Clinica Medica, Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo dei Tintori, Italy.
J Hypertens. 2010 May;28(5):999-1006. doi: 10.1097/HJH.0b013e328337a9e3.
We compared definitions of metabolic syndrome performed by ATPIII [the National Cholesterol Education Program Adult Treatment Panel III; three criteria of the following: systolic blood pressure >or=130 mmHg and/or diastolic blood pressure >or=85 mmHg, fasting serum glucose >or=110 mg/dl, high-density lipoprotein plasma cholesterol <or=40 mg/dl (men) or <or=50 mg/dl (women), plasma triglycerides >or=150 mg/dl, waist circumference >or=102 cm (men) or 88 cm (women)], AHA (the American Heart Association; same cut-off of ATPIII except serum glucose >or= 100 mg/dl) and IDF [the International Diabetes Federation; mandatory criteria of visceral obesity with reduced cut-off of 94 cm (men) or 80 cm (women), and at least two criteria with the same cut-off as in AHA] for their impact on metabolic syndrome prevalence, cardiac organ damage, long-term risk of cardiovascular events and death for any cause and risk of developing diabetes mellitus, in-office and out-of-office hypertension and left ventricular hypertrophy (LVH).
In 2051 participants, we measured office, home and ambulatory blood pressure as well as metabolic, anthropometric and echocardiographic variables. Measurements were performed between 1990 and 1992 and repeated 10 years later. Information on long-term incidence of cardiovascular events and all-cause deaths was also collected.
Prevalence of metabolic syndrome was significantly greater when using the AHA and IDF as compared to the ATPIII definition. Prevalence of LVH was higher in participants with than without metabolic syndrome and similar for the three definitions. Over 12-year follow-up, there were 179 cardiovascular events and 233 deaths for any cause. The risk of cardiovascular events and death was markedly greater for participants with as compared with those without metabolic syndrome, regardless of the definition of metabolic syndrome. This was the case also for the risk of new-onset diabetes mellitus, office, home and ambulatory hypertension and new-onset LVH.
Risks of fatal and nonfatal cardiovascular events, diabetes mellitus, hypertension and LVH were similar for the three definitions of metabolic syndrome. However, the AHA and IDF definitions are more sensitive than that of ATPIII in identifying metabolic syndrome condition.
我们比较了 ATPIII [美国国家胆固醇教育计划成人治疗专家组 III；以下三个标准之一：收缩压>或= 130mmHg 和/或舒张压>或= 85mmHg、空腹血清葡萄糖>或= 110mg/dl、高密度脂蛋白血浆胆固醇<或=40mg/dl（男性）或<或=50mg/dl（女性）、血浆甘油三酯>或= 150mg/dl、腰围>或= 102cm（男性）或 88cm（女性）]、AHA（美国心脏协会；与 ATPIII 相同的截止值，除了血清葡萄糖>或= 100mg/dl）和 IDF（国际糖尿病联合会；强制性标准为内脏肥胖，截止值降低为男性 94cm 或女性 80cm，以及至少两个标准与 AHA 相同的截止值）对代谢综合征患病率、心脏器官损伤、心血管事件和任何原因导致的死亡的长期风险以及发生糖尿病、门诊和非门诊高血压和左心室肥厚（LVH）的风险的影响。
在 2051 名参与者中，我们测量了办公室、家庭和动态血压以及代谢、人体测量和超声心动图变量。测量在 1990 年至 1992 年之间进行，并在 10 年后重复进行。还收集了长期心血管事件和全因死亡的发生率信息。
与 ATPIII 定义相比，使用 AHA 和 IDF 时代谢综合征的患病率显著更高。患有代谢综合征的参与者的 LVH 患病率高于无代谢综合征的参与者，且三种定义的患病率相似。在 12 年的随访中，有 179 例心血管事件和 233 例任何原因导致的死亡。无论代谢综合征的定义如何，患有代谢综合征的参与者的心血管事件和死亡风险明显高于没有代谢综合征的参与者。对于新发糖尿病、门诊、家庭和动态高血压以及新发 LVH 也是如此。
致命和非致命心血管事件、糖尿病、高血压和 LVH 的风险对于代谢综合征的三种定义相似。然而，AHA 和 IDF 定义比 ATPIII 定义更能敏感地识别代谢综合征状态。
