Diabetes Prevention Unit, Department of Chronic Disease Prevention, Division of Welfare and Health Promotion, National Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki, Finland.
Diabetes Metab. 2010 Nov;36(5):395-401. doi: 10.1016/j.diabet.2010.04.003. Epub 2010 Jul 29.
The study aimed to examine the role of the metabolic syndrome (MetS) as a predictor of incident cardiovascular disease (CVD) events and incident diabetes, and to compare the various definitions of MetS.
The population-based Health 2000 Study included 6105 individuals, aged 30-79 years, followed-up for 7 years. CVD during follow-up was defined as coronary death, acute myocardial infarction, coronary revascularization or stroke. MetS was defined according to the International Diabetes Federation (IDF), the 2005 National Cholesterol Education Program-Adult Treatment Panel III (ATP III), the World Health Organization (WHO) and the new Harmonization definitions. The Bayesian information criterion (BIC) was used to compare different Cox proportional-hazards regression models.
The highest prevalence estimates of MetS at baseline were observed with the Harmonization definition: 47.8% in men and 40.7% in women. During the follow-up, 238 cases of incident CVD and 172 cases of incident diabetes were observed. All definitions of MetS were significant predictors for incident CVD and diabetes. BIC suggested that the new Harmonization definition of MetS as one entity was a better predictor of the CVD endpoint than the sum of its components, but not for diabetes. Also, the Harmonization definition of MetS was a better predictor of CVD than the Framingham equation in women, but not in men.
Irrespective of definition, MetS is a significant predictor of incident CVD events and incident diabetes. Also, the new Harmonization definition may be a better predictor of incident CVD than the sum of its components.
本研究旨在探讨代谢综合征（MetS）作为心血管疾病（CVD）事件和糖尿病发病的预测因子的作用，并比较 MetS 的各种定义。
基于人群的 Health 2000 研究纳入了 6105 名年龄在 30-79 岁之间的个体，随访 7 年。随访期间的 CVD 定义为冠心病死亡、急性心肌梗死、冠状动脉血运重建或中风。MetS 根据国际糖尿病联合会（IDF）、2005 年美国国家胆固醇教育计划-成人治疗专家组 III（ATP III）、世界卫生组织（WHO）和新的协调定义进行定义。贝叶斯信息准则（BIC）用于比较不同的 Cox 比例风险回归模型。
在基线时，使用协调定义观察到 MetS 的最高患病率估计值：男性为 47.8%，女性为 40.7%。在随访期间，观察到 238 例新发 CVD 事件和 172 例新发糖尿病病例。MetS 的所有定义都是新发 CVD 和糖尿病的显著预测因子。BIC 表明，作为一个实体的新协调定义的 MetS 是 CVD 终点的更好预测因子，优于其组成部分的总和，但对糖尿病不是。此外，在女性中，协调定义的 MetS 是 CVD 的更好预测因子，而不是 Framingham 方程，但在男性中并非如此。
无论定义如何，MetS 都是新发 CVD 事件和糖尿病的显著预测因子。此外，新的协调定义可能比其组成部分的总和更能预测新发 CVD。
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