Lopes Neuza H, Paulitsch Felipe S, Pereira Alexandre C, Góis Aécio F, Gagliardi Antônio, Garzillo Cibele L, Ferreira João F, Stolf Noedir A, Hueb Whady
Heart Institute (InCor) of the University of Sao Paulo, Sao Paulo, Brazil.
Coron Artery Dis. 2008 Sep;19(6):383-8. doi: 10.1097/MCA.0b013e328306aa8a.
We characterized the impact of the metabolic syndrome (MetS) and its components on cardiovascular adverse events in patients with symptomatic chronic multivessel coronary artery disease, which have been followed prospectively for 2 years.
Patients enrolled in the MASS II study were evaluated for each component of the MetS, as well as the full syndrome.
The criteria for MetS were fulfilled in 52% of patients. The presence of MetS (P<0.05), glucose intolerance (P=0.007), and diabetes (P=0.04) was associated with an increased mortality in our studied population. Moreover, despite a clear tendency for each of its components to increase the mortality risk, only the presence of the MetS significantly increased the risk of mortality among nondiabetic study participants in a multivariate model (P=0.03, relative risk 3.5, 95% confidence interval 1.1-6). Finally, MetS was still associated with increased mortality even after adjustment for diabetes status. These results indicate a strong and consistent relationship of the MetS with mortality in patients with stable coronary artery disease.
Although glucose homeostasis seems to be the major force driving the increased risk of MetS, the operational diagnosis of MetS still has information for stratifying patients when diabetes information is taken into account.
我们对代谢综合征（MetS）及其各组分对有症状的慢性多支冠状动脉疾病患者心血管不良事件的影响进行了特征分析，这些患者已被前瞻性随访2年。
对纳入MASS II研究的患者进行了代谢综合征各组分以及整个综合征的评估。
52%的患者符合代谢综合征标准。在我们的研究人群中，代谢综合征的存在（P<0.05）、糖耐量异常（P=0.007）和糖尿病（P=0.04）与死亡率增加相关。此外，尽管其每个组分都有明显增加死亡风险的趋势，但在多变量模型中，仅代谢综合征的存在显著增加了非糖尿病研究参与者的死亡风险（P=0.03，相对风险3.5，95%置信区间1.1 - 6）。最后，即使在调整糖尿病状态后，代谢综合征仍与死亡率增加相关。这些结果表明代谢综合征与稳定型冠状动脉疾病患者的死亡率之间存在强烈且一致的关系。
尽管血糖稳态似乎是驱动代谢综合征风险增加的主要因素，但当考虑糖尿病信息时，代谢综合征的临床诊断仍可为患者分层提供信息。
