Mozaffary A, Bozorgmanesh M, Sheikholeslami F, Azizi F, Eskandari F, Hadaegh F
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Endocrine Research Center, Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Eur J Clin Nutr. 2014 Jul;68(7):853-8. doi: 10.1038/ejcn.2014.91. Epub 2014 May 28.
BACKGROUND/OBJECTIVES: To examine the association between the different definitions of metabolic syndrome (MetS) and the prediction of incident cardiovascular disease (CVD) and mortality events and to determine whether the concept of MetS adds to traditional risk factors among elderly Iranians.
SUBJECTS/METHODS: The association between MetS and outcomes was examined in 922 adults aged ⩾65 years, free of CVD at baseline, using multivariate Cox proportional hazards models. To examine whether MetS could enhance prediction of outcomes beyond that achieved by risk factors; the net reclassification improvement index was used.
During a median follow-up of 9.9 years, 207 CVD events and 193 deaths (82 CVD deaths) occurred. World health organization (WHO) and the joint interim statement (JIS) definitions were shown to be the strongest predictors of CVD events. The WHO definition predicted CVD and all-cause mortality events (hazard ratio (HR)=1.55 (95% confidence interval (CI)=1.15-2.09) and 2.08 (95% CI=1.23-3.51), respectively) and the JIS definition showed a risk for CVD mortality (HR=1.65 (95% CI=1.03-2.65)). Different definitions of MetS did not add to traditional risk factors in the prediction of different outcomes.
The WHO definition was the strongest predictor of CVD and mortality outcomes; however, none of the MetS definitions provided added value to traditional risk factors.
背景/目的：研究代谢综合征（MetS）不同定义与心血管疾病（CVD）及死亡事件发生风险预测之间的关联，并确定MetS概念在伊朗老年人中是否能补充传统危险因素。
对象/方法：采用多变量Cox比例风险模型，对922名年龄≥65岁、基线时无CVD的成年人进行MetS与结局之间关联的研究。为检验MetS能否在危险因素之外增强结局预测能力，使用了净重新分类改善指数。
在中位随访9.9年期间，发生了207例CVD事件和193例死亡（82例CVD死亡）。世界卫生组织（WHO）和联合临时声明（JIS）定义显示为CVD事件的最强预测因素。WHO定义预测CVD和全因死亡事件（风险比（HR）分别为1.55（95%置信区间（CI）=1.15 - 2.09）和2.08（95%CI = 1.23 - 3.51）），JIS定义显示有CVD死亡风险（HR = 1.65（95%CI = 1.03 - 2.65））。MetS的不同定义在不同结局预测中并未补充传统危险因素。
WHO定义是CVD和死亡结局的最强预测因素；然而，MetS的任何定义均未为传统危险因素增加额外价值。
