Department of Medicine, University of Kuopio and Kuopio University Hospital, Kuopio, Finland.
Atherosclerosis. 2010 May;210(1):237-42. doi: 10.1016/j.atherosclerosis.2009.10.042. Epub 2009 Nov 10.
We investigated whether the metabolic syndrome (MetS) and its components defined by four different criteria including subjects with prevalent diabetes in their definitions were associated with congestive heart failure (CHF) independent of interim myocardial infarction (MI) and prevalent diabetes during a 20-year follow-up in an elderly population-based study.
The MetS was defined according to the World Health Organization (WHO), the National Cholesterol Education Program (NCEP), the International Diabetes Federation (IDF), and the American Heart Association and the National Heart, Lung, and Blood Institute (AHA) criteria. The association of the MetS with incident CHF (303 cases) was investigated with Cox regression analyses in a 20-year follow-up study of 1032 Finns, aged 65-74 years at baseline. Among all subjects the MetS by all four criteria was significantly associated with a 1.45-1.74-fold risk for incident CHF after the adjustment for confounding factors. When subjects with interim MI during the follow-up and with prevalent diabetes were excluded, the MetS was significantly associated with a 1.37-1.87-fold risk for incident CHF after the adjustment for confounding factors. Of the single components of the MetS, the following were associated with incident CHF: impaired fasting glucose (IFG) [fasting plasma glucose (FPG)> or = 6.1 mmol/l, Hazards ratio (HR) 1.46 or FPG > or = 5.6 mmol/l, HR 1.62)]; raised blood pressure (BP) [(BP > or = 140/90 mmHg or antihypertensive medications, HR 1.89); central obesity (waist circumference > or = 94 cm in men or > or = 80 cm in women, HR 1.49); (waist circumference > or = 102 cm in men or > or = 88 cm in women, HR 1.48); obesity (body mass index > or = 30 kg/m(2), HR 1.79); and low high-density lipoprotein cholesterol (<1.03 mmol/l in men or <1.29 mmol/l in women, HR 1.55).
The MetS defined by four different criteria predicted CHF independent of interim MI and prevalent diabetes in elderly Finns, but not above and beyond the risk associated with one component of the MetS, hypertension.
我们研究了代谢综合征（MetS）及其各组成部分是否与充血性心力衰竭（CHF）相关，这些组成部分是根据 4 种不同的标准定义的，包括定义中存在现患糖尿病的患者，这一研究是在一项基于人群的老年患者 20 年随访中进行的，不考虑中间发生的心肌梗死（MI）和现患糖尿病。
MetS 根据世界卫生组织（WHO）、美国国家胆固醇教育计划（NCEP）、国际糖尿病联盟（IDF）、美国心脏协会和美国国立心肺血液研究所（AHA）标准进行定义。采用 Cox 回归分析方法，对 1032 名芬兰人（基线时年龄为 65-74 岁）进行了 20 年的随访研究，观察 MetS 与 CHF（303 例）发生的关系。在所有受试者中，根据所有 4 种标准定义的 MetS 与 CHF 发生的风险增加 1.45-1.74 倍相关，调整混杂因素后。排除随访期间发生中间 MI 和现患糖尿病的患者后，调整混杂因素后，MetS 与 CHF 发生的风险增加 1.37-1.87 倍相关。MetS 的各组成部分中，以下与 CHF 的发生相关：空腹血糖受损（IFG）[空腹血糖（FPG）≥6.1mmol/L，危险比（HR）1.46 或 FPG≥5.6mmol/L，HR 1.62]；血压升高[BP≥140/90mmHg 或服用降压药物，HR 1.89；腰围（男性≥94cm 或女性≥80cm，HR 1.49；腰围（男性≥102cm 或女性≥88cm，HR 1.48）；肥胖（BMI≥30kg/m2，HR 1.79]；低高密度脂蛋白胆固醇（男性<1.03mmol/L 或女性<1.29mmol/L，HR 1.55）。
在芬兰老年人中，根据 4 种不同标准定义的 MetS 预测 CHF 独立于中间 MI 和现患糖尿病，但不能预测与 MetS 一个组成部分（高血压）相关的风险之外的 CHF 。
