Li Rumei, Lu Bin, Li Qiang, Hu Ji, Huang Yun, Wang Yangang, Qin Guijun, Zhang Weiwei, Su Qing, Zhu Jun, Xu Yancheng, Jiang Hongwei, Wang Xinjun, Zhang Keqing, Yang Yuzhi, Hu Renming
Department of Endocrinology, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China.
Department of Endocrinology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China.
Prim Care Diabetes. 2024 Feb;18(1):97-103. doi: 10.1016/j.pcd.2023.11.001. Epub 2023 Nov 22.
As meta-inflammation is a common feature for obesity, type 2 diabetes (T2D), nonalcoholic fatty liver disease and atherosclerosis, we have proposed a new concept, metabolic inflammatory syndrome (MIS), to cluster such diseases. We aimed to characterize MIS and explore its association with coronary heart disease (CHD) among T2D inpatients in China.
A total number of 8344 T2D participants were enrolled. Each component of MIS and metabolic syndrome (MS) was analyzed. Their association with the risk of CHD was assessed using a binary logistic analysis.
Among the T2D inpatients, the detection rate of MIS was much higher than that of MS (93.6 % vs. 53.2 %). Among all the components of MIS and MS, carotid atherosclerosis (71.9 %) was most commonly detected, which increased with aging in subgroups. Surprisingly, the most common combination of MIS was with all 4 components in T2D patients, with a constituent ratio of 30.9 %. According to the odds ratios (ORs), MIS was a better predictor of CHD than MS, especially after adjustment for age, sex, smoking, and alcohol consumption (adjusted OR for MIS: 3.083; for MS: 1.515). The presence of more components of MIS was associated with a higher detection rate of CHD (P < 0.001). Among all the components of MIS and MS, carotid atherosclerosis best predicted the risk of CHD (adjusted OR: 1.787).
MIS is an independent risk factor for CHD, with a bigger OR value than MS. Carotid atherosclerosis, with the highest detection rate, was the best individual predictor of CHD and thus a critical component of MIS. The concept of MIS represents the understanding of metabolic diseases from the perspective of holistic integrative medicine.
由于元炎症是肥胖、2型糖尿病（T2D）、非酒精性脂肪性肝病和动脉粥样硬化的共同特征，我们提出了一个新概念，即代谢性炎症综合征（MIS），以将这些疾病归为一类。我们旨在对MIS进行特征描述，并探讨其与中国T2D住院患者冠心病（CHD）的关联。
共纳入8344名T2D参与者。对MIS和代谢综合征（MS）的各个组成部分进行了分析。使用二元逻辑分析评估它们与CHD风险的关联。
在T2D住院患者中，MIS的检出率远高于MS（93.6%对53.2%）。在MIS和MS的所有组成部分中，颈动脉粥样硬化的检出率最高（71.9%），且在亚组中随年龄增长而增加。令人惊讶的是，MIS在T2D患者中最常见的组合是包含所有4个组成部分，构成比为30.9%。根据优势比（OR），MIS比MS更能预测CHD，尤其是在调整年龄、性别、吸烟和饮酒因素后（MIS的调整OR：3.083；MS的调整OR：1.515）。MIS组成部分越多，CHD的检出率越高（P < 0.001）。在MIS和MS的所有组成部分中，颈动脉粥样硬化最能预测CHD风险（调整OR：1.787）。
MIS是CHD独立的危险因素，其OR值比MS更大。颈动脉粥样硬化检出率最高，是CHD最佳的个体预测指标，因此是MIS的关键组成部分。MIS的概念代表了从整体整合医学角度对代谢性疾病的认识。
