Metabolic syndrome and the risk of ischemic heart disease and stroke among Japanese men and women
Metabolic syndrome and the risk of ischemic heart disease and stroke among Japanese men and women
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DOI：
10.1161/strokeaha.106.469072
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发表时间：
2007-06-01
期刊：
影响因子：
8.3
通讯作者：
Shimamoto, Takashi
中科院分区：
文献类型：
--
作者：
Iso, Hiroyasu;Sato, Shinichi;Shimamoto, Takashi
背景和目的--在亚洲，关于代谢综合征和心血管疾病风险的证据有限。这项研究的目的是检验代谢综合征与日本男性和女性缺血性心血管疾病风险的关系。方法-我们对9087名年龄在40-69岁(3595名男性和5492名女性)、最初没有缺血性心脏病或中风的日本人进行了一项为期18年的前瞻性研究。在随访期间，有116例(74名男性和42名女性)缺血性心脏病和256例(144名男性和112名女性)缺血性中风。代谢综合征的定义由国家胆固醇教育计划成人治疗小组III(NCEP/ATPIII)的修订标准确定，有以下3个因素：(1)血清甘油三酯=1.69 mmol/L(150 mg/dL)；(2)高密度脂蛋白-胆固醇；男性1.03 mmol/L(40 mg/dL)；女性1.29 mmol/L(50 mg/dL)；(3)血糖=6.11 mmol/L(110 mg/dL)；(4)血压=130/85 mm Hg或服药；(5)体重指数=25.0 kg/m(2)。结果：在调整心血管危险因素后，无论男女，高血压、高甘油三酯和低高密度脂蛋白胆固醇与缺血性心脏病或中风的风险增加相关。代谢危险因素的数量和这些心血管终点的发生率之间存在剂量-反应关系。与代谢综合征相关的多变量风险比(95%CI)在男性为2.4(1.4~4.0)，在女性为2.3(1.2~4.3)，在缺血性卒中为2.0(1.3~3.1)和1.5(1.0~2.3)。代谢综合征对风险的贡献独立于血清总胆固醇水平，但在吸烟者中更强。结论-代谢综合征是日本中年男性和女性，特别是吸烟者缺血性心血管疾病的主要决定因素。
Background and Purpose - Limited evidence was available on the metabolic syndrome and risk of cardiovascular disease in Asia. The purpose of this study is to examine the association of the metabolic syndrome and risk of ischemic cardiovascular disease in Japanese men and women.Methods - We conducted an 18-year prospective study of 9087 Japanese people aged 40 to 69 years ( 3595 men and 5492 women), initially free of ischemic heart disease or stroke. During follow-up, there were 116 ( 74 men and 42 women) cases of ischemic heart disease and 256 ( 144 men and 112 women) ischemic strokes. Metabolic syndrome was defined by the modified criteria of the National Cholesterol Education Program Adult Treatment Panel III ( NCEP/ATPIII), with the presence of >= 3 of the following factors: ( 1) serum triglycerides >= 1.69 mmol/L ( 150 mg/dL); ( 2) HDL-cholesterol < 1.03 mmol/L ( 40 mg/dL) for men and < 1.29 mmol/L ( 50 mg/dL) for women; ( 3) glucose >= 6.11 mmol/L ( 110 mg/dL) fasting or >= 7.77 mmol/L ( 140 mg/dL) nonfasting, or on treatment; ( 4) blood pressure >= 130/85 mm Hg or medication use, and ( 5) body mass index >= 25.0 kg/m(2).Results - For both sexes, high blood pressure, high triglycerides and low HDL cholesterol were associated with increased risks of ischemic heart disease or stroke after adjustment for cardiovascular risk factors. A dose-response relationship was found between the number of metabolic risk factors and incidence of these cardiovascular end points. The multivariable hazard ratio ( 95% CI) associated with metabolic syndrome was 2.4 ( 1.4 to 4.0) in men and 2.3 ( 1.2 to 4.3) in women for ischemic heart disease, and 2.0 ( 1.3 to 3.1) and 1.5 ( 1.0 to 2.3), respectively, for ischemic stroke. The contribution of metabolic syndrome to the risks was independent of serum total cholesterol levels but stronger among smokers.Conclusions - The metabolic syndrome is a major determinant of ischemic cardiovascular disease among middle-aged Japanese men and women, in particular among smokers.