Ohnuki Tomohide, Takahashi Wakoh, Ohnuki Youichi, Kawada Shiaki, Takizawa Shunya
Division of Neurology, Department of Internal Medicine, Tokai University School of Medicine, Japan.
Intern Med. 2013;52(5):523-7. doi: 10.2169/internalmedicine.52.8858. Epub 2013 Mar 1.
The presence of metabolic syndrome (MetS) is strongly associated with stroke and cardiovascular diseases. However, the relationship between MetS and the localization of atherosclerosis at various sites remains uncertain. In this study, in order to reveal the relevance of MetS to atherosclerosis at several sites, we investigated the relationships among vascular risk factors, asymptomatic cerebral infarction and atherosclerosis in the aorta and carotid and coronary arteries in adults without overtly symptomatic cerebrovascular or cardiovascular disease.
The subjects in this study included 2,759 Japanese participants (1,845 men and 914 women, mean age: 52 years) with no history of stroke or cardiovascular events. The diagnosis of MetS was made based on modifications to criteria obtained from the National Cholesterol Education Program Adult Treatment Panel. In all subjects, the presence of cerebral infarction in the extra-cranial carotid, coronary and aortic arteries was investigated using MRI, B-mode ultrasonography and CT.
Of the 2,759 subjects, 796 (28.9%) fulfilled the criteria for MetS. The presence of MetS increased the odds ratio (OR) to 1.89 (95% confidence interval (CI): 1.35-2.65, p-value <0.0001) for asymptomatic cerebral infarction, 1.70 (95% CI: 1.37-2.10, p-value <0.0001) for carotid arteriosclerosis, 2.07 (95% CI: 1.62-2.27, p-value <0.0001) for coronary calcification and 1.67 (95% CI: 1.33-2.09, p-value<0.0001) for aortic calcification.
The presence of MetS was found to be significantly correlated with arteriosclerosis in all regions, including the cerebral small-vessels, extra-cranial carotid arteries, coronary arteries and abdominal aorta. MetS might be a predictor for small and large vessel disease throughout the body.
代谢综合征(MetS)的存在与中风和心血管疾病密切相关。然而,MetS与不同部位动脉粥样硬化的定位之间的关系仍不明确。在本研究中,为了揭示MetS与多个部位动脉粥样硬化的相关性,我们调查了无明显症状性脑血管或心血管疾病的成年人中血管危险因素、无症状性脑梗死与主动脉、颈动脉和冠状动脉粥样硬化之间的关系。
本研究的受试者包括2759名日本参与者(1845名男性和914名女性,平均年龄:52岁),他们没有中风或心血管事件史。MetS的诊断基于对从国家胆固醇教育计划成人治疗小组获得的标准的修改。在所有受试者中,使用MRI、B型超声和CT调查颅外颈动脉、冠状动脉和主动脉中脑梗死的存在情况。
在2759名受试者中,796名(28.9%)符合MetS标准。MetS的存在使无症状性脑梗死的比值比(OR)增加到1.89(95%置信区间(CI):1.35-2.65,p值<0.0001),颈动脉粥样硬化的比值比为1.70(95%CI:1.37-2.10,p值<0.0001),冠状动脉钙化的比值比为2.07(95%CI:1.62-2.27,p值<0.0001),主动脉钙化的比值比为1.67(95%CI:1.33-2.09,p值<0.0001)。
发现MetS的存在与所有区域的动脉硬化显著相关,包括脑小血管、颅外颈动脉、冠状动脉和腹主动脉。MetS可能是全身小血管和大血管疾病的一个预测指标。