Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Key Laboratory of Food Nutrition and Safety, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China.
BMJ Open. 2018 Oct 25;8(10):e022974. doi: 10.1136/bmjopen-2018-022974.
OBJECTIVE: Metabolic syndrome (MetS) is a notable risk factor of coronary heart disease (CHD). However, there are differences in the methods used to define MetS. The purpose of this study was to determine which MetS definition most fully reflects the 10-year probability of CHD based on the Framingham risk algorithm. DESIGN: Cross-sectional study. SETTING: Data were obtained from the China Health and Nutrition Survey and the Influencing Factors of Chronic Diseases Survey conducted among residents of Nanshan District in Shenzhen, China. PARTICIPANTS: In total, 1721 participants aged 20-80 years were included in this study. METHODS: MetS was diagnosed according to the criteria of the National Cholesterol Education Program's Adult Treatment Panel (revised NCEP-ATP III), the International Diabetes Federation (IDF) and the Chinese Diabetes Society (CDS). The NCEP-ATP III algorithm was used to calculate the Framingham risk score, and the Framingham risk score was used to define the probability of developing CHD within 10 years either as low (<6%), moderate (6%-10%), moderately high (10%-20%) or high (>20%). Chi-square tests with or without the Bonferroni correction were used to compare the differences in the distribution of the 10-year estimated risk of developing CHD among the three definitions. RESULTS: Compared with the other definitions, the revised NCEP-ATP III criteria identified more participants (30.96%, 95% CI 28.8% to 33.2%) as having MetS, while the CDS criteria showed the highest 10-year probability of developing CHD. The 10-year probability of developing CHD in the participants with MetS was significantly higher than that in the participants without MetS (CDS: χ=157.65, revised ATP III: χ=45.17, IDF: χ=306.15, all p<0.001), and all definitions more fully reflect the CHD risk in men than in women (revised NCEP-ATP III: χ=72.83; IDF: χ=63.60; CDS: χ=23.84; all p<0.001). CONCLUSIONS: This study demonstrates the differences in the prevalence and distribution of the 10-year estimated risk of developing CHD based on the definition of MetS. A significant finding of this study is that the MetS definitions have better performance for men than for women. Further studies in China, especially longitudinal studies, are needed to determine which definition of MetS is best suited for predicting CHD risk.
目的：代谢综合征（MetS）是冠心病（CHD）的显著危险因素。然而，用于定义 MetS 的方法存在差异。本研究旨在根据弗雷明汉风险算法确定哪种 MetS 定义最能全面反映 10 年 CHD 发病概率。
设计：横断面研究。
地点：数据来自中国深圳市南山区居民的中国健康与营养调查和慢性病影响因素调查。
参与者：共有 1721 名年龄在 20-80 岁的参与者纳入本研究。
方法：根据国家胆固醇教育计划成人治疗专家组（修订版 NCEP-ATP III）、国际糖尿病联盟（IDF）和中国糖尿病协会（CDS）的标准诊断 MetS。使用 NCEP-ATP III 算法计算弗雷明汉风险评分，并使用弗雷明汉风险评分将 10 年内发生 CHD 的概率定义为低（<6%）、中（6%-10%）、中高（10%-20%）或高（>20%）。使用带有或不带有 Bonferroni 校正的卡方检验比较三种定义之间 10 年估计 CHD 发病风险分布的差异。
结果：与其他定义相比，修订后的 NCEP-ATP III 标准将更多的参与者（30.96%，95%置信区间 28.8%至 33.2%）定义为 MetS，而 CDS 标准显示出最高的 10 年 CHD 发病概率。患有 MetS 的参与者 10 年内发生 CHD 的概率明显高于无 MetS 的参与者（CDS：χ=157.65，修订版 ATP III：χ=45.17，IDF：χ=306.15，均<0.001），所有定义都更充分地反映了男性的 CHD 风险高于女性（修订后的 NCEP-ATP III：χ=72.83；IDF：χ=63.60；CDS：χ=23.84；均<0.001）。
结论：本研究表明，基于 MetS 定义，CHD 发病风险的 10 年估计患病率和分布存在差异。本研究的一个重要发现是，MetS 定义对男性的预测效果优于女性。中国需要进一步研究，特别是纵向研究，以确定哪种 MetS 定义最适合预测 CHD 风险。
J Endocrinol Invest. 2016-11
Chin Med J (Engl). 2008-8-20
Front Cardiovasc Med. 2021-7-28
J Atheroscler Thromb. 2021-8-1
Lancet Diabetes Endocrinol. 2018-9
JAMA. 2018-1-16
J Endocrinol Invest. 2016-11
Nutr Metab Cardiovasc Dis. 2016-3
Eur J Prev Cardiol. 2015-4
Atherosclerosis. 2014-4
Zotero 插件