Department of Pediatrics, Division of Pediatric Endocrinology, University of Virginia, PO Box 800386 Charlottesville, VA, 22908, United States.
Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, 32608, United States.
Nutr Metab Cardiovasc Dis. 2020 Jan 3;30(1):92-98. doi: 10.1016/j.numecd.2019.08.010. Epub 2019 Aug 24.
Many traditional assessments of risk for coronary heart disease (CHD) and diabetes require laboratory studies performed after an 8-h fast. We assessed whether metabolic-syndrome (MetS) severity would remain linked to future CHD and diabetes even when assessed from non-fasting samples.
Participants in the Atherosclerosis Risk in Communities study were assessed at 4 visits and followed for 20-years of adjudicated CHD outcomes. We used Cox proportional-hazard models (for 20-year CHD outcomes) and logistic regression (for 9-year diabetes outcomes) to compare incident disease risk associated with a race/ethnicity-specific MetS-severity Z-score (MetS-Z) calculated in participants who were fasting (≥8 h) or non-fasting. All analyses were adjusted for sex, race, education, income and smoking. MetS Z-scores were overall similar between participants who were always fasting vs. those non-fasting at Visits 1-3 (all values -0.1 to 0.4), while MetS-Z for participants who were non-fasting at Visit-4 were higher at each visit. Baseline MetS-Z was linked to future CHD when calculated from both fasting and non-fasting measurements, with hazard ratio (HR) for fasting MetS-Z 1.53 (95% confidence interval [CI] 1.42, 1.66) and for non-fasting 1.28 (CI 1.08, 1.51). MetS-Z at Visit-1 also remained linked to future diabetes when measured from non-fasting samples, with odds ratio for fasting MetS-Z 3.10 (CI 2.88, 3.35) and for non-fasting 1.92 (CI 1.05, 3.51).
MetS-Z remained linked to future CHD and diabetes when assessed from non-fasting samples. A score such as this may allow for identification of at-risk individuals and serve as a motivation toward interventions to reduce risk.
许多评估冠心病（CHD）和糖尿病风险的传统方法都需要在禁食 8 小时后进行实验室检查。我们评估了即使在非禁食样本中评估，代谢综合征（MetS）严重程度是否仍与未来 CHD 和糖尿病相关。
社区动脉粥样硬化风险研究（Atherosclerosis Risk in Communities study）的参与者在 4 次就诊时进行评估，并随访 20 年以确定明确的 CHD 结局。我们使用 Cox 比例风险模型（用于 20 年 CHD 结局）和逻辑回归（用于 9 年糖尿病结局）来比较与种族/民族特异性 MetS 严重程度 Z 评分（MetS-Z）相关的发病风险，该评分是在禁食（≥8 小时）或非禁食的参与者中计算得出的。所有分析均根据性别、种族、教育、收入和吸烟情况进行了调整。在始终禁食的参与者与前 3 次就诊时非禁食的参与者之间，MetS-Z 总体相似（所有值为-0.1 至 0.4），而在第 4 次就诊时非禁食的参与者的 MetS-Z 在每次就诊时都更高。从禁食和非禁食测量中计算出的基线 MetS-Z 与未来 CHD 相关，禁食 MetS-Z 的风险比（HR）为 1.53（95%置信区间[CI] 1.42，1.66），非禁食为 1.28（CI 1.08，1.51）。在从非禁食样本中测量时，MetS-Z 与未来糖尿病仍相关，禁食 MetS-Z 的优势比为 3.10（CI 2.88，3.35），非禁食为 1.92（CI 1.05，3.51）。
即使在非禁食样本中评估，MetS-Z 与未来 CHD 和糖尿病仍相关。这样的评分可以识别高危个体，并作为减少风险的干预措施的动力。
