Prevalence and characteristics of the metabolic syndrome in the San Antonio Heart and Framingham Offspring Studies
Prevalence and characteristics of the metabolic syndrome in the San Antonio Heart and Framingham Offspring Studies
复制标题
DOI：
10.2337/diabetes.52.8.2160
复制
发表时间：
2003-08-01
期刊：
影响因子：
7.7
通讯作者：
Haffner, SM
中科院分区：
文献类型：
--
作者：
Meigs, JB;Wilson, PWF;Haffner, SM
代谢综合征可能是增加2型糖尿病和心血管疾病风险的常见表型。我们评估了3，224名白色受试者参加FOS研究（1991-1995年）和1，081名非西班牙裔白色受试者和1，656名墨西哥裔美国人参加圣安东尼奥心脏研究（SAHS）II期随访检查（1992-1996年）的人群样本中代谢综合征的患病率和特征。受试者为50%的女性，年龄30-79岁，无糖尿病，并根据国家胆固醇教育计划成人治疗小组第三次报告（ATP III）或世界卫生组织（WHO）提出的肥胖、血脂异常、高血糖和高血压标准分类为代谢综合征。我们使用回归模型来估计不同种族人群的发病率，并评估代谢综合征与胰岛素抵抗的相关性，并预测10年冠心病（CHD）风险。在FOS白色受试者中，根据ATP III和WHO标准，经年龄和性别调整的代谢综合征患病率为24%;在SAHS非西班牙裔白色受试者中，分别为23%和21%;在SAHS墨西哥裔美国受试者中，分别为31%和30%。墨西哥裔美国妇女的比率最高（ATP III，33%），白色妇女的比率最低（21%）。根据ATP III标准，代谢综合征受试者的空腹胰岛素水平在年龄、性别和种族调整后更高（11.3 μ U/ml），胰岛素抵抗的稳态模型评估（2.7）和预测的CHD风险（11.8%）高于无综合征者（分别为5.9 μ U/ml、1.3和6.4%;均P = 0.0001）;使用WHO标准时差异相似。我们的结论是，代谢综合征通常影响20-30%的中年人在美国的任何标准，与那些没有代谢综合征的人相比，代谢综合征的受试者更胰岛素抵抗和冠心病的预测风险增加。
The metabolic syndrome may be a common phenotype increasing risk for type 2 diabetes and cardiovascular disease. We assessed the prevalence and characteristics of the metabolic syndrome among population-based samples of 3,224 white subjects attending Framingham Offspring Study (FOS) exam 5 (1991-1995) and 1,081 non-Hispanic white and 1,656 Mexican-American subjects attending the San Antonio Heart Study (SAHS) phase II follow-up exam (1992-1996). Subjects were similar to50% women, aged 30-79 years, without diabetes, and classified with the metabolic syndrome according to criteria for obesity, dyslipidemia, hyperglycemia, and hypertension proposed by the Third Report of the National Cholesterol Education Program's Adult Treatment Panel (ATP III) or the World Health Organization (WHO). We used regression models to estimate rates across ethnic groups and to assess the association of the metabolic syndrome with insulin resistance and predicted 10-year coronary heart disease (CHD) risk. Among FOS white subjects, the age- and sex-adjusted prevalence of the metabolic syndrome was 24% by both ATP III and WHO criteria; among SAHS non-Hispanic white subjects, 23 and 21%, respectively; and among SAHS Mexican-American subjects, 31 and 30%. Rates were highest among Mexican-American women (ATP III, 33%) and lowest among white women (21%). Subjects with the metabolic syndrome by ATP III criteria had higher age-, sex-, and ethnicity-adjusted levels of fasting insulin (11.3 muU/ml), homeostasis model assessment of insulin resistance (2.7), and predicted CHD risk (11.8%) than those without the syndrome (5.9 muU/ml, 1.3, and 6.4%, respectively; all P = 0.0001); differences were similar using WHO criteria. We conclude that the metabolic syndrome typically affects 20-30% of middle-aged adults in the U.S. By any criteria, subjects with the metabolic syndrome are more insulin resistant and at increased predicted risk for CHD versus those without the metabolic syndrome.