代谢综合征与冠状动脉疾病的严重程度和复杂性有关吗：一项关于国际糖尿病联盟（IDF）和美国心脏协会/美国国立心肺血液研究所（AHA/NHLBI）代谢综合征定义的观察性研究。

Is metabolic syndrome related with coronary artery disease severity and complexity: An observational study about IDF and AHA/NHLBI metabolic syndrome definitions.

作者信息

Aykan Ahmet Çağrı, Gül İlker, Kalaycıoğlu Ezgi, Gökdeniz Tayyar, Hatem Engin, Menteşe Ümit, Yıldız Banu Şahin, Yıldız Mustafa

机构信息

Department of Cardiology, Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.

出版信息

Cardiol J. 2014;21(3):245-51. doi: 10.5603/CJ.a2013.0126. Epub 2013 Oct 21.

DOI:10.5603/CJ.a2013.0126

PMID:24142676

Abstract

BACKGROUND

The aim of the present study was to assess the relation between metabolic syndrome (MS) and coronary artery disease (CAD) complexity, assessed by Syntax score (SS), and severity in non-diabetic patients with stable CAD who underwent coronary angiography, and to evaluate whether the MS defined by different definitions, including International Diabetes Federation (IDF) and American Heart Association/National Heart Lung Blood Institute (AHA/NHLBI) guidelines, similarly correlated with SS.

METHODS

The present study is cross sectional and observational with prospective inclusion of 248 consecutive patients (157 male) who underwent coronary angiography due to stable CAD.

RESULTS

The prevalence of MS was 54.4% according to IDF definition and 50.4% according to AHA/NHLBI definition. MS score according to IDF definitions (r = 0.446, p < 0.001), MS score according to AHA/NHLBI definitions (r = 0.341, p < 0.001) were moderately correlated with SS. In Fisher r to z transformation test the correlations of the presence of MS according to IDF and AHA/NHLBI definitions with SS were not statistically significant (p = 0.168, z = -1.38). The systolic blood pressure (p < 0.001, B = 0.354, 95% CI = -0.308 to 0.228), diastolic blood pressure (p = 0.006, B = -0.194, 95% CI = -0.333 to -0.056), age (p = 0.014, B = 0.147, 95% CI = 0.029 to 0.264), left ventricular ejection fraction (p = 0.031, B = -0.150, 95% CI= -0.286 to -0.014), waist/hip circumference (p < 0.001, B = 45.713, 95% CI = 23.235 to 68.1919) and log10 high density lipoprotein (p < 0.001, B = -22.209, 95% CI = -33.298 to-11.119) were the independent predictors of SS in linear regression analysis.

CONCLUSIONS

MS is associated with the presence and complexity of CAD. Besides the presence of discrepancy in the limits of waist circumference, both IDF and AHA/NHLBI criteria were similarly correlated with CAD complexity.

摘要

背景

本研究旨在评估代谢综合征（MS）与冠状动脉疾病（CAD）复杂性（通过Syntax评分（SS）评估）以及接受冠状动脉造影的非糖尿病稳定性CAD患者病情严重程度之间的关系，并评估包括国际糖尿病联盟（IDF）和美国心脏协会/国家心肺血液研究所（AHA/NHLBI）指南在内的不同定义所界定的MS与SS的相关性是否相似。

方法

本研究为横断面观察性研究，前瞻性纳入了248例因稳定性CAD接受冠状动脉造影的连续患者（157例男性）。

结果

根据IDF定义，MS患病率为54.4%；根据AHA/NHLBI定义，MS患病率为50.4%。根据IDF定义的MS评分（r = 0.446，p < 0.001）、根据AHA/NHLBI定义的MS评分（r = 0.341，p < 0.001）与SS呈中度相关。在Fisher r到z转换检验中，根据IDF和AHA/NHLBI定义的MS存在情况与SS的相关性无统计学意义（p = 0.168，z = -1.38）。收缩压（p < 0.001，B = 0.354，95%CI = -0.308至0.228）、舒张压（p = 0.006，B = -0.194，95%CI = -0.333至-0.056）、年龄（p = 0.014，B = 0.147，95%CI = 0.029至0.264）、左心室射血分数（p = 0.031，B = -0.150，95%CI = -0.286至-0.014）、腰臀围比（p < 0.001，B = 45.713，95%CI = 23.235至68.1919）和log10高密度脂蛋白（p < 0.001，B = -22.209，95%CI = -33.298至-11.119）是线性回归分析中SS的独立预测因素。