Department of Medicine II, University Hospital, LMU Munich, Munich, Germany.
Department of Internal Medicine, Tam Tri Da Nang Hospital, Phan Chau Trinh University, Quảng Nam, Vietnam.
Dig Dis. 2021;39(4):334-340. doi: 10.1159/000513068. Epub 2020 Nov 16.
Although obesity is associated with metabolic changes, not all obese patients are characterized by the metabolic syndrome (MS). The goal of this study was to determine the prevalence of the MS, its characteristics, and the associated demographic factors in a large cohort of severely obese patients presenting for potential bariatric surgery.
A total of 256 obese patients (68.7% female, 41.9 ± 11.6 years, BMI 49 ± 9.1 kg/m2) were evaluated using the harmonized criteria of the MS.
In this cohort, the prevalence of MS was 78.1% with no gender difference. The prevalence did not correlate with BMI, body weight, or waist circumference; however, the presence of MS and numbers of MS criteria met correlated with age. The prevalence of individual criteria varied considerably (central obesity [100%], hypertension [86.7%], elevated glucose (58.6%), low HDL-cholesterol [50%], and hypertriglyceridemia [43.7%]). On average, 3.4 ± 1.1 criteria were met, 3.5% fulfilled only one criterion (central obesity), and 16.4% met all 5 criteria. After adjusting for age and gender, hypertriglyceridemia and hypertension were more common in diabetic than in non-diabetic patients. Similarly, low HDL and elevated glucose were more common in hypertriglyceridemic individuals.
In severely obese patients, the prevalence of the MS and the number of criteria met was high. However, over 20% of severely obese individuals have no MS and thus may be at lower risk for cardiovascular complications of obesity. It is currently unclear whether treatment strategies with respect to obesity should differ between severely obese individuals with and without the MS.
尽管肥胖与代谢变化有关，但并非所有肥胖患者都具有代谢综合征（MS）的特征。本研究旨在确定大量接受潜在减重手术的严重肥胖患者中 MS 的患病率、其特征以及与人口统计学相关的因素。
共评估了 256 名肥胖患者（68.7%为女性，41.9±11.6 岁，BMI 为 49±9.1kg/m2），采用 MS 的协调标准进行评估。
在该队列中，MS 的患病率为 78.1%，且无性别差异。患病率与 BMI、体重或腰围无关；然而，MS 的存在和符合 MS 标准的数量与年龄相关。个别标准的患病率差异很大（中心性肥胖[100%]、高血压[86.7%]、血糖升高[58.6%]、低 HDL-胆固醇[50%]和高三酰甘油血症[43.7%]）。平均符合 3.4±1.1 项标准，3.5%仅符合一项标准（中心性肥胖），16.4%符合全部 5 项标准。在调整年龄和性别后，糖尿病患者比非糖尿病患者更常见高三酰甘油血症和高血压。同样，在高三酰甘油血症患者中更常见低 HDL 和血糖升高。
在严重肥胖患者中，MS 的患病率和符合标准的数量较高。然而，超过 20%的严重肥胖个体没有 MS，因此可能患肥胖相关心血管并发症的风险较低。目前尚不清楚针对肥胖的治疗策略是否应该因严重肥胖个体是否存在 MS 而有所不同。
