Tang Zi-Hui, Wang Lin, Zeng Fangfang, Zhang Keqin
Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, Tongji University School of Medicine, Building 2nd, NO,389 Xincun Road, Shanghai 200063, China.
BMC Cardiovasc Disord. 2014 Sep 24;14:124. doi: 10.1186/1471-2261-14-124.
The purpose of this study was, in high-risk patients, to simultaneously estimate the effect of metabolic syndrome (MetS) on diastolic or systolic heart failure (DHF or SHF), to evaluate MetS predictive value for both outcomes.
We retrospective enrolled 347 high-risk patients who were scheduled to undergo coronary angiography. They were categorized into DHF cases, SHF cases and reference group. The association of MetS with DHF or SHF was assessed by multinomial logistic regression model. The shared contributor to both outcomes was estimated by bivariate association analysis. The predictive performance of MetS severity score was evaluated using the area under the receiver-operating characteristic curve (AUC).
Hypertension (HT) and triglycerides (TG) were detected to independently associate with DHF (P = 0.044 and 0.049, respectively), while HT and fasting plasma glucose (FPG) independently associate with SHF (P = 0.036 and 0.016, respectively). Bivariate association analysis showed that HT as a shared predictor to both outcomes (P = 0.028). MetS severity score significantly associated with DHF or SHF independently (P = 0.004 and 0.043, respectively), and was a shared predictor to both outcomes (P = 0.049), and showed a high value in predicting DHF and SHF (AUC = 0.701 and 0.722, respectively).
Our findings signify that MetS is an independently shared predictor of DHF and SHF, and HT is also independently associated with both outcomes in high-risk patients. Prevalence of DHF or SHF trends to increase with increasing MetS severity showing high predictive value for both outcomes.
本研究旨在评估高危患者中代谢综合征（MetS）对舒张性或收缩性心力衰竭（DHF或SHF）的影响，并评价MetS对这两种结局的预测价值。
我们回顾性纳入了347例计划接受冠状动脉造影的高危患者。他们被分为DHF组、SHF组和参照组。采用多项逻辑回归模型评估MetS与DHF或SHF的相关性。通过双变量关联分析估计两种结局的共同影响因素。使用受试者工作特征曲线下面积（AUC）评估MetS严重程度评分的预测性能。
高血压（HT）和甘油三酯（TG）被检测出与DHF独立相关（分别为P = 0.044和0.049），而HT和空腹血糖（FPG）与SHF独立相关（分别为P = 0.036和0.016）。双变量关联分析显示，HT是两种结局的共同预测因素（P = 0.028）。MetS严重程度评分分别与DHF或SHF显著独立相关（分别为P = 0.004和0.043），并且是两种结局的共同预测因素（P = 0.049），在预测DHF和SHF方面显示出较高价值（AUC分别为0.701和0.722）。
我们的研究结果表明，MetS是DHF和SHF的独立共同预测因素，HT在高危患者中也与这两种结局独立相关。DHF或SHF的患病率随MetS严重程度增加而呈上升趋势，对两种结局均显示出较高的预测价值。
