Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China.
Int J Cardiol. 2010 Mar 4;139(2):159-65. doi: 10.1016/j.ijcard.2008.10.012. Epub 2008 Nov 28.
Whether metabolic syndrome (MetS) could serve as a valid indicator for cardiovascular disease (CVD) is in controversy. The aim of the study was to prospectively evaluate the predictive value of the MetS for CVD events in Chinese population by different MetS definitions.
This was a community-based cohort study. MetS was defined according to the World Health Organization (WHO), the International Diabetes Federation (IDF), the National Cholesterol Education Program Adult Treatment Panel III (NCEPIII) and Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (JCDCG), respectively. 2788 subjects were included. The incidence of CVD events was monitored during a 5.5-year period.
The proportion of MetS defined by the WHO, IDF, NCEPIII and JCDCG criteria was 25.9%, 15.4%, 22.0% and 26.1%, respectively in men, and 24.5%, 28.0%, 31.1% and 23.0%, respectively in women. After adjusting for age, all four definitions were associated with increased risk of CVD events in women, but not in men. The corresponding hazard ratios (HRs) [95% confidence intervals (CIs)] in women were 2.13 (1.44-3.16), 1.49 (1.01-2.19), 1.50 (1.02-2.21) and 2.10 (1.41-3.11). The HRs remained significant with WHO and JCDCG definitions, not with the IDF and NCEPIII definitions, when factors of LDL cholesterol, and smoking were adjusted.
The MetS by the WHO and JCDCG definition was associated with increased risk of CVD events in Chinese women after adjustment for age, total cholesterol, LDL cholesterol, and smoking.
代谢综合征(MetS)是否可以作为心血管疾病(CVD)的有效指标存在争议。本研究旨在通过不同的 MetS 定义,前瞻性评估中国人群中 MetS 对 CVD 事件的预测价值。
这是一项基于社区的队列研究。MetS 根据世界卫生组织(WHO)、国际糖尿病联盟(IDF)、美国国家胆固醇教育计划成人治疗专家组第三版(NCEPIII)和中华医学会心血管病学分会血脂异常与冠心病防治指南修订联合委员会(JCDCG)的标准进行定义。共纳入 2788 例受试者,监测 5.5 年期间 CVD 事件的发生率。
男性中,WHO、IDF、NCEPIII 和 JCDCG 标准定义的 MetS 比例分别为 25.9%、15.4%、22.0%和 26.1%,女性中分别为 24.5%、28.0%、31.1%和 23.0%。调整年龄后,所有四种定义在女性中均与 CVD 事件风险增加相关,但在男性中无相关性。女性对应的危险比(HR)[95%置信区间(CI)]分别为 2.13(1.44-3.16)、1.49(1.01-2.19)、1.50(1.02-2.21)和 2.10(1.41-3.11)。当调整 LDL 胆固醇和吸烟等因素时,HRs 在 WHO 和 JCDCG 定义中仍然显著,但在 IDF 和 NCEPIII 定义中则不显著。
在调整年龄、总胆固醇、LDL 胆固醇和吸烟等因素后,WHO 和 JCDCG 定义的 MetS 与中国女性 CVD 事件风险增加相关。