Vanhala M J, Kumpusalo E A, Pitkäjärvi T K, Takala J K
Pieksämäki District Health Centre, Naarajärvi Health Station, Finland.
J Cardiovasc Risk. 1997 Aug;4(4):291-5.
To investigate methods for the detection of different clusterings of the insulin-resistant abnormalities consistent with the concept of the 'metabolic syndrome' in clinical practice, and to research the occurrence of these clusters in a middle-aged Finnish population.
We studied a random sample of 207 middle-aged subjects in the city of Tampere, and all 1148 subjects of four middle-aged age groups in Pieksamaki town, in central Finland. Clusterings of the following eight markers of insulin resistance were recorded as the main outcome measures: 1) at least one first-degree relative with non-insulin-dependent diabetes (NIDDM); 2) obesity: body mass index (BMI) > or = 30 kg/m2; 3) central adiposity: waist-to-hip ratio (WHR) > or = 1.00 in men and > or = 0.88 in women; 4) hypertension: systolic blood pressure > or = 160 mmHg or diastolic blood pressure > or = 95 mmHg, or receiving drug treatment for hypertension; 5) hypertriglyceridaemia > or = 1.70 mmol/l; 6) low high-density lipoprotein (HDL) cholesterol: < 1.0 mmol/l in men and < 1.20 mmol/l in women; 7) abnormal glucose metabolism according to WHO criteria and 8) hyperinsulinaemia: fasting plasma insulin > or = 13.0 mU/l.
The metabolic syndrome, defined as a clustering of dyslipidaemia (hypertriglyceridaemia, low HDL cholesterol, or both) and insulin resistance (abnormal glucose tolerance, hyperinsulinaemia, or both) was present in 17% of men and in 8% of women; this sex difference was statistically significant (P< .001). The syndrome was detectable with a sensitivity of 96% and a specificity of 55% by the combined four markers of insulin resistance (NIDDM in a close relative, obesity, central adiposity and hypertension).
In clinical practice, the metabolic syndrome can be detected during normal clinical examination. The occurrence of the syndrome is already high by middle age.
探讨在临床实践中检测与“代谢综合征”概念相符的胰岛素抵抗异常不同聚类的方法，并研究这些聚类在芬兰中年人群中的发生情况。
我们研究了坦佩雷市207名中年受试者的随机样本，以及芬兰中部派克斯迈基镇四个中年年龄组的所有1148名受试者。记录以下八种胰岛素抵抗标志物的聚类情况作为主要观察指标：1）至少有一位非胰岛素依赖型糖尿病（NIDDM）的一级亲属；2）肥胖：体重指数（BMI）≥30kg/m²；3）中心性肥胖：男性腰臀比（WHR）≥1.00，女性≥0.88；4）高血压：收缩压≥160mmHg或舒张压≥95mmHg，或正在接受高血压药物治疗；5）高甘油三酯血症≥1.70mmol/l；6）低高密度脂蛋白（HDL）胆固醇：男性<1.0mmol/l，女性<1.20mmol/l；7）根据世界卫生组织标准的葡萄糖代谢异常；8）高胰岛素血症：空腹血浆胰岛素≥13.0mU/l。
代谢综合征定义为血脂异常（高甘油三酯血症、低HDL胆固醇或两者兼有）和胰岛素抵抗（葡萄糖耐量异常、高胰岛素血症或两者兼有）的聚类，在17%的男性和8%的女性中存在；这种性别差异具有统计学意义（P<.001）。通过胰岛素抵抗的四种联合标志物（近亲中的NIDDM、肥胖、中心性肥胖和高血压）检测该综合征的敏感性为96%，特异性为55%。
在临床实践中，代谢综合征可在正常临床检查期间检测到。该综合征在中年时的发生率已经很高。
