Epidemiology, Public Health and Biostatistics, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK.
Atherosclerosis. 2010 May;210(1):256-61. doi: 10.1016/j.atherosclerosis.2009.10.045. Epub 2009 Nov 10.
The metabolic syndrome increases mortality risk. However, as "non-affected" individuals may still have up to two risk factors, the utility of using three or more components to identify the syndrome, and its predictive advantage over individual components have yet to be determined.
Participants, male Vietnam-era veterans (n=4265) from the USA, were followed-up from 1985/1986 for 14.7 years (61,498 person-years), and all-cause and cardiovascular disease deaths collated. Cox's proportional-hazards regression was used to assess the effect of the metabolic syndrome and its components on mortality adjusting for a wide range of potential confounders.
At baseline, 752 participants (17.9%) were identified as having metabolic syndrome. There were 231 (5.5%) deaths from all-causes, with 60 from cardiovascular disease. After adjustment for a range of covariates, the metabolic syndrome increased the risk of all-cause, HR 2.03, 95%CI 1.52, 2.71, and cardiovascular disease mortality, HR 1.92, 95%CI 1.10, 3.36. Risk increased dose-dependently with increasing numbers of components. The increased risk from possessing only one or two components was not statistically significant. The adjusted risk for four or more components was greater than for only three components for both all-cause, HR 2.30, 95%CI 1.45, 3.66 vs. HR 1.70, 95%CI 1.11, 2.61, and cardiovascular disease mortality, HR 3.34, 95%CI 1.19, 9.37 vs. HR 2.81, 95%CI 1.07, 7.35. The syndrome was more informative than the individual components for all-cause mortality, but could not be assessed for cardiovascular disease mortality due to multicollinearity. Hyperglycaemia was the individual strongest parameter associated with mortality.
The metabolic syndrome is informative in predicting mortality, with risk increasing as the number of components increase above the threshold required for diagnosis.
代谢综合征会增加死亡风险。然而，由于“非患病”个体可能仍存在两个以上的风险因素，因此使用三个或更多成分来识别该综合征及其预测优势超过单个成分仍有待确定。
参与者是来自美国的男性越南时代退伍军人（n=4265），从 1985/1986 年开始随访 14.7 年（61498人年），并整理了所有原因和心血管疾病的死亡情况。Cox 比例风险回归用于评估代谢综合征及其成分对死亡率的影响，同时调整了广泛的潜在混杂因素。
在基线时，752 名（17.9%）参与者被确定患有代谢综合征。共有 231 名（5.5%）死于所有原因，其中 60 名死于心血管疾病。在调整了一系列协变量后，代谢综合征增加了所有原因的死亡风险，HR 2.03，95%CI 1.52，2.71，以及心血管疾病死亡风险，HR 1.92，95%CI 1.10，3.36。随着成分数量的增加，风险呈剂量依赖性增加。只有一个或两个成分的风险增加没有统计学意义。对于四个或更多成分，其调整后的风险大于只有三个成分，分别为所有原因，HR 2.30，95%CI 1.45，3.66 vs. HR 1.70，95%CI 1.11，2.61，以及心血管疾病死亡风险，HR 3.34，95%CI 1.19，9.37 vs. HR 2.81，95%CI 1.07，7.35。对于所有原因的死亡率，该综合征比单个成分更具信息性，但由于共线性，无法评估其与心血管疾病死亡率的关系。高血糖是与死亡率最相关的个体最强参数。
代谢综合征对于预测死亡率具有信息性，随着超过诊断所需成分数量的增加，风险会增加。
