Student Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
BMC Public Health. 2024 Feb 12;24(1):444. doi: 10.1186/s12889-024-17707-7.
Cardiovascular diseases (CVDs) are a major cause of morbidity and mortality worldwide. Controversial views exist over the effects of metabolically unhealthy obesity phenotypes on CVDs. This study aimed to perform a meta-analysis to assess the association between metabolic syndrome and myocardial infarction (MI) among individuals with excess body weight (EBW).
We searched PubMed/Medline, Scopus, and Web of Science databases as of December 9, 2023. Cohort studies involving patients with overweight or obesity that reported the relevant effect measures for the association between metabolic syndrome and MI were included. We excluded studies with incomplete or unavailable original data, reanalysis of previously published data, and those that did not report the adjusted effect sizes. We used the Newcastle Ottawa Scale for quality assessment. Random-effect model meta-analysis was performed. Publication bias was assessed by Begg's test.
Overall, nine studies comprising a total of 61,104 participants were included. There was a significant positive association between metabolic syndrome and MI among those with obesity (hazard ratio (HR): 1.68; 95% confidence interval (CI): 1.27, 2.22). Subgroup analysis showed higher HRs for obesity (1.72; 1.03, 2.88) than overweight (1.58; 1.-13-2.21). Meta-regression revealed no significant association between nationality and risk of MI (p = 0.75). All studies had high qualities. There was no significant publication bias (p = 0.42).
Metabolic syndrome increased the risk of MI in those with EBW. Further studies are recommended to investigate other risk factors of CVDs in EBW, in order to implement preventive programs to reduce the burden of CVD in obesity.
心血管疾病（CVDs）是全球发病率和死亡率的主要原因。代谢不健康的肥胖表型对 CVDs 的影响存在争议。本研究旨在进行荟萃分析，以评估超重人群（EBW）中代谢综合征与心肌梗死（MI）之间的关联。
截至 2023 年 12 月 9 日，我们在 PubMed/Medline、Scopus 和 Web of Science 数据库中进行了搜索。纳入了涉及超重或肥胖患者的队列研究，这些研究报告了代谢综合征与 MI 之间关联的相关效应测量值。我们排除了研究数据不完整或不可用、重新分析先前发表的数据以及未报告调整后效应大小的研究。我们使用纽卡斯尔-渥太华量表进行质量评估。采用随机效应模型进行荟萃分析。采用贝叶斯检验评估发表偏倚。
总体而言，纳入了 9 项共 61104 名参与者的研究。在肥胖人群中，代谢综合征与 MI 之间存在显著的正相关（危险比（HR）：1.68；95%置信区间（CI）：1.27，2.22）。亚组分析显示，肥胖者的 HR 更高（1.72；1.03，2.88），而超重者的 HR 较低（1.58；1.21，2.01）。元回归显示，国籍与 MI 风险之间无显著相关性（p=0.75）。所有研究的质量都很高。没有显著的发表偏倚（p=0.42）。
代谢综合征增加了 EBW 人群发生 MI 的风险。建议进行进一步的研究，以调查 EBW 中其他 CVD 风险因素，以便实施预防计划，降低肥胖人群 CVD 的负担。
