Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
Department of Pathology and Pathophysiology, School of Medicine, Tongji University, Shanghai 200092,China.
Eur J Intern Med. 2018 Jan;47:75-81. doi: 10.1016/j.ejim.2017.10.010. Epub 2017 Oct 29.
Studies have showed the associations between different definitions of metabolic syndrome (MetS) and risk of ischemic stroke were inconsistent. In this study, we compared associations of different MetS definitions with ischemic stroke in Chinese elderly population.
A total of 1713 individuals aged 70-84years from Rugao Longevity and Ageing Study were analyzed. The MetS was defined by four different criteria: Chinese Adult Dyslipidemia Prevention Guide, International Diabetes Federation (IDF), Updated ATPIII (Updated ATPIII) by American heart association/American heart, lung and blood institute (AHA/NHLBI), and Joint Interim Statement(JIS) recommended by IDF and the American heart association/American national institutes of health/American heart, lung and blood institute (AHA/NIH/NHLBI).
Prevalence of MetS in the whole population was 24.0% (Chinese guide), 32.5% (IDF), 38.8% (Updated ATPIII) and 24.0% (JIS) and in stroke population was 27.1% (Chinese guide), 41.1% (IDF), 48.8% (Updated ATPIII) and 27.1% (JIS), respectively. The agreement between definitions was highest in Updated ATPIII vs. IDF (kappa=0.863). It showed that only definitions of IDF (OR 1.55, 95%CI 1.04-2.31, p=0.031) and Updated ATPIII (OR 1.64, 95%CI 1.11-2.42, p=0.013) were independently associated with risk of ischemic stroke in multivariable logistic regression analysis. The risk of ischemic stroke increased with the increasing of numbers of Mets components in Updated ATPIII (p<0.05).
In this population, Updated ATPIII criteria was a more suitable definition of Mets than definitions of Chinese guide, IDF and JIS for screening high-risk individuals of ischemic stroke, and the additive effects of Mets components might play a greater role than its composition alone in ischemic stroke.
研究表明，代谢综合征（MetS）的不同定义与缺血性卒中风险之间的关联并不一致。本研究旨在比较中国老年人群中不同 MetS 定义与缺血性卒中的相关性。
本研究共纳入来自如皋长寿与衰老研究的 1713 名 70-84 岁个体。MetS 采用 4 种不同标准定义：中国成人血脂异常防治指南、国际糖尿病联盟（IDF）、美国心脏协会/美国心脏、肺和血液研究所（AHA/NHLBI）更新的 ATPIII（更新的 ATPIII）以及 IDF 和美国心脏协会/美国国立卫生研究院/美国心脏、肺和血液研究所（AHA/NIH/NHLBI）推荐的联合临时声明（JIS）。
在整个研究人群中，MetS 的患病率为 24.0%（中国指南）、32.5%（IDF）、38.8%（更新的 ATPIII）和 24.0%（JIS），在卒中人群中分别为 27.1%（中国指南）、41.1%（IDF）、48.8%（更新的 ATPIII）和 27.1%（JIS）。更新的 ATPIII 与 IDF 之间的一致性最高（kappa=0.863）。多变量逻辑回归分析显示，仅 IDF（OR 1.55，95%CI 1.04-2.31，p=0.031）和更新的 ATPIII（OR 1.64，95%CI 1.11-2.42，p=0.013）定义与缺血性卒中风险独立相关。在更新的 ATPIII 中，随着 MetS 成分数量的增加，缺血性卒中的风险也随之增加（p<0.05）。
在本研究人群中，与中国指南、IDF 和 JIS 相比，更新的 ATPIII 标准更适合用于筛选缺血性卒中高危个体，且 MetS 成分的累加效应可能比其单一成分在缺血性卒中发病中发挥更大作用。
