Kokubo Yoshihiro, Okamura Tomonori, Yoshimasa Yasunao, Miyamoto Yoshihiro, Kawanishi Katsuyuki, Kotani Yasushi, Okayama Akira, Tomoike Hitonobu
Department of Preventive Cardiology, National Cardiovascular Center, 5-7-1, Fujishiro-dai, Suita 565-8565, Japan.
Hypertens Res. 2008 Nov;31(11):2027-35. doi: 10.1291/hypres.31.2027.
Abdominal obesity is a prerequisite for some definitions of metabolic syndrome (MetS). We investigated the impact of MetS defined by two different criteria, which either did or did not require abdominal obesity as a prerequisite, on cardiovascular disease (CVD) incidence in an urban Japanese cohort study. We studied 5,332 Japanese (aged 30-79 years, without CVD at baseline), who completed a baseline survey (September 1989 to March 1994) and were followed up through December 2005. MetS was defined by the NCEP-ATPIII (modified by Asian obesity criteria) and the Japanese criteria. After 61,846 person-years of follow-up, we documented 317 CVD incidences. The MetS frequencies of the Japanese and of the modified NCEP-ATPIII criteria were 17.7% and 25.1% for men and 5.0% and 14.3% for women, respectively. The multivariate hazard ratios (HRs; 95% confidence intervals [CI]) of CVD incidence for MetS by the modified NCEP-ATPIII criteria were 1.75 (1.27-2.41) in men and 1.90 (1.31-2.77) in women, and those for MetS by the Japanese criteria were 1.34 (0.96-1.87) in men and 2.20 (1.31-3.68) in women. The multivariate HRs of CVD incidence for MetS for the Japanese and for the modified NCEP-ATPIII criteria were 2.92 (1.54-5.55) and 1.94 (0.98-3.82) in men under 60 years old, respectively. The CVD incidence risks increased according to the number of MetS components. The risks were similar among participants with the same number of MetS components, regardless of abdominal obesity. In conclusion, the number of MetS components (modified NCEP-ATPIII criteria) may be more strongly associated with CVD incidence than the abdominal obesity essential criteria (the Japanese criteria) in a general urban Japanese population. (Hypertens Res 2008; 31: 2027-2035).
腹部肥胖是某些代谢综合征（MetS）定义的先决条件。在一项日本城市队列研究中，我们调查了由两种不同标准定义的MetS（一种要求腹部肥胖作为先决条件，另一种则不要求）对心血管疾病（CVD）发病率的影响。我们研究了5332名日本人（年龄在30 - 79岁之间，基线时无CVD），他们完成了基线调查（1989年9月至1994年3月）并随访至2005年12月。MetS由NCEP - ATPIII（根据亚洲肥胖标准修改）和日本标准定义。经过61846人年的随访，我们记录了317例CVD发病情况。日本标准和修改后的NCEP - ATPIII标准定义的MetS在男性中的频率分别为17.7%和25.1%，在女性中分别为5.0%和14.3%。根据修改后的NCEP - ATPIII标准，MetS的CVD发病多变量风险比（HRs；95%置信区间[CI]）在男性中为1.75（1.27 - 2.41），在女性中为1.90（1.31 - 2.77）；根据日本标准，MetS的CVD发病多变量风险比在男性中为1.34（0.96 - 1.87），在女性中为2.20（1.31 - 3.68）。对于60岁以下男性，根据日本标准和修改后的NCEP - ATPIII标准，MetS的CVD发病多变量HRs分别为2.92（1.54 - 5.55）和1.94（0.98 - 3.82）。CVD发病风险根据MetS组分数量增加。在具有相同数量MetS组分的参与者中，无论是否有腹部肥胖，风险相似。总之，在一般日本城市人群中，MetS组分数量（修改后的NCEP - ATPIII标准）可能比腹部肥胖基本标准（日本标准）与CVD发病率的关联更强。（《高血压研究》2008年；31：2027 - 2035）
