Department of Cardiology, Division of Internal Medicine, Zabok General Hospital, Zabok, Croatia.
Endocr J. 2012;59(12):1065-76. doi: 10.1507/endocrj.ej12-0131. Epub 2012 Aug 17.
Metabolic syndrome (MetS) is the occurrence of diabetes mellitus/glucose intolerance, arterial hypertension, central obesity, dyslipidemia, and microalbuminuria in the same patient (definition by WHO). Presence of metabolic syndrome is associated with larger myocardial infarction size and complications following acute myocardial infarction. Two hundred and thirty patients with acute coronary syndromes were analyzed. Those with MetS (n=141) included patients with diabetes mellitus/glucose intolerance and at least two of the following criteria: hypertension, hypertriglyceridemia/low HDL cholesterol, android obesity/body mass index (BMI) ≥ 30, or microalbuminuria. Control group did not meet criteria for MetS. Presence of heart failure was assigned according to Killip classification. The MetS group had larger myocardial infarction size determined by peak creatine-kinase (CK) (1484±1354 vs. 981±890, p = 0.003) and CK MB (141±117 vs. 95±78, p = 0.002). While in non-MetS group males had larger myocardial infarction than females, in MetS group females had larger myocardial infarction than males. Cardiac failure occurred more in MetS group of patients, again was more prominent in females. Occurrence of metabolic syndrome in acute coronary syndrome patients predisposes to larger myocardial infarction size, more on the account of female patients having MetS. MetS, again particularly in females, predisposes to higher chance of having heart failure during acute coronary syndrome. Recognizing the female group with MetS as of higher risk for large myocardial infarction and heart failure leads us to pay special attention on this patient population.
代谢综合征（MetS）是指同一患者同时发生糖尿病/葡萄糖耐量异常、动脉高血压、中心性肥胖、血脂异常和微量白蛋白尿（世界卫生组织的定义）。代谢综合征的存在与急性心肌梗死患者更大的心肌梗死面积和并发症相关。对 230 例急性冠状动脉综合征患者进行了分析。代谢综合征组（n=141）包括患有糖尿病/葡萄糖耐量异常和至少以下两个标准的患者：高血压、高三酰甘油血症/低高密度脂蛋白胆固醇、男性型肥胖/体重指数（BMI）≥30 或微量白蛋白尿。对照组不符合代谢综合征标准。心力衰竭的存在根据 Killip 分类进行分配。代谢综合征组的肌酸激酶峰值（CK）（1484±1354 vs. 981±890，p=0.003）和 CK-MB（141±117 vs. 95±78，p=0.002）确定的心肌梗死面积更大。虽然在非代谢综合征组中男性的心肌梗死面积大于女性，但在代谢综合征组中女性的心肌梗死面积大于男性。代谢综合征组患者发生心力衰竭的情况更为常见，而女性更为突出。急性冠状动脉综合征患者代谢综合征的发生会导致更大的心肌梗死面积，这主要是由于患有代谢综合征的女性患者。代谢综合征，尤其是女性患者，在急性冠状动脉综合征期间发生心力衰竭的可能性更高。认识到具有代谢综合征的女性群体发生大面积心肌梗死和心力衰竭的风险更高，这使我们特别关注这一患者群体。
