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根据日本原有标准定义的既往存在的代谢综合征在非致命性心肌梗死患者中的患病率。

Prevalence of preexisting metabolic syndrome as defined by Japanese original criteria among patients with non-fatal myocardial infarction.

作者信息

Hamada Riichiro, Muto Shigeki, Otsuka Nobuyoshi, Sato Eriko, Zhang Yufeng

机构信息

Seirei Center for Health Promotion and Preventive Medicine, Seirei Social Welfare Community, Japan.

出版信息

Intern Med. 2011;50(22):2749-57. doi: 10.2169/internalmedicine.50.5976. Epub 2011 Nov 15.

Abstract

OBJECTIVE

We aimed to clarify the prevalence of preexisting Metabolic Syndrome (MetS) defined by the Japanese original criteria among patients with non-fatal myocardial infarction (MI).

METHODS

This is a retrospective cohort study using the computer database obtained by the preliminary health checkup from April 2003 to December 2008. We extracted the subjects with newly developed non-fatal MI from the study population. The newly non-fatal MI was diagnosed by the history of coronary heart disease (CHD) and new appearance of abnormal Q wave on electrocardiograms. MetS was diagnosed by using the Japanese original criteria. If waist circumference was not available, BMI was used alternatively. We evaluated the prevalence of preexisting MetS and other risk factors of CHD among the subjects. We compared the prevalence of preexisting risk factors between MetS group and non-MetS group.

RESULTS

From a study population of 298,455 subjects, 446 subjects with a history of CHD were found. Among the 446, 92 subjects (85 men and 7 women) with abnormal Q wave on electrocardiogram were found. The prevalence of preexisting MetS with non-fatal MI was 19.6% (95% CI; 15.5-23.7%). The prevalence of other preexisting risk factors were 60.0% with smoking history, 55.6% with over-work, 53.3% with stressful life and 36.1% with impaired glucose tolerance. These prevalence rates were not significantly different between MetS group and non-MetS group. Only the prevalence (22.3%) of elevated LDL-cholesterol in the non-MetS group was significantly higher than in the MetS group (14.4%).

CONCLUSION

Preexisting MetS may be able to predict only 20% of future MI. To prevent future myocardial infarction, precaution guidance may be required for people with not only preexisting MetS but also other preexisting risk factors of CHD.

摘要

目的

我们旨在阐明按照日本原有标准定义的代谢综合征(MetS)在非致死性心肌梗死(MI)患者中的患病率。

方法

这是一项回顾性队列研究,使用了2003年4月至2008年12月初步健康检查获得的计算机数据库。我们从研究人群中提取新发生非致死性MI的受试者。新发生的非致死性MI通过冠心病(CHD)病史和心电图上新出现的异常Q波来诊断。MetS采用日本原有标准进行诊断。若无法获取腰围,则改用体重指数(BMI)。我们评估了受试者中既往存在的MetS及其他CHD危险因素的患病率。我们比较了MetS组和非MetS组中既往存在危险因素的患病率。

结果

在298,455名研究对象中,发现446名有CHD病史的受试者。在这446名受试者中,发现92名(85名男性和7名女性)心电图有异常Q波。非致死性MI患者中既往存在MetS的患病率为19.6%(95%可信区间;15.5 - 23.7%)。其他既往存在的危险因素的患病率分别为:吸烟史60.0%,过度劳累55.6%,生活压力大53.3%,糖耐量受损36.1%。这些患病率在MetS组和非MetS组之间无显著差异。仅非MetS组中低密度脂蛋白胆固醇升高的患病率(22.3%)显著高于MetS组(14.4%)。

结论

既往存在的MetS可能仅能预测未来MI的20%。为预防未来心肌梗死,不仅对既往存在MetS的人群,而且对其他既往存在CHD危险因素的人群,可能都需要进行预防指导。

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