Shaya Fadia T, Gu Anna, Saunders Elijah
The Department of Pharmaceutical Health Services Research, University of Maryland, School of Pharmacy, Baltimore, MD; The Department of Epidemiology and Preventive Medicine, University of Maryland, School of Medicine, Baltimore, MD.
The Department of Pharmaceutical Health Services Research, University of Maryland, School of Pharmacy, Baltimore, MD.
Diabetes Metab Syndr. 2007 Sep;1(3):151-157. doi: 10.1016/j.dsx.2007.05.003.
The metabolic syndrome (MeS) is a clustering of a group of metabolic risk factors in one person that predisposes to higher risk of cardiovascular disease (CVD) and type II diabetes. The metabolic syndrome has become increasingly common in the United States. With the increase in CVD morbidity and mortality among US adult populations, particularly African Americans, it becomes urgent to monitor and control metabolic syndrome in an effort to inform effective CVD prevention programs. We sought to assess the prevalence of and predictors of MeS syndrome in an urban, high risk, predominantly African American hypertensive population.
The study is part of the NHLBI U01 grant "Baltimore Partnership Programs to Reduce Cardiovascular Disparities". A sample of 150 earlier enrolled patients was selected. Risk factors for metabolic syndrome were assessed at baseline, and include risk factors of abdominal obesity (BMI = 30), high triglycerides (triglycerides = 150 mg/dL), low HDL cholesterol (HDL < 40 mg/dL in men, or HDL <50 mg/dL in women), elevated blood pressure (BP = 130/85 mmHg), and elevated fasting glucose (blood glucose = 100 mg/dL) - per ATP III criteria. We assessed the prevalence of MeS in general and across subgroups, and predictors of MeS were assessed using logistic regression.
The prevalence of MeS in this group of patients was 40%. Significant predictors of MeS include presence of diabetes (P = 0.03; OR = 3.03, 95% CI: 1.07-8.54), younger than 64 (P = 0.04; OR = 2.38, 95% CI: 1.02-5.56), and female gender (P = 0.02; OR = 2.63; OR = 1.18-5.88). The effect of self-perceived health status remain marginally significant (P = 0.13).
In this patient sample, the prevalence of MeS is higher than estimates based on the US general population. Our findings of factors associated with MeS are consistent with existing studies, with the exception of age factor, suggesting the impact of higher treatment rate and better medication compliance among elderly patients.
代谢综合征(MeS)是指个体中一组代谢风险因素的聚集,这使得患心血管疾病(CVD)和II型糖尿病的风险更高。代谢综合征在美国已变得越来越普遍。随着美国成年人群尤其是非裔美国人中CVD发病率和死亡率的增加,监测和控制代谢综合征以制定有效的CVD预防计划变得迫在眉睫。我们试图评估一个城市中高危、主要为非裔美国人的高血压人群中代谢综合征的患病率及其预测因素。
该研究是美国国立心肺血液研究所(NHLBI)U01资助项目“巴尔的摩减少心血管疾病差异合作项目”的一部分。选取了150名早期入组的患者作为样本。在基线时评估代谢综合征的危险因素,包括腹部肥胖(BMI = 30)、高甘油三酯(甘油三酯 = 150 mg/dL)、低高密度脂蛋白胆固醇(男性HDL < 40 mg/dL,女性HDL < 50 mg/dL)、血压升高(BP = 130/85 mmHg)以及空腹血糖升高(血糖 = 100 mg/dL)——依据ATP III标准。我们评估了总体及各亚组中代谢综合征的患病率,并使用逻辑回归分析评估代谢综合征的预测因素。
该组患者中代谢综合征的患病率为40%。代谢综合征的显著预测因素包括糖尿病(P = 0.03;OR = 3.03,95%置信区间:1.07 - 8.54)、年龄小于64岁(P = 0.04;OR = 2.38,95%置信区间:1.02 - 5.56)以及女性(P = 0.02;OR = 2.63;OR = 1.18 - 5.88)。自我感知健康状况的影响仍略显显著(P = 0.13)。
在这个患者样本中,代谢综合征的患病率高于基于美国普通人群的估计值。我们关于与代谢综合征相关因素的研究结果与现有研究一致,但年龄因素除外,这表明老年患者中治疗率较高和药物依从性较好的影响。