Kowalski Jan, Sliwczyńska-Rodziewicz Dorota, Ciećwierz Julita, Kowalczyk Edward, Pawlicki Lucjan, Irzmański Robert, Mejer Anna, Szadkowska Iwona, Barylski Marcin
Uniwersytet Medyczny w Łodzi, III Katedra Rehabilitacji z Klinika Chorób Wewnetrznych i Rehabilitacji Kardiologicznej.
Pol Merkur Lekarski. 2011 Apr;30(178):241-5.
All risk factors of metabolic syndrome (MS) are responsible for endothelial dysfunction what accelerate the development of atherosclerosis. It causes increased cardiovascular risk and development of cardiovascular complications in these subjects. The aim of the study was to assess the presence of vascular complications in subjects with MS.
The study comprised of 108 patients with metabolic syndrome (36 males and 72 females), aged 46-67 (57+/-8.5) years. MS was diagnosed according to the International Diabetes Federation criteria from 2005. Ischaemic heart disease was diagnosed according to the coronarography or patient care documentation. The assessment of nephrological complications was conducted with use of glomerular filtration rate (eGFR) calculated by using the simplified Modification of Diet in Renal Disease Study (MDRD) equation. The occurrence of brain strokes and diabetic foot was estimated basing on medical history and documentation. Vascular complications in the bottom of the eye were assessed with ophtalmoscopic examination and fluorescein angiography.
The frequency of vascular complications in subjects with MS was: vascular complications in the bottom of the eye - 72.7% (symptoms of vascular angiopathy without retinopathy - 41.2%, retinopathy - 31.5%), ischaemic heart disease - 54.9%, eGFR < 90 m/min. - 38.9%, diabetic foot - 5.55%. brain stroke - 3.7%. Ischaemic heart disease was present in all subjects with MS qualified to the second and higher class of retinopathy.
In patients with MS, ischaemic heart disease was the most common macroangiopathic complication, with increasing in the frequency together with retinopathy intensification. Changes in the bottom of the eye were the most common microangiopathic complications. Early identification and treatment of metabolic syndrome may have important value in prophylaxis and delay of vascular complications.
代谢综合征（MS）的所有危险因素均会导致内皮功能障碍，而这会加速动脉粥样硬化的发展。这会增加这些受试者患心血管疾病的风险并引发心血管并发症。本研究的目的是评估MS患者血管并发症的情况。
本研究纳入了108例代谢综合征患者（36例男性和72例女性），年龄在46 - 67岁（57±8.5岁）。根据2005年国际糖尿病联盟标准诊断MS。根据冠状动脉造影或患者护理记录诊断缺血性心脏病。使用简化的肾脏疾病饮食改良研究（MDRD）方程计算的肾小球滤过率（eGFR）来评估肾脏并发症。根据病史和记录评估中风和糖尿病足的发生情况。通过眼底镜检查和荧光素血管造影评估眼底血管并发症。
MS患者血管并发症的发生率为：眼底血管并发症 - 72.7%（无视网膜病变的血管病变症状 - 41.2%，视网膜病变 - 31.5%），缺血性心脏病 - 54.9%，eGFR < 90 m/min - 38.9%，糖尿病足 - 5.55%，中风 - 3.7%。所有符合二级及更高等级视网膜病变的MS患者均患有缺血性心脏病。
在MS患者中，缺血性心脏病是最常见的大血管并发症，其发生率随视网膜病变加重而增加。眼底改变是最常见的微血管并发症。早期识别和治疗代谢综合征可能对预防和延缓血管并发症具有重要价值。
