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代谢综合征及其组分对中国农村老年新发心血管疾病预测作用的性别差异。

Gender discrepancy in the predictive effect of metabolic syndrome and its components on newly onset cardiovascular disease in elderly from rural China.

机构信息

Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, China.

Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, First Hospital of China Medical University, 110001, Shenyang, China.

出版信息

BMC Geriatr. 2021 Sep 25;21(1):505. doi: 10.1186/s12877-021-02393-6.

Abstract

BACKGROUND

This study aimed to estimate whether metabolic syndrome (MetS) and its components could be used to predict cardiovascular disease (CVD) in a longitudinal analysis in a rural elderly Chinese population.

METHOD

At baseline during 2012-2013, a total of 2486 elderly from rural Chinese were enrolled and were followed up during 2015-2017. Stroke and coronary heart disease (CHD) were included in CVD and were diagnosed by clinicians. The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and the International Diabetes Federation (IDF) criteria were used to define MetS separately.

RESULT

Hazard ratios adjusting for CHD, stroke and CVD in those with MetS using the NCEP ATP III criteria in females were 1.27 (95 % CI 0.73, 2.21), 1.54 (95 % CI 0.99, 2.40) and 1.45 (95 % CI 1.00, 2.10), respectively; 1.33 (95 % CI 0.77, 2.32), 1.44 (95 % CI 0.92, 2.25) and 1.36 (95 % CI 0.94, 1.97), respectively, with the AHA/NHLBI criteria; and 1.10 (95 % CI 0.89,1.36), 1.62 (95 % CI 1.03, 2.55) and 1.36 (95 % CI 0.93, 1.97), respectively, with the IDF criteria. Additionally, abdominal obesity using the AHA/NHLBI criteria was significantly associated with the incidence of stroke (HR: 1.60; 95 % CI 1.01, 2.52). However, among rural elderly males, neither MetS nor its components predicted new-onset CVD.

CONCLUSIONS

MetS is correlated with high incidence of CVD among rural elderly female, and only using the NCEP ATP III criteria to define MetS could make the incidence of CVD obvious difference. In order to reduce rural elderly CVD, effective measures to prevent, diagnose, and treat MetS should be enacted in a timely manner, especially among females.

摘要

背景

本研究旨在评估代谢综合征(MetS)及其成分是否可用于预测农村老年中国人群的心血管疾病(CVD)的纵向分析。

方法

在 2012-2013 年的基线期间,共纳入了 2486 名农村老年人,并在 2015-2017 年进行了随访。中风和冠心病(CHD)被纳入 CVD,并由临床医生诊断。国家胆固醇教育计划成人治疗专家组 III(NCEP ATP III)、美国心脏协会/美国国立心肺血液研究所(AHA/NHLBI)和国际糖尿病联盟(IDF)标准分别用于定义 MetS。

结果

在女性中,使用 NCEP ATP III 标准定义的 MetS 患者的 CHD、中风和 CVD 的风险比分别为 1.27(95%可信区间为 0.73,2.21)、1.54(95%可信区间为 0.99,2.40)和 1.45(95%可信区间为 1.00,2.10);使用 AHA/NHLBI 标准的分别为 1.33(95%可信区间为 0.77,2.32)、1.44(95%可信区间为 0.92,2.25)和 1.36(95%可信区间为 0.94,1.97);使用 IDF 标准的分别为 1.10(95%可信区间为 0.89,1.36)、1.62(95%可信区间为 1.03,2.55)和 1.36(95%可信区间为 0.93,1.97)。此外,使用 AHA/NHLBI 标准的腹型肥胖与中风的发生率显著相关(HR:1.60;95%可信区间为 1.01,2.52)。然而,在农村老年男性中,代谢综合征及其成分均与新发 CVD 无关。

结论

代谢综合征与农村老年女性 CVD 的高发病率相关,仅使用 NCEP ATP III 标准定义代谢综合征可使 CVD 的发病率明显不同。为了降低农村老年 CVD 的发病率,应及时采取有效的预防、诊断和治疗代谢综合征的措施,尤其是在女性中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f6b/8464148/b820dc7f1450/12877_2021_2393_Fig1_HTML.jpg

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