The impact of the metabolic syndrome and its components on the incidence of ischemic heart disease and stroke: the Japan public health center-based study
The impact of the metabolic syndrome and its components on the incidence of ischemic heart disease and stroke: the Japan public health center-based study
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DOI：
10.1038/hr.2009.14
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发表时间：
2009-04-01
影响因子：
5.4
通讯作者：
Tsugane, Shoichiro
中科院分区：
文献类型：
--
作者：
Noda, Hiroyuki;Iso, Hiroyasu;Tsugane, Shoichiro
在这项研究中，我们的目的是研究代谢综合征及其组成部分对相对较低肥胖人群心血管疾病风险的影响。共有8249名男性和15064名女性，年龄40-69岁，没有缺血性心脏病，中风和/或癌症的历史完成了1993年至1995年的危险因素调查。根据美国心脏协会/国家心肺血液研究所（AHA/NHLBI）和国际糖尿病联合会（IDF）的修订标准定义代谢综合征。2003年全年进行了系统的心血管监测，确定了693例缺血性心脏病和中风事件。我们观察到代谢综合征与缺血性心脏病和缺血性卒中的风险显著相关，但与出血性卒中无关。基于AHA/NHLBI标准的代谢综合征男性中缺血性心脏病的多变量风险比（95%置信区间）为2.25（1.44-3.51），缺血性卒中的多变量风险比为1.88（1.40-2.52）。根据IDF标准，缺血性心脏病和缺血性卒中的代谢综合征风险比分别为1.61（0.99-2.64）和1.94（1.41-2.68）。基于AHA/NHLBI标准的代谢综合征人群归因分数（PAF）高于基于IDF标准的：男性缺血性心血管疾病为19 vs. 12%（P差异=0.003），因为具有≥ 2个风险因素的非超重男性也处于高风险（PAF的20%）。我们的数据表明，基于AHA/NHLBI标准的代谢综合征预测缺血性心血管疾病优于基于IDF标准的综合征，因为从参考组中排除了非超重的高危个体。
In this study, we aimed to examine the impact of the metabolic syndrome and its components on the risk of cardiovascular disease among a relatively less-obese population. A total of 8249 men and 15 064 women, aged 40-69 years, with no history of ischemic heart disease, stroke and/or cancer completed a risk-factor survey between 1993 and 1995. The metabolic syndrome was defined based on modified criteria of the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and the International Diabetes Federation (IDF). Systematic cardiovascular surveillance was carried out throughout 2003, and 693 events of ischemic heart disease and stroke were identified. We observed significant associations of the metabolic syndrome with the risk of ischemic heart disease and ischemic stroke, but not with hemorrhagic stroke. The multivariable hazard ratio (95% confidence interval) of ischemic heart disease among men for the metabolic syndrome based on the AHA/NHLBI criteria was 2.25 (1.44-3.51) and that of ischemic stroke was 1.88 (1.40-2.52). The respective hazard ratios for the metabolic syndrome based on the IDF criteria were 1.61 (0.99-2.64) for ischemic heart disease and 1.94 (1.41-2.68) for ischemic stroke. The population-attributable fraction (PAF) of the metabolic syndrome based on the AHA/NHLBI criteria was higher than that based on the IDF criteria: 19 vs. 12% (P for difference=0.003) for ischemic cardiovascular disease among men, because non-overweight men with >= 2 risk factors were also at high risk (20% of the PAF). Our data suggest that the metabolic syndrome based on the AHA/NHLBI criteria predicts ischemic cardiovascular disease better than the syndrome based on the IDF criteria, because of the exclusion of non-overweight high-risk individuals from the reference group.