Zhang Zhichao, Pang Yuanxin, Shen Jun, Chen Weihai, Hao ChuanZhen, Lei Zhijun
Department of Electrocardiogram Room, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital, Soochow University, Suzhou, China.
Department of Endocrinology, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China.
BMC Cardiovasc Disord. 2025 Feb 11;25(1):93. doi: 10.1186/s12872-025-04529-7.
Metabolic syndrome (MetS) is a significant global health issue that is strongly associated with an increased risk of cardiovascular disease (CVD). While MetS was initially proposed to identify more high-risk individuals and facilitate early management, hyperuricemia has not yet been included in its definition, despite its strong association with MetS. This study aims to explore the prognostic value of incorporating hyperuricemia into the definition of MetS.
Data derived from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2018 were analyzed. The old version of MetS (MetS) aligned with NCEP-ATP III criteria, whereas the new version of MetS (MetS) included hyperuricemia as a sixth criterion. Baseline characteristics were compared between participants with and without MetS, and outcomes were assessed by multivariate analyses.
Among the 36,363 participants analyzed, 12,594 (34.6%) and 14,137 (38.9%) met MetS and MetS criteriarespectively. Compared to MetS, MetS identified additional 1534(4.24%) participants at metabolic risk. Both MetS and MetS were significantly associated with long-term all-cause and CVD mortality (all P < 0.001). Furthermore, the additional participants identified by MetS exhibited a similar risk of all-cause and CVD mortality as those meeting MetS criteria. MetS demonstrated enhanced identification and reclassification abilities compared to MetS, as evidenced by improvement in C-index, NRI and IDI.
The inclusion of hyperuricemia in the MetS criteria could identify a larger proportion of individuals at metabolic risk, thereby facilitating early management to prevent long-term adverse events.
代谢综合征（MetS）是一个重大的全球健康问题，与心血管疾病（CVD）风险增加密切相关。虽然最初提出MetS是为了识别更多高危个体并促进早期管理，但高尿酸血症尽管与MetS密切相关，却尚未被纳入其定义。本研究旨在探讨将高尿酸血症纳入MetS定义的预后价值。
分析了1999年至2018年期间进行的美国国家健康与营养检查调查（NHANES）的数据。旧版MetS（MetS）符合NCEP-ATP III标准，而新版MetS（MetS）将高尿酸血症作为第六条标准纳入。比较了患有和未患有MetS的参与者的基线特征，并通过多变量分析评估结果。
在分析的36363名参与者中，分别有12594名（34.6%）和14137名（38.9%）符合MetS和MetS标准。与MetS相比，MetS识别出另外1534名（4.24%）有代谢风险的参与者。MetS和MetS均与长期全因死亡率和CVD死亡率显著相关（所有P<0.001）。此外，MetS识别出的额外参与者表现出与符合MetS标准的参与者相似的全因死亡率和CVD死亡率风险。与MetS相比，MetS表现出更强的识别和重新分类能力，C指数、NRI和IDI的改善证明了这一点。
将高尿酸血症纳入MetS标准可以识别出更大比例的有代谢风险的个体，从而便于早期管理以预防长期不良事件。
