Does diagnosis of the metabolic syndrome detect further men at high risk of cardiovascular death beyond those identified by a conventional cardiovascular risk score? The DECODE Study: The Diabetes Epidemiology: Collaborative analysis Of Diagnostic Criteria in Europe (DECODE) Study Group
Does diagnosis of the metabolic syndrome detect further men at high risk of cardiovascular death beyond those identified by a conventional cardiovascular risk score? The DECODE Study: The Diabetes Epidemiology: Collaborative analysis Of Diagnostic Criteria in Europe (DECODE) Study Group
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除了传统心血管风险评分所识别的人群之外，代谢综合征的诊断是否可以进一步发现心血管死亡高风险人群？
DOI：
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发表时间：
2007
影响因子：
--
通讯作者：
B. Balkau
中科院分区：
文献类型：
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作者：
B. Balkau
背景目前尚不清楚代谢综合征是否能检测到除常规心血管风险评分外的其他心血管疾病（CVD）死亡高风险个体。设计：前瞻性研究。方法：从参与DECODE研究的7个基于人群的欧洲队列中，共对2790名年龄在50-69岁的无糖尿病男性进行了10年以上的CVD死亡率随访。结果使用欧洲SCORE项目方程，约51%的男性估计10年内发生致命性CVD的风险低于5%，其中22%患有代谢综合征，如国家胆固醇教育计划成人治疗小组III所定义。在低风险男性中，校正年龄和研究中心后，患有该综合征的男性与未患有该综合征的男性相比，致死性CVD的风险比为2.71（1.33-5.51）（P<0.01）。在低心血管疾病风险男性中，腰围较大（> 102 cm）的优势比为2.24（1.05-4.76）。结论：具有低心血管风险评分和代谢综合征的男性比没有代谢综合征的男性有更高的致命性CVD风险。因此，在临床实践中使用代谢综合征在男性中是合理的，但腰围提供了一个更简单的诊断工具，在这些低风险男性中具有相似的致命CVD风险。大腰围可用于预筛选，并可纳入CVD风险评分。
Background It is not known whether the metabolic syndrome detects further individuals at high risk of death from cardiovascular disease (CVD), beyond those identified by a conventional cardiovascular risk score. Design A prospective study. Methods A total of 2790 men without diabetes, aged 50–69 years from seven population-based European cohorts participating in the DECODE Study, were followed for CVD mortality over 10 years. Results Some 51% of the men had an estimated 10-year risk of fatal CVD under 5%, using the European SCORE project equation, and 22% of them had the metabolic syndrome, as defined by the National Cholesterol Education Program Adult Treatment Panel III. In the low-risk men, the hazards ratio for fatal CVD, after adjusting for age and study centre, was 2.71 (1.33–5.51) for men with the syndrome (P<0.01) compared with men without the syndrome. A large waist circumference (>102cm) carried an odds ratio of 2.24 (1.05–4.76) in the low CVD risk men. Conclusions Men with a low cardiovascular risk score and the metabolic syndrome had a significantly higher risk of fatal CVD than those without the syndrome. The use of the metabolic syndrome in clinical practice is thus justified in men, but waist circumference provided a simpler diagnostic tool with similar fatal CVD risk in these low-risk men. A large waist circumference could be used for prescreening, and could be included in CVD risk scores.
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影响因子：
16.2
作者：
McNeill, AM;Schmidt, MI;Heiss, G
通讯作者：
Heiss, G
影响因子：
16.2
作者：
Stern, MP;Williams, K;Haffner, SM
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Haffner, SM
影响因子：
16.2
作者：
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影响因子：
7.7
作者：
Hanson, RL;Imperatore, G;Knowler, WC
通讯作者：
Knowler, WC
影响因子：
16.2
作者：
Resnick, HE;Jones, K;Howard, BV
通讯作者：
Howard, BV