The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study
The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study
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DOI：
10.2337/diacare.28.2.385
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发表时间：
2005-02-01
期刊：
影响因子：
16.2
通讯作者：
Heiss, G
中科院分区：
文献类型：
--
作者：
McNeill, AM;Schmidt, MI;Heiss, G
目的 - 评估国家胆固醇教育计划第三次成人治疗专家组报告 (ATP III) 中代谢综合征定义与心血管疾病 (CVD) 之间关联的程度。 研究设计和方法 - 使用 Cox 回归来估计社区动脉粥样硬化风险 (ARIC) 中 12,089 名黑人和白人中年人发生冠心病 (CHD) 和中风的相对风险 研究结果——基线时没有糖尿病或流行性心血管疾病的个体中，代谢综合征的发病率与 23% 相似。在平均 11 年的随访中，发生了 879 起 CHD 事件和 216 起缺血性中风事件。在代谢综合征的组成部分中，血压升高和高密度脂蛋白胆固醇水平低与冠心病的关联性最强。在调整年龄、吸烟、低密度脂蛋白胆固醇和种族/ARIC中心后，患有代谢综合征的男性和女性患冠心病的可能性比对照受试者高1.5倍和2倍（性别交互作用P<0.03）。在代谢综合征和代谢综合征与缺血性中风之间也发现了类似的关联。受试者操作特征曲线比较表明，代谢综合征并未显着改善冠心病风险预测，超出弗雷明汉风险评分 (FRS) 所达到的水平。 结论 没有糖尿病或 CVD 但患有代谢综合征的个体，长期心血管结局的风险增加，尽管统计模型表明大部分风险是由 FRS 造成的。然而，识别患有代谢综合征的个体可能会提供早期干预共同疾病途径的机会，这些途径使个体易患CVD和糖尿病。Diabetes Care 28:385-390, 2005。
OBJECTIVE- To assess the magnitude of the association between the National Cholesterol Education Program's Third Adult Treatment Panel Report (ATP III) definition Of the metabolic syndrome and cardiovascular disease (CVD).RESEARCH DESIGN AND METHODS- Cox regression was used to estimate the relative risk of incident coronary heart disease (CHD) and stroke among 12,089 black and white middle-aged individuals in the Atherosclerosis Risk in Communities (ARIC) study.RESULTS - The Metabolic syndrome was present in similar to23% of individuals without diabetes or prevalent CVD at baseline. Over an average of 11 years of follow-up, 879 incident CHD and 216 ischemic stroke events Occurred. Among the components Of the metabolic syndrome, elevated blood pressure and low levels of HDL cholesterol exhibited the strongest associations with CHD. Men and women with the metabolic syndrome were similar to1.5 and 2 times more likely to develop CHD than control subjects after adjustment for age, smoking, LDL cholesterol, and race/ARIC center (sex interaction P < 0.03). Similar associations were found between the Metabolic syndrome and metabolic syndrome and incident ischemic Stroke. Comparison of receiver operating, characteristic curves indicated that the metabolic syndrome did not Materially improve CHD risk prediction beyond the level achieved by the Framingham Risk Score (FRS).CONCLUSIONS Individuals without diabetes or CVD, but with the metabolic syndrome, were at increased risk for long-term cardiovascular outcomes, although statistical models suggested that most of that risk was accounted for by the FRS. Nevertheless, identification of Individuals with the Metabolic syndrome may provide opportunities to intervene earlier in the development of shared disease pathways that predispose individuals to both CVD and diabetes.Diabetes Care 28:385-390, 2005.