Shrestha R, Jha S C, Khanal M, Gyawali P, Yadav B K, Jha B
Department of Biochemistry, Nepal Medical College, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2011 Oct-Dec;51(184):157-63.
Different authorities have put forward their criteria to define metabolic syndrome (MetS). The aim of this study was to find the prevalence of MetS in hypertensive individuals by the available three different definitions from National Cholesterol Education Program (NCEP), International diabetes Federation (IDF) and WHO and their association with other cardiac risk factors.
After anthropometric measurements fasting blood was analyzed for glucose, lipids, high sensitivity C-reactive protein (hsCRP) and anti-oxidized LDL antibody in 150 hypertensive individuals. A ten-year coronary heart disease risk was predicted using the Framingham risk score (FRS).
The prevalence of MetS was 54.7 % by NCEP, 42.0 % by IDF) and 18.7 % by WHO. As many as 63.4 % had MetS by any definition, while only 9.4 % fulfilled all the criteria of the three definitions. The association of cardiac risk factors also varied according to the definition used. hsCRP was significantly elevated in MetS compared to non-MetS. Body mass index, waist circumference and HDL-C were associated in MetS defined by NCEP and IDF. FRS was higher in MetS defined by Adult Treatment Panel and WHO definitions. An increase in urine albumin and a decrease in eGFR were associated with MetS individuals defined by WHO only.
There is a wide variation in the prevalence of MetS and associated cardiac risk factors according to three different definitions used. The different cardiac risk factors among MetS also vary with the definitions used. However, hsCRP and emerging risk factor are significantly elevated in hypertensive individuals with MetS as defined by all definitions.
不同机构提出了各自定义代谢综合征(MetS)的标准。本研究旨在通过美国国家胆固醇教育计划(NCEP)、国际糖尿病联盟(IDF)和世界卫生组织(WHO)现有的三种不同定义,找出高血压患者中代谢综合征的患病率及其与其他心脏危险因素的关联。
对150名高血压患者进行人体测量后,分析其空腹血糖、血脂、高敏C反应蛋白(hsCRP)和抗氧化低密度脂蛋白抗体。使用弗明汉风险评分(FRS)预测十年冠心病风险。
根据NCEP定义,代谢综合征的患病率为54.7%;根据IDF定义为42.0%;根据WHO定义为18.7%。无论采用哪种定义,多达63.4%的患者患有代谢综合征,而只有9.4%的患者符合所有三种定义的标准。心脏危险因素的关联也因所使用的定义而异。与非代谢综合征患者相比,代谢综合征患者的hsCRP显著升高。体重指数、腰围和高密度脂蛋白胆固醇(HDL-C)与NCEP和IDF定义的代谢综合征相关。根据成人治疗小组和WHO定义,代谢综合征患者的FRS更高。尿白蛋白增加和估算肾小球滤过率(eGFR)降低仅与WHO定义的代谢综合征患者相关。
根据所使用的三种不同定义,代谢综合征的患病率及其相关心脏危险因素存在很大差异。代谢综合征中的不同心脏危险因素也因所使用的定义而异。然而,在所有定义所界定的患有代谢综合征的高血压患者中,hsCRP和新出现的危险因素均显著升高。