（分别为94.0%对95.9%和86.4%对84.5%）。HTG在男性中显著比女性更常见（80.0%对73.0%，P<0.001），而HDL-C浓度降低在女性中更常见（82.8%对59.2%，P<0.001）。在超过三分之一的急性缺血综合征患者中检测到的DM组分，在女性中显著比男性更常见（39.2%对33.1%，P<0.05）。三种组分的组合在男性中显著比女性更常见，而四种 - 五种组分的组合在女性中更常见（55.6%对41.4%，P<0.001；58.6%对44.4%，P<0.01）。男性中最常见的三种组分组合是AH + AO + HTG，女性是AH + AO + 低HDL-C；男性和女性中最常见的四种组分组合都是AH + AO + HTG + 低HDL-C。结论。在代谢综合征中，急性缺血综合征患者致动脉粥样硬化性血脂异常组分之间的差异与患者性别有关：男性TG浓度升高的频率显著更高，女性HDL-C浓度降低的频率更高；这是血脂异常进一步研究中需要解决的问题。
