Departments of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Metab Syndr Relat Disord. 2010 Apr;8(2):149-56. doi: 10.1089/met.2009.0053.
Metabolic syndrome is a constellation of risk factors used to identify individuals at greatest risk for developing cardiovascular disease (CVD). Early diagnosis of CVD would benefit African-Americans (AA), who have a higher prevalence of and mortality rate from CVD compared to Caucasians (CA). Two definitions for metabolic syndrome were used to classify healthy CA and AA, and evaluate how other CVD risk factors [C-reactive protein (CRP), percent body fat, fitness level, insulin resistance, and non-high-density lipoprotein cholesterol (HDL-C)] changed metabolic syndrome classification.
Healthy AA (n = 97) and CA (n = 51) ranging from normal weight to obese, 18-45 years of age, with neither hypertension nor diabetes, were evaluated for cardiorespiratory fitness, height, weight, percent body fat, hip and waist circumference, blood pressure (BP), and fasting blood glucose, insulin, triglycerides, HDL, non-HDL-C, and CRP. Participants were classified as meeting the criteria for metabolic syndrome according to the National Cholesterol Education Program Adult Treatment Panel III 2004 (NCEP ATP III) and the International Diabetes Federation (IDF) definitions.
Significant ethnic differences (P < 0.01) in classification were noted for both metabolic syndrome definitions (NCEP ATP III, CA = 16.7% vs. AA = 5.7%; IDF, CA = 23.5% vs. AA = 8.2%). Ethnic differences were eliminated when fitness level or percent body fat was included as a criterion.
If diagnosis of metabolic syndrome is intended for early recognition of CVD risk and slowing CVD development, current definitions for metabolic syndrome will not capture healthy AA. Health-care providers may consider assessing percent body fat and participation in regular exercise, because these criteria would help identify AA at risk.
代谢综合征是一组风险因素，用于识别患心血管疾病（CVD）风险最高的个体。早期诊断 CVD 将使非裔美国人（AA）受益，他们患 CVD 的患病率和死亡率都高于白种人（CA）。使用两种代谢综合征定义来对健康的 CA 和 AA 进行分类，并评估其他 CVD 风险因素[C 反应蛋白（CRP）、体脂肪百分比、健康水平、胰岛素抵抗和非高密度脂蛋白胆固醇（HDL-C）]如何改变代谢综合征的分类。
评估了 97 名体重正常至肥胖的健康 AA（n = 97）和 51 名 CA（n = 51），年龄在 18-45 岁之间，既没有高血压也没有糖尿病，评估了他们的心肺健康水平、身高、体重、体脂肪百分比、臀围和腰围、血压（BP）和空腹血糖、胰岛素、甘油三酯、HDL、非-HDL-C 和 CRP。参与者根据国家胆固醇教育计划成人治疗专家组第三版 2004 年（NCEP ATP III）和国际糖尿病联合会（IDF）的定义，被归类为符合代谢综合征标准。
两种代谢综合征定义（NCEP ATP III，CA = 16.7% vs. AA = 5.7%；IDF，CA = 23.5% vs. AA = 8.2%）的分类均显示出明显的种族差异（P < 0.01）。当将健康水平或体脂肪百分比作为标准纳入时，种族差异被消除。
如果代谢综合征的诊断旨在早期识别 CVD 风险并减缓 CVD 发展，那么目前的代谢综合征定义将无法捕捉到健康的 AA。医疗保健提供者可能会考虑评估体脂肪百分比和定期运动的参与情况，因为这些标准将有助于识别有风险的 AA。
