Cardiovascular Risk and Lipid Unit, Instituto de Investigaciones Sanitarias, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense Madrid, Red Investigación Cardiovascular (RIC), RD12/0042/0033, Instituto de Salud Carlos III, Spain.
Cardiology Department, Hospital Clínico San Carlos, Madrid, Spain.
Eur J Intern Med. 2014 Jun;25(5):438-43. doi: 10.1016/j.ejim.2014.03.014. Epub 2014 Apr 5.
Metabolic syndrome (MS) is an association of cardiovascular risk factors that increases the risk of coronary disease or type 2 diabetes mellitus (DM2), and has also been associated with the presence of liver steatosis (LS). In this study the relation of MS and LS with cholesterol control was analyzed in very high cardiovascular risk patients (coronary patients and/or DM2).
A cross-sectional epidemiological study including 6988 patients, from whom information was obtained on their characteristics, lipid profile and treatments.
4455 patients (65%) of the total study population had MS. Of MS criteria, high BP was the criterion most represented in the total population, while high TGs was the least. Within the total population, coronary patients showed a greater proportion of high BP, high TG and low HDL-c than those without coronary disease. Although no influence of MS was seen on the achievement of LDL-c targets (<70 mg/dL), the presence of high BP, high blood glucose and low HDL-c was related to poorer control of LDL-c. Finally, patients with MS showed a greater proportion of liver steatosis and this was associated in turn with poorer control of LDL-c.
The criteria for MS are closely related to cholesterol control. LS is more prevalent in patients with MS, and it is associated with poorer control of LDL-c. We should focus on the presence of MS in high and very high CV risk patients in order to improve their lipid control.
代谢综合征（MS）是心血管危险因素的联合，会增加冠心病或 2 型糖尿病（DM2）的风险，并且还与肝脏脂肪变性（LS）的存在有关。在这项研究中，我们分析了极高心血管风险患者（冠心病患者和/或 DM2 患者）中 MS 和 LS 与胆固醇控制的关系。
这是一项横断面流行病学研究，共纳入 6988 例患者，收集了他们的特征、血脂谱和治疗信息。
在总研究人群中，有 4455 例（65%）患者患有 MS。在 MS 的标准中，高血压是总人群中最常见的标准，而高甘油三酯血症则是最不常见的标准。在总人群中，冠心病患者的高血压、高甘油三酯和低 HDL-c 的比例高于无冠心病患者。尽管 MS 对 LDL-c 目标（<70mg/dL）的达标没有影响，但高血压、高血糖和低 HDL-c 的存在与 LDL-c 控制不佳有关。最后，患有 MS 的患者出现 LS 的比例更高，而 LS 又与 LDL-c 控制不佳有关。
MS 的标准与胆固醇控制密切相关。LS 在 MS 患者中更为常见，并且与 LDL-c 控制不佳有关。我们应该关注高和极高心血管风险患者中 MS 的存在，以改善他们的血脂控制。
