Chen Yan-Yan, Li Guang-Wei, Yao Chong-Hua, Hu Yi-Song, Zhai Feng-Ying, Yang Xiao-Guang, Kong Ling-Zhi
Center of Endocrinology and Metabolism, China-Japan Friendship Hospital, Beijing 100029, China.
Zhonghua Yi Xue Za Zhi. 2009 Feb 17;89(6):385-8.
To investigate the impact of metabolic syndrome (MS) with or without hyperglycemia on stroke prevalence compared to that of diabetes alone.
44 100 subjects, 20 570 males and 23 530 females, aged 25 - 75, who had participated in the Chinese Residents Nutrition and Health Examination Survey held in the mainland of China 2002, underwent anthropometry, measurement of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), high density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), and 2 hour plasma glucose (2 h PG) after 75 g oral glucose tolerance test (OGTT). 22 570 subjects, 10 698 males and 11 872 females, were divided into 5 groups: control group without MS risk factors (n = 17 518), Group of diabetes mellitus (DM) without MS (n = 638), group of MS with normoglycemia (n = 2501), Group of MS with mild hyperglycemia (n = 1058), and group MS with DM (n = 855). The relationship between MS and stroke was studied by multiple logistic regression analysis.
The prevalence of MS increased along with age. The MS prevalence rates of the subjects with FPG > or = 5.6 mmol/L in the age groups 25 - 34, 35 - 44, 45 - 54, and > or = 55 were 23.5%, 37.2%, 45.7%, and 53.0% respectively, all significantly higher than those of the subjects with the FPG < 5.6 mmol/L (2.2%, 4.7%, 7.8%, and 9.5% respectively, all P < 0.01). The prevalence rates of stroke of the groups of DM, normal blood sugar with MS, mild hyperglycemia with MS, and DM with MS were 2.94%, 2.27%, 2.89%, and 4.11%, respectively, all significantly higher than that of the control group (0.19%, all P < 0.01). After adjustment for age, sex, smoking status, and LDL-C, no significant difference was observed between the neighboring MS groups (all P > 0.05). Compared to the group of MS with normoglycemia, the OR value for stroke of the DM with MS was 1.84 (95% CI 1.20 - 2.83, P < 0.01), which was still significant after adjusting for LDL-C (P < 0.05).
(1) People with glucose intolerance had very high prevalence of stroke than novmoglgcemic people. (2) Hyperglycemia in MS has an extremely important role in the impact of MS on stroke in Chinese. (3) Diabetes by itself has the same significance as the combination of MS components in the development of stroke.
探讨伴有或不伴有高血糖的代谢综合征（MS）与单纯糖尿病相比对中风患病率的影响。
44100名年龄在25 - 75岁之间的受试者，其中男性20570名，女性23530名，他们参加了2002年在中国内地进行的中国居民营养与健康状况调查，接受了人体测量、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FPG）以及75克口服葡萄糖耐量试验（OGTT）后2小时血糖（2h PG）的测量。22570名受试者，其中男性10698名，女性11872名，被分为5组：无MS危险因素的对照组（n = 17518）、无MS的糖尿病（DM）组（n = 638）、血糖正常的MS组（n = 2501）、轻度高血糖的MS组（n = 1058）以及合并DM的MS组（n = 855）。通过多因素logistic回归分析研究MS与中风之间的关系。
MS患病率随年龄增长而升高。在25 - 34岁、35 - 44岁、45 - 54岁以及≥55岁年龄组中，FPG≥5.6 mmol/L的受试者的MS患病率分别为23.5%、37.2%、45.7%和53.0%，均显著高于FPG < 5.6 mmol/L的受试者（分别为2.2%、4.7%、7.8%和9.5%，均P < 0.01）。DM组、血糖正常的MS组、轻度高血糖的MS组以及合并DM的MS组的中风患病率分别为2.94%、2.27%、2.89%和4.11%，均显著高于对照组（0.19%，均P < 0.01）。在调整年龄、性别、吸烟状况和LDL-C后，相邻的MS组之间未观察到显著差异（均P > 0.05）。与血糖正常的MS组相比，合并DM的MS组中风的OR值为1.84（95%CI 1.20 - 2.83，P < 0.01），在调整LDL-C后仍具有显著性（P < 0.05）。
（1）糖耐量异常者的中风患病率远高于血糖正常者。（2）MS中的高血糖在MS对中国人中风的影响中起极其重要的作用。（3）在中风的发生发展中，糖尿病本身与MS各组分合并存在具有相同的意义。
