Sackler Faculty of Medicine, School of Public Health, Department of Epidemiology and Preventive Medicine, Tel Aviv University, Tel Aviv, Israel.
Sheba Medical Center, The Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel.
Diabetes Metab Res Rev. 2019 May;35(4):e3121. doi: 10.1002/dmrr.3121. Epub 2019 Jan 28.
We compared strengths of associations conferred by the metabolic syndrome (MetS) and its components across four chronic disease categories (cancer, cardiovascular diseases [CVDs], chronic kidney disease [CKD], and chronic obstructive pulmonary disease [COPD]) in a community-dwelling high-risk population.
This is a cross-sectional analysis of Israeli adults insured in a single health maintenance organization during 2010 to 2013 and having greater than or equal to two MetS components (hypertension, dysglycemia, low high-density lipoprotein level, high plasma triglyceride level, and obesity). Data regarding MetS components, chronic disease prevalence, and sociodemographic variables were retrieved from electronic health records and disease registries.
Among 347 244 eligible members, 54.2% had MetS. MetS was negatively associated with cancer, (prevalence ratio [PR] = 0.86; 95% confidence interval, 0.79-0.93) and positively associated with CKD (PR = 1.07, [1.01-1.13]). Some MetS components conferred different associations across the chronic diseases: a high triglyceride level was positively associated with cancer (PR = 1.15, 1.12-1.18) and CKD (PR = 1.37, 1.32-1.41) but negatively associated with CVD (PR = 0.88, 0.86-0.90) and COPD (PR = 0.93, 0.88-0.98). In the presence of MetS, those with dysglycemia had higher cancer prevalence than those with normoglycemia (PR-interaction MetSdysglycemia on cancer = 1.14, 1.06-1.22). Likewise, in the presence of MetS, men were more likely than women to present with CVD (PR-interaction MetSsex on CVD = 1.12, [1.05-1.20]).
Prevalences of the MetS and MetS components distribute unequally across four chronic diseases. MetS including dysglycemia may warrant screening for cancer, and MetS in males may indicate the presence of CVD. Longitudinal studies may reveal if MetS is associated with different risks or merely indicates better prognosis once having a chronic illness.
我们比较了代谢综合征（MetS）及其成分在社区高风险人群中四种慢性疾病（癌症、心血管疾病[CVD]、慢性肾脏病[CKD]和慢性阻塞性肺疾病[COPD]）中的关联强度。
这是对 2010 年至 2013 年期间在单一健康维护组织投保的以色列成年人进行的一项横断面分析，这些成年人患有大于或等于两种 MetS 成分（高血压、血糖异常、低高密度脂蛋白水平、高血浆甘油三酯水平和肥胖）。电子健康记录和疾病登记处中检索了关于 MetS 成分、慢性疾病患病率和社会人口统计学变量的数据。
在 347244 名合格成员中，54.2%患有 MetS。MetS 与癌症呈负相关（患病率比[PR] = 0.86；95%置信区间，0.79-0.93），与 CKD 呈正相关（PR = 1.07，[1.01-1.13]）。一些 MetS 成分在慢性疾病中具有不同的关联：高甘油三酯水平与癌症（PR = 1.15，1.12-1.18）和 CKD（PR = 1.37，1.32-1.41）呈正相关，但与 CVD（PR = 0.88，0.86-0.90）和 COPD（PR = 0.93，0.88-0.98）呈负相关。在存在 MetS 的情况下，血糖异常者的癌症患病率高于血糖正常者（MetS血糖异常对癌症的交互作用 PR = 1.14，1.06-1.22）。同样，在存在 MetS 的情况下，男性比女性更有可能患有 CVD（MetS性别对 CVD 的交互作用 PR = 1.12，[1.05-1.20]）。
MetS 和 MetS 成分的患病率在四种慢性疾病中的分布不均。包括血糖异常的 MetS 可能需要进行癌症筛查，而男性中的 MetS 可能表明存在 CVD。纵向研究可能会揭示 MetS 是否与不同的风险相关，或者是否仅仅表明在患有慢性疾病后具有更好的预后。
