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采用国际糖尿病联盟(IDF)和美国国家胆固醇教育计划成人治疗小组第三次报告(ATPIII)诊断标准对西班牙成年劳动者病前代谢综合征患病率的研究:与心血管危险因素的关系

Prevalence of premorbid metabolic syndrome in Spanish adult workers using IDF and ATPIII diagnostic criteria: relationship with cardiovascular risk factors.

作者信息

Tauler Pedro, Bennasar-Veny Miquel, Morales-Asencio Jose M, Lopez-Gonzalez Angel A, Vicente-Herrero Teofila, De Pedro-Gomez Joan, Royo Vanessa, Pericas-Beltran Jordi, Aguilo Antoni

机构信息

Fundamental Biology and Health Sciences Department, Universitat Illes Balears, Palma, Spain.

Research Group on Evidence, Lifestyles & Health, Universitat Illes Balears, Palma, Spain.

出版信息

PLoS One. 2014 Feb 20;9(2):e89281. doi: 10.1371/journal.pone.0089281. eCollection 2014.

Abstract

BACKGROUND

Metabolic Syndrome (MetS) is a complex disorder defined as a cluster of interconnected risk factors such as hypertension, dyslipidemia, obesity and high blood glucose levels. Premorbid metabolic syndrome (PMetS) is defined by excluding patients with previously diagnosed cardiovascular disease or diabetes mellitus from those suffering MetS. We aimed to determine the prevalence of PMetS in a working population, and to analyse the relationship between the diagnostic criteria of the International Diabetes Federation (IDF) and of the National Cholesterol Education Program Adult Treatment Panel III (ATPIII). The relationship between the presence of PMetS and cardiovascular risk factors was also analysed.

RESEARCH METHODOLOGY/FINDINGS: A cross-sectional study was conducted in 24,529 male and 18,736 female Spanish (white western European) adult workers (20-65 years) randomly selected during their work health periodic examinations. Anthropometrics, blood pressure and serum parameters were measured. The presence of MetS and PMetS was ascertained using ATPIII and IDF criteria. Cardiovascular risk was determined using the Framingham-REGICOR equation. The results showed MetS had an adjusted global prevalence of 12.39% using ATPIII criteria and 16.46% using IDF criteria. The prevalence of PMetS was slightly lower (11.21% using ATPIII criteria and 14.72% using IDF criteria). Prevalence in males was always higher than in females. Participants with PMetS displayed higher values of BMI, waist circumference, blood pressure, glucose and triglycerides, and lower HDL-cholesterol levels. Logistic regression models reported lower PMetS risk for females, non-obese subjects, non-smokers and younger participants. Cardiovascular risk determined with Framingham-REGICOR was higher in participants with PMetS.

CONCLUSIONS

PMetS could be a reliable tool for the early identification of apparently healthy individuals who have a significant risk for developing cardiovascular events and type 2 diabetes.

摘要

背景

代谢综合征(MetS)是一种复杂的病症,被定义为一组相互关联的风险因素,如高血压、血脂异常、肥胖和高血糖水平。病前代谢综合征(PMetS)的定义是,在患有代谢综合征的患者中排除先前诊断患有心血管疾病或糖尿病的患者。我们旨在确定工作人群中PMetS的患病率,并分析国际糖尿病联盟(IDF)和美国国家胆固醇教育计划成人治疗小组第三次报告(ATPIII)的诊断标准之间的关系。还分析了PMetS的存在与心血管危险因素之间的关系。

研究方法/结果:对24529名男性和18736名女性西班牙(西欧白人)成年工人(20 - 65岁)进行了一项横断面研究,这些工人是在工作健康定期检查期间随机选取的。测量了人体测量学指标、血压和血清参数。使用ATPIII和IDF标准确定MetS和PMetS的存在情况。使用弗雷明汉-REGICOR方程确定心血管风险。结果显示,使用ATPIII标准时,MetS的校正总体患病率为12.39%,使用IDF标准时为16.46%。PMetS的患病率略低(使用ATPIII标准时为11.21%,使用IDF标准时为14.72%)。男性患病率始终高于女性。患有PMetS的参与者表现出更高的体重指数、腰围、血压、血糖和甘油三酯值,以及更低的高密度脂蛋白胆固醇水平。逻辑回归模型显示,女性、非肥胖受试者、非吸烟者和年轻参与者的PMetS风险较低。使用弗雷明汉-REGICOR确定的心血管风险在患有PMetS的参与者中更高。

结论

PMetS可能是一种可靠的工具,用于早期识别表面健康但有发生心血管事件和2型糖尿病重大风险的个体。

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