Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University, PO Box 980111, Richmond, VA 23298-0111, USA.
Metabolism. 2012 Mar;61(3):302-9. doi: 10.1016/j.metabol.2011.07.002. Epub 2011 Aug 15.
The metabolic syndrome is associated with increased cardiovascular risk, and its prevalence increases with age. Various definitions of the metabolic syndrome exist, but whether some definitions are more predictive of future cardiovascular events in the elderly is unclear. We compared the risk of incident cardiovascular events in elderly individuals at least 65 years old from the Cardiovascular Health Study with and without the metabolic syndrome as defined by the European Group for the Study of Insulin Resistance (EGIR), National Cholesterol Education Program (NCEP)/American Heart Association (AHA), American Association of Clinical Endocrinologists, International Diabetes Federation (IDF), and modified World Health Organization (WHO) criteria (n = 3390). Participants were without baseline diabetes or cardiovascular disease. Except for EGIR, all definitions of the metabolic syndrome were significantly associated with increased risk of incident cardiovascular (coronary or cerebrovascular) events. Adjusted hazard ratios (HRs) for risk of incident cardiovascular events as defined by the modified WHO, NCEP/AHA, American Association of Clinical Endocrinologists, and IDF criteria ranged from 1.153 (P = .045) for NCEP/AHA to 1.314 (P < .001) for IDF, with 95% confidence interval (CI) ranging from 1.003 to 1.503. Adjusted HR for EGIR was 1.087 (95% CI, 0.908-1.301; P = .362). Similarly, all definitions of the metabolic syndrome were significantly associated with incident coronary events except for the EGIR definition. Only the modified WHO definition was associated with increased risk for cerebrovascular events (adjusted HR, 1.301; 95% CI, 1.038-1.631; P = .022). Although all metabolic syndrome definitions except EGIR were associated with total cardiovascular events and coronary events, only the modified WHO definition was also associated with risk of cerebrovascular events.
代谢综合征与心血管风险增加相关，其患病率随年龄增长而增加。存在多种代谢综合征的定义，但某些定义是否能更好地预测老年人未来的心血管事件尚不清楚。我们比较了心血管健康研究中至少 65 岁的老年人中存在和不存在欧洲胰岛素抵抗研究组（EGIR）、美国国家胆固醇教育计划（NCEP）/美国心脏协会（AHA）、美国临床内分泌医师协会、国际糖尿病联合会（IDF）和改良世界卫生组织（WHO）标准定义的代谢综合征的个体发生心血管事件（冠状动脉或脑血管）的风险（n=3390）。参与者无基线糖尿病或心血管疾病。除 EGIR 外，所有代谢综合征定义均与发生心血管（冠状动脉或脑血管）事件的风险增加显著相关。根据改良 WHO、NCEP/AHA、美国临床内分泌医师协会和 IDF 标准定义的代谢综合征风险的校正危险比（HR）范围为 1.153（P=0.045）（NCEP/AHA）至 1.314（P<0.001）（IDF），95%置信区间（CI）范围为 1.003 至 1.503。EGIR 的校正 HR 为 1.087（95%CI，0.908-1.301；P=0.362）。同样，除 EGIR 定义外，所有代谢综合征定义均与新发冠状动脉事件显著相关。只有改良 WHO 定义与脑血管事件风险增加相关（校正 HR，1.301；95%CI，1.038-1.631；P=0.022）。虽然除 EGIR 外，所有代谢综合征定义均与总心血管事件和冠状动脉事件相关，但只有改良 WHO 定义也与脑血管事件风险相关。
