Jewish General Hospital/McGill University, Montreal, Quebec, Canada.
J Am Coll Cardiol. 2010 Sep 28;56(14):1113-32. doi: 10.1016/j.jacc.2010.05.034.
We sought to conduct a systematic review and meta-analysis of the cardiovascular risk associated with the metabolic syndrome as defined by the 2001 National Cholesterol Education Program (NCEP) and 2004 revised National Cholesterol Education Program (rNCEP) definitions.
Numerous studies have investigated the cardiovascular risk associated with the NCEP and rNCEP definitions of the metabolic syndrome. There is debate regarding the prognostic significance of the metabolic syndrome for cardiovascular outcomes.
We searched the Cochrane Library, EMBASE, and Medline databases through June 2009 for prospective observational studies investigating the cardiovascular effects of the metabolic syndrome. Two reviewers extracted data, which were aggregated using random-effects models.
We identified 87 studies, which included 951,083 patients (NCEP: 63 studies, 497,651 patients; rNCEP: 33 studies, 453,432 patients). There was little variation between the cardiovascular risk associated with NCEP and rNCEP definitions. When both definitions were pooled, the metabolic syndrome was associated with an increased risk of cardiovascular disease (CVD) (relative risk [RR]: 2.35; 95% confidence interval [CI]: 2.02 to 2.73), CVD mortality (RR: 2.40; 95% CI: 1.87 to 3.08), all-cause mortality (RR: 1.58; 95% CI: 1.39 to 1.78), myocardial infarction (RR: 1.99; 95% CI: 1.61 to 2.46), and stroke (RR: 2.27; 95% CI: 1.80 to 2.85). Patients with the metabolic syndrome, but without diabetes, maintained a high cardiovascular risk.
The metabolic syndrome is associated with a 2-fold increase in cardiovascular outcomes and a 1.5-fold increase in all-cause mortality. Studies are needed to investigate whether or not the prognostic significance of the metabolic syndrome exceeds the risk associated with the sum of its individual components. Furthermore, studies are needed to elucidate the mechanisms by which the metabolic syndrome increases cardiovascular risk.
我们旨在进行一项系统回顾和荟萃分析，以评估根据 2001 年国家胆固醇教育计划（NCEP）和 2004 年修订的国家胆固醇教育计划（rNCEP）定义的代谢综合征相关的心血管风险。
许多研究已经调查了代谢综合征与 NCEP 和 rNCEP 定义之间的心血管风险。对于代谢综合征对心血管结局的预后意义存在争议。
我们通过 Cochrane 图书馆、EMBASE 和 Medline 数据库检索了截至 2009 年 6 月的前瞻性观察性研究，以调查代谢综合征对心血管的影响。两位评审员提取数据，然后使用随机效应模型对其进行汇总。
我们确定了 87 项研究，其中包括 951083 名患者（NCEP：63 项研究，497651 名患者；rNCEP：33 项研究，453432 名患者）。NCEP 和 rNCEP 定义之间的心血管风险差异不大。当两种定义都被合并时，代谢综合征与心血管疾病（CVD）风险增加相关（相对风险[RR]：2.35；95%置信区间[CI]：2.02 至 2.73）、CVD 死亡率（RR：2.40；95% CI：1.87 至 3.08）、全因死亡率（RR：1.58；95% CI：1.39 至 1.78）、心肌梗死（RR：1.99；95% CI：1.61 至 2.46）和中风（RR：2.27；95% CI：1.80 至 2.85）。患有代谢综合征但没有糖尿病的患者仍然存在较高的心血管风险。
代谢综合征与心血管结局增加 2 倍和全因死亡率增加 1.5 倍相关。需要研究以确定代谢综合征的预后意义是否超过其各个组成部分的风险总和。此外，需要研究阐明代谢综合征增加心血管风险的机制。
