Jung Keum Ji, Jee Yon Ho, Jee Sun Ha
1 Yonsei University, Seoul, Korea.
2 MRC Population Health Research Unit, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK.
Asia Pac J Public Health. 2017 Mar;29(2):122-131. doi: 10.1177/1010539516688082. Epub 2017 Jan 24.
Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors. However, rather than using a dichotomous scale, a continuous metabolic syndrome (cMetS) score has been proposed to evaluate MetS because current MetS criteria do not function well in identifying those at high risk of cardiovascular mortality. The objective of this study was to examine the association between cMetS score and vascular mortality among Korean population. We included 441 411 individuals who visited health promotion centers and were given a medical examination from 1994 to 2004. MetS status, sum of MetS components, and cMetS score were calculated. The individuals with MetS had a higher hazard ratio (HR) for mortality from atherosclerotic vascular disease (HR = 1.54, 95% CI = 1.42-1.67), ischemic heart disease (HR = 1.74, 95% CI = 1.51-2.01), and total stroke (HR = 1.44, 95% CI = 1.28-1.62) when compared with those without MetS. Graded, strong associations between cMetS score and vascular mortality, particularly from ischemic heart disease and ischemic stroke, were observed. Subjects with a cMetS score ≥30 were at about 64 times greater risk for vascular mortality than those with a cMetS score below 0. cMetS score can be used to predict the risk of vascular death and provides a useful guideline to identify individuals at high risk for metabolic syndrome among Koreans.
代谢综合征(MetS)是一组心血管危险因素。然而,由于目前的MetS标准在识别心血管疾病死亡高风险人群方面效果不佳,因此有人提出用连续代谢综合征(cMetS)评分来评估MetS,而不是使用二分法量表。本研究的目的是探讨韩国人群中cMetS评分与血管性死亡率之间的关联。我们纳入了441411名在1994年至2004年期间前往健康促进中心进行体检的个体。计算了MetS状态、MetS各组分的总和以及cMetS评分。与无MetS的个体相比,患有MetS的个体死于动脉粥样硬化性血管疾病(风险比[HR]=1.54,95%置信区间[CI]=1.42-1.67)、缺血性心脏病(HR=1.74,95%CI=1.51-2.01)和全卒中(HR=1.44,95%CI=1.28-1.62)的风险更高。观察到cMetS评分与血管性死亡率之间存在分级的、强关联,尤其是与缺血性心脏病和缺血性卒中之间的关联。cMetS评分≥30的受试者发生血管性死亡的风险比cMetS评分低于0的受试者高约64倍。cMetS评分可用于预测血管性死亡风险,并为识别韩国人群中代谢综合征高风险个体提供有用的指导。