National Cholesterol Education Program versus World Health Organization metabolic syndrome in relation to all-cause and cardiovascular mortality in the San Antonio Heart Study
National Cholesterol Education Program versus World Health Organization metabolic syndrome in relation to all-cause and cardiovascular mortality in the San Antonio Heart Study
复制标题
DOI：
10.1161/01.cir.0000140762.04598.f9
复制
发表时间：
2004-09-01
期刊：
影响因子：
37.8
通讯作者：
Stern, MP
中科院分区：
文献类型：
--
作者：
Hunt, KJ;Resendez, RG;Stern, MP
背景：为了评估代谢综合征（MetS）临床定义对识别心血管风险增加个体的效用，我们使用国家胆固醇教育计划（NCEP）和世界卫生组织的定义，检查了1984年至1988年圣安东尼奥心脏研究参与者的代谢综合征（MetS）与全因死亡率和心血管死亡率之间的关系。方法和结果：在入组时年龄在25 - 64岁的2815名参与者中，509名同时符合两个标准，197名仅符合NCEP标准，199名仅符合WHO标准。在平均12.7年的时间里，229人死亡（117人死于心血管疾病）。此外，在2372名初级预防人群（即基线时没有糖尿病或心血管疾病的人）中，发生了132例死亡（50例死于心血管疾病）。在初级预防人群中，NCEP-MetS与心血管死亡率之间存在年龄、性别和种族校正的唯一显著关联（风险比[HR]， 2.01; 95% CI, 1.13-3.57）。在一般人群中，NCEP-MetS的全因死亡率hr为1.47 (95% CI, 1.13-1.92)， WHO-MetS的全因死亡率hr为1.27 （95% CI, 0.97-1.66）。此外，对于心血管疾病死亡率，有证据表明性别改变了MetS的预测能力。对于女性和男性，NCEP-MetS的hr分别为4.65 （95% CI, 2.35-9.21）和1.82 (95% CI, 1.14-2.91)，而WHO-MetS的hr分别为2.83 （95% CI, 1.55-5.17）和1.15 （95% CI, 0.72-1.86）。结论——总之，尽管两种定义在一般人群中都具有预测性，但更简单的NCEP定义在低风险受试者中更具预测性。
Background-To assess the utility of clinical definitions of the metabolic syndrome (MetS) to identify individuals with increased cardiovascular risk, we examined the relation between the MetS, using both the National Cholesterol Education Program (NCEP) and the World Health Organization definitions, and all-cause and cardiovascular mortality in San Antonio Heart Study participants enrolled between 1984 and 1988.Methods and Results-Among 2815 participants, 25 to 64 years of age at enrollment, 509 met both criteria, 197 met NCEP criteria only, and 199 met WHO criteria only. Over an average of 12.7 years, 229 deaths occurred ( 117 from cardiovascular disease). Moreover, in the primary prevention population of 2372 participants (ie, those without diabetes or cardiovascular disease at baseline), 132 deaths occurred ( 50 from cardiovascular disease). In the primary prevention population, the only significant association adjusted for age, gender, and ethnic group was between NCEP-MetS and cardiovascular mortality ( hazard ratio [HR], 2.01; 95% CI, 1.13-3.57). In the general population, all-cause mortality HRs were 1.47 (95% CI, 1.13-1.92) for NCEP-MetS and 1.27 (95% CI, 0.97-1.66) for WHO-MetS. Furthermore, for cardiovascular mortality, there was evidence that gender modified the predictive ability of the MetS. For women and men, respectively, HRs for NCEP-MetS were 4.65 (95% CI, 2.35-9.21) and 1.82 (95% CI, 1.14-2.91), whereas HRs for WHO-MetS were 2.83 (95% CI, 1.55-5.17) and 1.15 (95% CI, 0.72-1.86).Conclusions-In summary, although both definitions were predictive in the general population, the simpler NCEP definition tended to be more predictive in lower-risk subjects.