Lönnberg Lena, Leppert Jerzy, Ohrvik John, Rehn Mattias, Chabok Abbas, Damberg Mattias
Centre for Clinical Research Vastmanland Hospital Vasteras, Uppsala University, Uppsala, Sweden
Centre for Clinical Research Vastmanland Hospital Vasteras, Uppsala University, Uppsala, Sweden.
BMJ Open. 2024 Sep 16;14(9):e081444. doi: 10.1136/bmjopen-2023-081444.
We examined how asymptomatic metabolic syndrome (MetS) in midlife affects cardiovascular (CV) morbidity and all-cause mortality later in life and studied difference in time to event and from the individual components related to MetS.
Population-based matched cohort study including data from a screening programme for identification of CV risk factors.
Primary care, County of Västmanland, Sweden.
All inhabitants turning 40 or 50 years between 1990 and 1999 were invited to a health screening. Total 34 269 (60.1%) individuals completed the health examination. Participants that met a modified definition of MetS were individually matched to two controls without MetS with regard to age, sex and date of health examination.
None.
CV events and all-cause mortality from the index examination to June 2022.
All 5084 participants with MetS were matched to two controls. There were 1645 (32.4%) CV events in the MetS group and 2321 (22.8%) CV events for controls. 1317 (25.9%) MetS and 1904 (18.7%) control subjects died. The adjusted HRs (aHR) for CV event and death were significantly higher when MetS was present (aHR) 1.39*** (95% CI 1.28 to 1.50) and 1.27*** (95% CI 1.16 to 1.40) respectively. The factor analysis identified three dominating factors: blood pressure, cholesterol and blood glucose. Mean time for first CV event and death was 2.6 years and 1.5 years shorter respectively for participants within the highest quartile compared with participants with lower mean arterial blood pressure (MAP). The aHR for each 10 mm Hg increased MAP were 1.19*** (95% CI 1.15 to 1.23) for CV event and 1.16*** (95% CI 1.11 to 1.21) for death.
The risk of a CV event and premature death is significantly increased when MetS is present. Early detection of metabolic risk factors, especially, high blood pressure, opens a window of opportunity to introduce preventive treatment to reduce CV morbidity and all-cause mortality.
我们研究了中年时无症状代谢综合征（MetS）如何影响晚年的心血管（CV）发病率和全因死亡率，并研究了事件发生时间以及与MetS相关的各个组成部分之间的差异。
基于人群的匹配队列研究，纳入了一项用于识别CV危险因素的筛查项目的数据。
瑞典韦斯特曼兰郡的初级保健机构。
邀请了1990年至1999年间年满40或50岁的所有居民参加健康筛查。共有34269人（60.1%）完成了健康检查。符合MetS改良定义的参与者在年龄、性别和健康检查日期方面与两名无MetS的对照个体进行了匹配。
无。
从指数检查到2022年6月的CV事件和全因死亡率。
所有5084名患有MetS的参与者均与两名对照个体进行了匹配。MetS组有1645例（32.4%）CV事件，对照组有2321例（22.8%）CV事件。1317名（25.9%）患有MetS的参与者和1904名（18.7%）对照个体死亡。存在MetS时，CV事件和死亡的调整后风险比（aHR）显著更高，分别为1.39***（95%CI 1.28至1.50）和1.27***（95%CI 1.16至1.40）。因子分析确定了三个主要因素：血压、胆固醇和血糖。与平均动脉压（MAP）较低的参与者相比，处于最高四分位数的参与者首次发生CV事件和死亡的平均时间分别短2.6年和1.5年。CV事件中，MAP每升高10 mmHg的aHR为1.19***（95%CI 1.15至1.23），死亡的aHR为1.16***（95%CI 1.11至1.21）。
存在MetS时，CV事件和过早死亡的风险显著增加。早期发现代谢危险因素，尤其是高血压，为引入预防性治疗以降低CV发病率和全因死亡率提供了一个机会窗口。
