Department of Gastroenterology, Goztepe, Training and Research Hospital, Istanbul, Turkey.
Saudi J Gastroenterol. 2011 Nov-Dec;17(6):376-82. doi: 10.4103/1319-3767.87177.
BACKGROUND/AIM: Metabolic syndrome (MetS) is a clinical condition characterized by central obesity, elevated triglycerides, low-high density lipoproteins, impaired fasting glucose, and hypertension. There is insufficient data on the prevalence of MetS in patients with inflammatory bowel disease (IBD). This study sought to determine the prevalence of MetS in a Turkish cohort of patients with IBD and the association between insulin resistance (IR) and the MetS parameters, in this population.
A total of 177 patients over 18 years of age (62 with Crohn's disease (CD) and 115 with ulcerative colitis (UC)) were enrolled in the study. The presence of at least three criteria of the International Diabetes Federation (IDF) was accepted for the diagnosis of MetS. The Homeostasis Model Assessment (HOMA) was used to determine IR. HOMA values < 1 were considered normal and values > 2.5 indicated a high probability of IR.
MetS frequency was higher in patients n=34 (29.5%) with UC than in patients n=11 (17.7%) with CD (P < 0.01). MetS was detected in 12 of the 117 patients (10.3%) with IBD, under 45 years of age, and in 33 of 60 patients (55%) over 45 years of age. HOMA value in n=31 patients (27%) with UC was > 2.5. Body mass index, insulin (P < 0.001), waist circumference, fasting plasma glucose, leukocyte count (P < 0.01), triglycerides, C-reactive protein, and uric acid values (P < 0.05) were significantly higher in UC patients with IR than those without IR.
Frequent occurrence of MS with increasing age in IBD, particularly in UC, showed the importance of early diagnosis and treatment of cardiovascular disease risk factors in the long-term follow-up of these diseases.
背景/目的：代谢综合征（MetS）是一种以中心性肥胖、甘油三酯升高、高低密度脂蛋白水平降低、空腹血糖受损和高血压为特征的临床病症。关于炎症性肠病（IBD）患者代谢综合征的患病率，目前数据还不够充分。本研究旨在确定土耳其 IBD 患者队列中代谢综合征的患病率，以及该人群中胰岛素抵抗（IR）与代谢综合征参数之间的关系。
共纳入 177 名年龄在 18 岁以上的患者（62 名克罗恩病（CD）患者和 115 名溃疡性结肠炎（UC）患者）。接受国际糖尿病联合会（IDF）的至少三项标准，诊断为代谢综合征。采用稳态模型评估（HOMA）来确定 IR。HOMA 值<1 被认为是正常的，而值>2.5 则表示存在高概率的 IR。
UC 患者 n=34（29.5%）中代谢综合征的发生率高于 CD 患者 n=11（17.7%）（P<0.01）。在年龄<45 岁的 117 名 IBD 患者中，有 12 名（10.3%）和年龄>45 岁的 60 名患者中的 33 名（55%）患有代谢综合征。UC 患者 n=31（27%）的 HOMA 值>2.5。IR 的 UC 患者的体重指数、胰岛素（P<0.001）、腰围、空腹血糖、白细胞计数（P<0.01）、甘油三酯、C 反应蛋白和尿酸值（P<0.05）均显著高于非 IR 患者。
IBD 患者 MS 的发病率随年龄增长而增加，尤其是在 UC 中，这表明在这些疾病的长期随访中，应重视心血管疾病危险因素的早期诊断和治疗。
