代谢综合征分类与中风地理和种族差异原因研究（REGARDS）中常见心血管疾病和未来风险的变化。
Variations in prevalent cardiovascular disease and future risk by metabolic syndrome classification in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study.
机构信息
Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
出版信息
Am Heart J. 2010 Mar;159(3):385-91. doi: 10.1016/j.ahj.2009.12.022.
BACKGROUND
The International Diabetes Federation (IDF) and Adult Treatment Panel (ATP) III define metabolic syndrome (MetSyn) differently, with unclear implications for cardiovascular disease (CVD) risk.
METHODS
We examined 22,719 participants in the REGARDS study. We classified participants as: no MetSyn, MetSyn by ATP-III and IDF criteria, MetSyn by ATP-only, or MetSyn by IDF-only. To assess current CVD, we determined the odds of self-reported CVD by MetSyn category using multivariable logistic regression, controlling for socio-demographic and behavioral factors. To estimate future coronary heart disease risk, we calculated Framingham risk scores (FRS).
RESULTS
Overall, 10,785 individuals (47%) had MetSyn. Of these, 79% had MetSyn by both definitions, 6% by ATP-only, and 14% by IDF-only. Compared to those without MetSyn, ATP-only individuals had the highest odds of current CVD and of having a FRS >20%. Also compared to those without MetSyn, IDF-only individuals had 43% higher odds of current CVD and 2-fold increased odds of having a FRS >20%.
CONCLUSIONS
Consistent with previous reports, ATP-III MetSyn criteria identified individuals with increased odds of CVD and elevated future coronary heart disease risk. However, the IDF definition identified a clinically important number of additional individuals at excess CVD risk.
背景
国际糖尿病联合会（IDF）和成人治疗专家组（ATP）III 对代谢综合征（MetSyn）的定义不同，这对心血管疾病（CVD）风险的影响尚不清楚。
方法
我们研究了 REGARDS 研究中的 22719 名参与者。我们将参与者分为：无 MetSyn、符合 ATP-III 和 IDF 标准的 MetSyn、仅符合 ATP 的 MetSyn 或仅符合 IDF 的 MetSyn。为了评估当前的 CVD，我们使用多变量逻辑回归来确定每个 MetSyn 类别中自我报告 CVD 的可能性，同时控制社会人口统计学和行为因素。为了估计未来的冠心病风险，我们计算了弗雷明汉风险评分（FRS）。
结果
总体而言，10785 人（47%）患有 MetSyn。其中，79%的人符合两种定义，6%的人仅符合 ATP，14%的人仅符合 IDF。与没有 MetSyn 的人相比，仅符合 ATP 的人当前 CVD 的可能性和 FRS>20%的可能性最高。与没有 MetSyn 的人相比，仅符合 IDF 的人当前 CVD 的可能性高出 43%，FRS>20%的可能性高出 2 倍。
结论
与之前的报告一致，ATP-III MetSyn 标准确定了 CVD 风险增加和未来冠心病风险升高的个体。然而，IDF 定义确定了数量众多的患有 CVD 风险过高的额外个体。
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