Khosravi-Boroujeni Hossein, Ahmed Faruk, Sadeghi Masoumeh, Roohafza Hamidreza, Talaei Mohammad, Dianatkhah Minoo, Pourmogaddas Ali, Sarrafzadegan Nizal
Menzies Health Institute Queensland, and School of Medicine, Griffith University, Gold Coast Campus, QLD, Australia.
Isfahan Cardiac Rehabilitation Research Center, Cardiovascular Research Institue, Isfahan University of Medical Sciences, Isfahan, Iran.
BMC Public Health. 2015 Dec 29;15:1313. doi: 10.1186/s12889-015-2623-3.
Metabolic Syndrome (MetS) is a complex disorder which increases the risk of chronic diseases, including cardiovascular diseases and diabetes mellitus. As a result of modern lifestyles, the prevalence of MetS has been rising globally. This study aims to investigate whether overall prevalence of MetS varies when using different definitions of MetS and to identify the best and most predictive definition of the MetS for cardiovascular disease (CVD) events over 10 years in a cohort of an Iranian population.
Adults aged ≥ 35 years from urban and rural regions in central Iran were selected at baseline and followed up for more than 10 years. Data on socio-demographic characteristics, anthropometry, blood pressure and smoking status were collected at baseline. In addition, various biochemical indices were assessed. MetS was defined based on five available definitions, and cardiovascular events during 10 years follow up were confirmed by an expert group. The hazard ratios were calculated by the Cox proportional hazards model.
The highest prevalence of MetS was observed by using AHA-NHBI definition (36.9%), followed by JIS definition (31.2%). On the other hand, EGIR (8.8%) provided the lowest prevalence. The risk of developing CVD, irrespective of definitions, was approximately two fold higher in the presence of MetS. After controlling for possible confounders, AHA-NHBI definition was found to be the best predictor of CVD.
This study demonstrated a great variability in the prevalence of MetS among Iranian adults when using different definitions of MetS. CVD risk was significantly higher in MetS participants, as well as in participants with any risk factors of MetS; however, the AHA-NHBI definition was found to be the best predictor of CVD. Thus protective measures, including lifestyle modifications, plus control of individual risk factors is necessary to prevent cardiovascular events.
代谢综合征（MetS）是一种复杂的病症，会增加包括心血管疾病和糖尿病在内的慢性疾病风险。由于现代生活方式，MetS在全球的患病率一直在上升。本研究旨在调查使用不同的MetS定义时，MetS的总体患病率是否会有所不同，并在一组伊朗人群中确定对10年内心血管疾病（CVD）事件而言最佳且最具预测性的MetS定义。
从伊朗中部城乡地区选取年龄≥35岁的成年人作为基线人群，并进行了超过10年的随访。在基线时收集了社会人口学特征、人体测量学、血压和吸烟状况的数据。此外，还评估了各种生化指标。根据五种可用定义对MetS进行定义，并由一个专家组确认10年随访期间的心血管事件。通过Cox比例风险模型计算风险比。
采用美国心脏协会 - 美国国立卫生研究院定义（AHA - NHBI）时观察到MetS的患病率最高（36.9%），其次是日本工业标准定义（JIS，31.2%）。另一方面，欧洲胰岛素抵抗研究组（EGIR）定义的患病率最低（8.8%）。无论采用何种定义，存在MetS时发生CVD的风险大约高出两倍。在控制了可能的混杂因素后，发现AHA - NHBI定义是CVD的最佳预测指标。
本研究表明，在伊朗成年人中使用不同的MetS定义时，MetS的患病率存在很大差异。MetS参与者以及具有任何MetS危险因素的参与者发生CVD的风险显著更高；然而，发现AHA - NHBI定义是CVD的最佳预测指标。因此，包括生活方式改变以及控制个体危险因素在内的预防措施对于预防心血管事件是必要的。
