Institute of Clinical Medicine, Family Medicine, University of Turku, Finland.
Acta Diabetol. 2011 Jun;48(2):157-65. doi: 10.1007/s00592-010-0251-z. Epub 2011 Jan 15.
The aim was to analyze the relationship between metabolic syndrome (MetS) and vascular risk among the aged. A prospective population-based study, with a 9-year follow-up. All subjects of the municipality of Lieto in Finland aged ≥64 in 1998-99 participated (n = 1183). Hazard ratios (HRs) for fatal or non-fatal coronary (CHD), cerebrovascular (CV), or all vascular events predicted by MetS (defined by International Diabetes Federation) were estimated. During the 9-year follow-up, a total of 348 vascular events occurred, including 208 CHD and 150 CV events. After multivariable adjustment, CHD events (1.70, 1.07-2.71, P = .026) and vascular events (1.57, 1.07-2.30, P = .021) were more common in men with MetS compared to men without it. Evaluating MetS components individually, low HDL-cholesterol among women predicted a higher occurrence of CV (2.44, 1.46-4.09, P < .001) and all vascular (1.78, 1.26-2.53, P = .001) events. Elevated blood pressure among men was related to fewer CHD events (0.46, 0.25-0.83, P = .010). Our findings suggest that MetS does predict vascular events in late life among men. In older women, only low HDL-cholesterol was associated with vascular risk. Slightly or moderately elevated blood pressure values do not predict vascular events in this age group.
目的在于分析代谢综合征(MetS)与老年人血管风险之间的关系。这是一项前瞻性的基于人群的研究,随访时间为 9 年。所有芬兰利托市年龄≥64 岁的居民均参加了研究(n=1183)。采用危险比(HRs)评估 MetS(由国际糖尿病联合会定义)预测的致命性或非致命性冠心病(CHD)、脑血管病(CV)或所有血管事件的发生情况。在 9 年的随访期间,共发生了 348 例血管事件,包括 208 例 CHD 和 150 例 CV 事件。经过多变量调整后,患有 MetS 的男性发生 CHD 事件(1.70,1.07-2.71,P=0.026)和血管事件(1.57,1.07-2.30,P=0.021)的风险均高于未患有 MetS 的男性。评估 MetS 各组成部分时,女性的低 HDL-胆固醇水平预示着 CV(2.44,1.46-4.09,P<0.001)和所有血管(1.78,1.26-2.53,P=0.001)事件的发生风险更高。男性血压升高与 CHD 事件减少有关(0.46,0.25-0.83,P=0.010)。我们的研究结果表明,MetS 确实可以预测男性晚年的血管事件。在老年女性中,只有低 HDL-胆固醇与血管风险相关。该年龄组中,血压轻度或中度升高并不预示血管事件的发生。