Bansal M, Shrivastava S, Mehrotra R, Agarwal V, Kasliwal R R
Indraprastha Apollo Hospital, New Delhi.
J Assoc Physicians India. 2009 Jan;57:17-22.
Conflicting data exists regarding relationship between the Framingham risk score (FRS) and presence of metabolic syndrome (MS). Strong influence of age on FRS may further modify this relationship as prevalence of MS at younger age increases in South-Asian countries including India. However, only limited information is available about the prevalence of MS and its relationship with FRS in such populations at present.
Clinical examination and biochemical investigations were performed in 1905 asymptomatic office executives who underwent routine health check-up at a tertiary care centre in India during the year 2005. Diagnosis of MS and FRS were based on the modified National Cholesterol Education Program-Adult Treatment Panel III guidelines.
Mean age of the subjects was 45.2 +/- 10.3 years and 71.8% were males. MS was present in 47.5% (905 of 1905) subjects. Overall, 76.8% patients with MS had 10-year cardiovascular (CV) risk < 10%, 20.6% had 10-20% risk and only 2.7% had > 20% risk according to FRS. In the lowest age-quartile, 95.9% patients had 10-year risk < 10%, 4.1% patients had 10-20% risk and none had > 20% risk. In contrast, in the highest age-quartile, less than half of the patients had 10-year risk <10% and nearly half had 10-20% risk of CV events.
Although the prevalence of MS is markedly high in young asymptomatic Indians, majority have low 10-year risk of CV events as estimated by FRS. These findings necessitate continued emphasis on detection of MS in these populations as reliance on FRS alone may result in underestimation of CV risk in them.
关于弗雷明汉风险评分（FRS）与代谢综合征（MS）之间的关系，存在相互矛盾的数据。年龄对FRS有很大影响，随着包括印度在内的南亚国家年轻人中MS患病率的增加，这种关系可能会进一步改变。然而，目前关于这类人群中MS患病率及其与FRS关系的信息有限。
对2005年在印度一家三级医疗中心接受常规健康检查的1905名无症状办公室职员进行了临床检查和生化检测。MS和FRS的诊断基于修改后的美国国家胆固醇教育计划成人治疗小组第三次报告指南。
受试者的平均年龄为45.2±10.3岁，男性占71.8%。47.5%（1905名中的905名）受试者患有MS。总体而言，根据FRS，76.8%的MS患者10年心血管（CV）风险<10%，20.6%的患者风险为10 - 20%，只有2.7%的患者风险>20%。在年龄最低的四分位数组中，95.9%的患者10年风险<10%，4.1%的患者风险为10 - 20%，没有人风险>20%。相比之下，在年龄最高的四分位数组中，不到一半的患者10年风险<10%，近一半的患者有10 - 20%的CV事件风险。
尽管年轻无症状印度人的MS患病率明显较高，但根据FRS估计，大多数人10年CV事件风险较低。这些发现表明，在这些人群中仍需继续重视MS的检测，因为仅依靠FRS可能会低估他们的CV风险。
