Tan Mun Chieng, Wong Teck Wee, Ng Ooi Chuan, Joseph Anthony, Hejar Abdul Rahman
Southeast Asian J Trop Med Public Health. 2014 Jan;45(1):226-35.
Metabolic syndrome (MetS) is common among patients with type 2 diabetes mellitus (T2DM) and increases the risk of cardiovascular disease (CVD) and all-cause mortality. The objective of this study was to investigate the association between the components of MetS and the prevalence of CVD among patients with T2DM. We studied 313 patients aged > or = 30 years diagnosed with T2DM at two tertiary care hospitals. Patients were recruited by systematic random sampling. Clinical data was obtained using an interviewer-administered structured questionnaire and from a review of their medical records. MetS was diagnosed using NCEP ATP III, WHO, IDF and the new Harmonized definitions. Specific MetS components such as BMI, waist circumference, waist-to-hip ratio, hypertension, HDL-C and triglyceride levels were evaluated to determine if they had an association with CVD. Thirty-six point one percent of the subjects had CVD. The mean age of the subjects was 55.7 +/- 9.2 years and the mean duration of having diabetes was 10.1 +/- 8.1 years. The overall prevalences of MetS (> or = 3 of 5 components) (95% CI) were 96.1% (94.0-98.3), 95.8% (93.6-98.1), 84.8% (80.8-88.9) and 97.7% (96.1-99.4) using NCEP ATP III, WHO, IDF and Harmonized definitions, respectively. Patients with MetS had a higher prevalence of CVD using NCEP ATP III (98.2% vs 93.5%), WHO (98.2% vs 93.0%), IDF (87.6% vs 82.0%) and Harmonized criteria (98.2% vs 96.0%). The greater the number of MetS components, the greater the chance of having CVD using three definitions for diagnosing MetS: WHO, IDF and Harmonized (p < 0.05). MetS and the combination of the individual components of MetS were significantly associated with CVD among type 2 diabetic patients in Malaysia. Aggressive treatment of MetS components is required to reduce cardiovascular risk in T2DM.
代谢综合征（MetS）在2型糖尿病（T2DM）患者中很常见，会增加心血管疾病（CVD）风险和全因死亡率。本研究的目的是调查T2DM患者中MetS各组分与CVD患病率之间的关联。我们研究了在两家三级医疗机构诊断为T2DM的313例年龄≥30岁的患者。通过系统随机抽样招募患者。使用访员管理的结构化问卷并查阅其病历获取临床数据。采用美国国家胆固醇教育计划成人治疗组第三次报告（NCEP ATP III）、世界卫生组织（WHO）、国际糖尿病联盟（IDF）及新的统一定义来诊断MetS。评估特定的MetS组分，如体重指数（BMI）、腰围、腰臀比、高血压、高密度脂蛋白胆固醇（HDL-C）和甘油三酯水平，以确定它们是否与CVD有关联。36.1%的受试者患有CVD。受试者的平均年龄为55.7±9.2岁，糖尿病平均病程为10.1±8.1年。采用NCEP ATP III、WHO、IDF和统一定义时，MetS（5项组分中≥3项）的总体患病率（95%置信区间）分别为96.1%（94.0 - 98.3）、95.8%（93.6 - 98.1）、84.8%（80.8 - 88.9）和97.7%（96.1 - 99.4）。采用NCEP ATP III（98.2%对93.5%）、WHO（98.2%对93.0%）、IDF（87.6%对82.0%）和统一标准时，患有MetS的患者CVD患病率更高（98.2%对96.0%）。对于WHO、IDF和统一这三种诊断MetS的定义，MetS组分数量越多，患CVD几率越大（p<0.05）。在马来西亚，2型糖尿病患者中，MetS及其各组分的组合与CVD显著相关。需要积极治疗MetS组分以降低T2DM患者的心血管风险。
