Wiley Joshua F, Carrington Melinda J
Centre for Primary Care and Prevention, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
Centre for Primary Care and Prevention, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
Prev Med. 2016 Jul;88:189-95. doi: 10.1016/j.ypmed.2016.04.006. Epub 2016 Apr 16.
Metabolic syndrome is a cluster of cardio-metabolic risk factors and is associated with increased mortality. There is no standard, validated way to assess the severity of aggregated metabolic syndrome risk factors. Cardiovascular and diabetes risk factor data came from two studies conducted in Australia from 2006 to 2010 in adults aged 18 or above. In medication free adults, sex-specific clinical thresholds and Principal Component Analysis were used to develop a formula to calculate a metabolic syndrome severity score (MetSSS). These scores were compared to scores derived using the same process in subgroups by sex, age, medication status, and time. We also examined the MetSSS in relation to other known risk factors. In 2125 adults (57.6±14.7years of age), the MetSSS ranged from 0 to 8.7 with a mean of 2.6. There were strong correlations (.95-.99) between the MetSSS in medication free adults and the MetSSS calculated from subgroups. MetSSS predicted medication initiation for hypertension, hyperlipidemia and hyperglycemia over six months (OR=1.31, 95% CI [1.00-1.70], per MetSSS unit, p=.043). Lower education, medication prescription, history of smoking and age were associated with higher MetSSS (all p<.05). Higher physical but not mental health quality of life was associated with lower MetSSS (p<.001). A standardized formula to measure cardio-metabolic risk factor severity was constructed and demonstrated expected relations with known risk factors. The use of the MetSSS is recommended as a measure of change within individuals in cardio-metabolic risk factors and to guide treatment and management.
代谢综合征是一组心血管代谢危险因素，与死亡率增加相关。目前尚无评估代谢综合征危险因素聚集严重程度的标准且经过验证的方法。心血管和糖尿病危险因素数据来自2006年至2010年在澳大利亚对18岁及以上成年人进行的两项研究。在未服用药物的成年人中，采用性别特异性临床阈值和主成分分析来制定计算代谢综合征严重程度评分（MetSSS）的公式。将这些评分与在按性别、年龄、用药状况和时间划分的亚组中采用相同方法得出的评分进行比较。我们还研究了MetSSS与其他已知危险因素的关系。在2125名成年人（年龄57.6±14.7岁）中，MetSSS范围为0至8.7，平均为2.6。未服用药物的成年人中的MetSSS与亚组计算得出的MetSSS之间存在强相关性（0.95 - 0.99）。MetSSS可预测六个月内高血压、高脂血症和高血糖的药物起始使用情况（每MetSSS单位，OR = 1.31，95% CI [1.00 - 1.70]，p = 0.043）。较低的教育程度、药物处方、吸烟史和年龄与较高的MetSSS相关（所有p < 0.05）。较高的身体而非心理健康生活质量与较低的MetSSS相关（p < 0.001）。构建了一个测量心血管代谢危险因素严重程度的标准化公式，并证明了其与已知危险因素的预期关系。建议使用MetSSS来衡量个体心血管代谢危险因素的变化，并指导治疗和管理。
