Metabolic syndrome, endothelial dysfunction, and risk of cardiovascular events: The Northern Manhattan Study (NOMAS)
Metabolic syndrome, endothelial dysfunction, and risk of cardiovascular events: The Northern Manhattan Study (NOMAS)
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DOI：
10.1016/j.ahj.2008.02.022
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发表时间：
2008-08-01
影响因子：
4.8
通讯作者：
Homma, Shunichi
中科院分区：
文献类型：
--
作者：
Suzuki, Takeki;Hirata, Kumiko;Homma, Shunichi
背景代谢综合征（MetS）易患心血管疾病。内皮功能障碍被认为是动脉粥样硬化发病机制的重要因素。我们测试了这样的假设：MetS 和内皮功能障碍都是血管危险因素，并为预测多种族社区样本中的心血管事件提供了额外的预后价值。 方法 研究人群包括 819 名参加 NOMAS 的受试者（467 名女性，平均年龄 66.5±8.8 岁，66% 西班牙裔）。代谢综合征的定义使用修订后的成人治疗组 III 标准。使用高分辨率超声测量肱动脉血流介导的扩张（FMD）。内皮功能障碍定义为 FMD < 8.44%（下 3 个四分位数）。 Cox比例风险模型用于评估MetS和内皮功能障碍对心血管事件风险的影响。结果在81-21个月的随访期间，84名受试者发生了事件。在多变量模型中，代谢综合征与心血管事件独立相关，包括心血管危险因素（调整后风险比 2.08，95% CI 1.27-3.40）。同时患有 MetS 和内皮功能障碍的受试者比单独患有其中一种的受试者发生心血管事件的风险更高（调整后的风险比 2.60，95% CI 1.14-5.92）。结论 代谢综合征与心血管事件相关。 MetS 和 FMD 的联合使用可识别出心血管事件风险较高的人群。代谢综合征和无创FMD检测可同时用于心血管风险预测。
Background Metabolic syndrome (MetS) predisposes to cardiovascular disease. Endothelial dysfunction is thought to be an important factor in the pathogenesis of atherosclerosis. We tested the hypothesis that both MetS and endothelial dysfunction are vascular risk factors and provide additive prognostic values in predicting cardiovascular events in a multiethnic community sample.Methods The study population consisted of 819 subjects (467 female, mean age 66.5 8.8 years, 66% Hispanic) enrolled in the NOMAS. Metabolic syndrome was defined using the revised Adult Treatment Panel III criteria. Brachial artery flow-mediated dilation (FMD) was measured using high-resolution ultrasound. Endothelial dysfunction was defined as FMD < 8.44% (lower 3 quartiles). Cox proportional hazards models were used to assess the effect of MetS and endothelial dysfunction on risk of cardiovascular events.Results During 81 21 months of follow-up, events occurred in 84 subjects. Metabolic syndrome was independently associated with cardiovascular events in a multivariate model, including cardiovascular risk factors (adjusted hazard ratio 2.08, 95% CI 1.27-3.40). Subjects with both MetS and endothelial dysfunction were at higher risk for cardiovascular events than those with either one of them alone (adjusted hazard ratio 2.60, 95% CI 1.14-5.92).Conclusions Metabolic syndrome is associated with incident cardiovascular events. Combined use of MetS and FMD identifies those who are at higher risk of cardiovascular events. Metabolic syndrome and noninvasive FMD testing can be used concurrently for cardiovascular risk prediction.