Esteghamati Alireza, Hafezi-Nejad Nima, Sheikhbahaei Sara, Heidari Behnam, Zandieh Ali, Ebadi Maryam, Nakhjavani Manouchehr
Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, PO Box 13145-784, Tehran, Iran.
Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, PO Box 13145-784, Tehran, Iran.
J Clin Lipidol. 2014 May-Jun;8(3):279-86. doi: 10.1016/j.jacl.2014.02.002. Epub 2014 Feb 15.
To evaluate the risk of coronary heart disease (CHD) associated with metabolic syndrome (MetS) and its individual components in a representative sample of diabetic and nondiabetic Iranians. Moreover, we aimed to define the most hazardous MetS components.
Two cohorts consisting of 1737 nondiabetic and 2385 diabetic participants were followed for the first CHD event during 8.5 years (until December 2013).
MetS is defined as having 3 individual components associated with increased risk of CHD (hazard ratio [HR] for MetS: in the unadjusted were 2.85 [2.27-3.57] and in the fully adjusted model 1.80 [1.42-2.28]). MetS was associated with lower hazard of CHD in subjects older than 65 (HR: 1.50 vs. 3.47; P for interaction < .05) and in men (HR: 1.68 vs. 4.87; P for interaction < .05). Presence of 4 of 5 individual MetS components increased the risk of CHD associated with MetS as a constellation. The value of MetS is augmented in the presence of low high-density lipoprotein-cholesterol (HR: 5.74 [2.52-13.08]) versus its absence (HR 1.91 [1.33-2.75]), high triglycerides (HR: 3.39 [1.38-8.34] vs. 1.99 [1.40-2.82] in its absence) and elevated blood pressure (HR: 2.61 [1.43-4.76] vs. 1.80 [1.26-2.58] in its absence).
We address the value of MetS components in the prediction of CHD and in the absence of traditional risk factors. This study provides evidence for the synergistic effect of MetS components on the incidence of CHD.
在具有代表性的伊朗糖尿病和非糖尿病样本中，评估与代谢综合征（MetS）及其各个组分相关的冠心病（CHD）风险。此外，我们旨在确定最具危险性的MetS组分。
两个队列分别由1737名非糖尿病参与者和2385名糖尿病参与者组成，随访8.5年（至2013年12月）以观察首次发生的CHD事件。
MetS被定义为具有3个与CHD风险增加相关的个体组分（未调整时MetS的风险比[HR]：2.85[2.27 - 3.57]，完全调整模型中为1.80[1.42 - 2.28]）。在65岁以上的受试者中（HR：1.50对3.47；交互作用P <.05）以及男性中（HR：1.68对4.87；交互作用P <.05），MetS与较低的CHD风险相关。5个MetS个体组分中出现4个会增加与作为一个整体的MetS相关的CHD风险。与不存在低高密度脂蛋白胆固醇相比（HR：1.91[1.33 - 2.75]），存在低高密度脂蛋白胆固醇时（HR：5.74[2.52 - 13.08]）、高甘油三酯时（HR：3.39[1.38 - 8.34]对不存在时的1.99[1.40 - 2.82]）以及血压升高时（HR：2.61[1.43 - 4.76]对不存在时的1.80[1.26 - 2.58]），MetS的影响增强。
我们阐述了MetS组分在预测CHD以及在不存在传统风险因素时的价值。本研究为MetS组分对CHD发病率的协同作用提供了证据。
