Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
J Geriatr Cardiol. 2012 Jun;9(2):123-9. doi: 10.3724/SP.J.1263.2012.01172.
The predictive value of the metabolic syndrome (MetS) for mortality from all-cause and cardiovascular disease (CVD) in the Chinese population is unclear. The aim of this present study was to compare MetS with its individual components as predictors of mortality in Chinese elderly adults.
A cohort of 1,535 subjects (994 men and 541 women) aged 50 years or older was selected from employees of a machinery factory in 1994 and followed until 2009. Cox models were used to estimate the hazard ratios (HRs) predicted by MetS according to the harmonized definition and by its individual components.
The baseline prevalence of MetS was 28.0% in men and 48.4% in women. During a median follow-up of 15 years, 414 deaths occurred, of these, 153 participants died from CVD. Adjusted for age and gender, the HRs of mortality from all-cause and CVD in participants with MetS were 1.47 (95% confidence interval (CI): 1.20-1.80) and 1.96 (95%CI: 1.42-2.72), respectively, compared with those without MetS. Non-significant higher risk of CVD mortality was seen in those with one or two individual components (HR = 1.22, 95%CI: 0.59-2.50; HR = 1.82, 95%CI: 0.91-3.64, respectively), while a substantially higher risk of CVD mortality only appeared in those with 3, 4, or 5 components (HR = 2.81-3.72), compared with those with no components. On evaluating the MetS components individually, we found that, independent of MetS, only hypertension and impaired glucose predicted higher mortality.
The number of positive MetS components seems no more informative than classifying (dichotomous) MetS for CVD risks assessment in this Chinese cohort.
代谢综合征(MetS)对中国人群全因和心血管疾病(CVD)死亡率的预测价值尚不清楚。本研究旨在比较 MetS 及其各组分作为中国老年人群死亡率预测指标的价值。
1994 年,我们从一家机械厂的员工中选择了 1535 名年龄在 50 岁及以上的受试者(994 名男性和 541 名女性),并随访至 2009 年。Cox 模型用于估计按照协调定义和各组分预测的 MetS 的风险比(HR)。
男性 MetS 的基线患病率为 28.0%,女性为 48.4%。在中位随访 15 年期间,发生了 414 例死亡,其中 153 例死于 CVD。调整年龄和性别后,MetS 患者全因和 CVD 死亡率的 HR 分别为 1.47(95%置信区间:1.20-1.80)和 1.96(95%置信区间:1.42-2.72),与无 MetS 者相比。有一个或两个单独组分的患者 CVD 死亡率风险略有升高(HR=1.22,95%置信区间:0.59-2.50;HR=1.82,95%置信区间:0.91-3.64),而有 3、4 或 5 个组分的患者 CVD 死亡率风险显著升高(HR=2.81-3.72),与无组分者相比。单独评估 MetS 各组分时,我们发现,无论是否存在 MetS,只有高血压和葡萄糖受损独立预测死亡率升高。
在这个中国队列中,与分类(二分类)MetS 相比,阳性 MetS 组分的数量对于评估 CVD 风险的信息价值可能并不高。