Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Room 533, No. 17, Hsuchow Road, Taipei, 100, Taiwan.
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Sci Rep. 2021 Feb 11;11(1):3677. doi: 10.1038/s41598-021-83118-y.
Few studies quantify a cascade of dynamic transitions on the detailed components of metabolic syndrome (MetS) and subsequent progressions to cardiovascular disease (CVD) and its death. A total of 47,495 subjects repeatedly attending a community-based integrated screening program in Taiwan were recruited. The refined MetS-related classification (RMRC) in relation to five criteria of MetS was defined as free of metabolic disorder (FMD, none of any criteria), mild metabolic disorder (MMD, 1-2 criteria) and MetS. A multistate Markov model was used for modelling such a multistate process. The estimated progression rate from FMD to MMD was 44.82% (95% CI 42.95-46.70%) whereas the regression rate was estimated as 29.11% (95% CI 27.77-30.45%). The progression rate from MMD to MetS was estimated as 6.15% (95% CI 5.89-6.42%). The estimated annual incidence rates of CVD increased with the severity of RMRC, being 1.62% (95% CI 1.46-1.79%) for FMD, 4.74% (95% CI 4.52-4.96%) for MMD, to 20.22% (95% CI 19.52-20.92%) for MetS. The estimated hazard rate of CVD death was 6.1 (95% CI 4.6-7.7) per thousand. Elucidating the dynamics of MetS-related transition and quantifying the incidence and prognosis of CVD provide a new insight into the design and the evaluation of intervention programs for CVD.
很少有研究对代谢综合征（MetS）的详细成分进行动态变化的级联进行量化，并对心血管疾病（CVD）及其死亡的后续进展进行量化。总共招募了 47495 名在台湾的社区综合筛查计划中反复就诊的受试者。与 MetS 的五个标准相关的改良 MetS 相关分类（RMRC）被定义为无代谢紊乱（FMD，无任何标准）、轻度代谢紊乱（MMD，1-2 个标准）和 MetS。多状态马尔可夫模型用于对这种多状态过程进行建模。从 FMD 到 MMD 的估计进展率为 44.82%（95%CI 42.95-46.70%），而回归率估计为 29.11%（95%CI 27.77-30.45%）。从 MMD 到 MetS 的进展率估计为 6.15%（95%CI 5.89-6.42%）。估计的 CVD 年发病率随着 RMRC 的严重程度而增加，FMD 的发病率为 1.62%（95%CI 1.46-1.79%），MMD 的发病率为 4.74%（95%CI 4.52-4.96%），MetS 的发病率为 20.22%（95%CI 19.52-20.92%）。CVD 死亡的估计危险率为每千人 6.1（95%CI 4.6-7.7）。阐明 MetS 相关转变的动态，并量化 CVD 的发病和预后，为 CVD 干预计划的设计和评估提供了新的视角。
