Carotid atherosclerosis and coronary heart disease in the metabolic syndrome - Prospective data from the Bruneck Study
Carotid atherosclerosis and coronary heart disease in the metabolic syndrome - Prospective data from the Bruneck Study
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DOI：
10.2337/diacare.26.4.1251
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发表时间：
2003-04-01
期刊：
影响因子：
16.2
通讯作者：
Muggeo, M
中科院分区：
文献类型：
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作者：
Bonora, E;Kiechl, S;Muggeo, M
目的 - 本研究旨在前瞻性评估代谢综合征受试者的颈动脉粥样硬化和冠心病 (CHD)。 研究、设计和方法 - 在一项基于人群的前瞻性调查中，对 888 名 40-79 岁受试者进行了调查，其中 303 名受试者被确定为符合世界卫生组织 (WHO) 标准，158 名受试者被确定为符合国家胆固醇教育计划 (NCEP)-成人治疗小组的标准(ATP)-III 代谢综合征诊断标准。通过回波双工扫描评估颈动脉状态的 5 年变化，并通过病史和死亡证明评估致命性和非致命性 CHD 事件，对代谢综合征受试者和其余样本（对照受试者）进行比较。 结果 - 与对照受试者相比，根据 WHO 标准，患有代谢综合征的受试者颈动脉粥样硬化的 5 年发病率和进展增加：51% 与 35% 形成新斑块（P = 0.021），在调整几个混杂因素后，颈动脉狭窄>40%（P = 0.002）的比例为 34% vs. 19%。根据这些标准患有代谢综合征的受试者在随访期间冠心病的发病率也有所增加：对照受试者为 8%，对照受试者为 3%（P = 0.012）。当使用 NCEP-ATPIII 标准时，也发现了类似的结果。 结论 - 患有代谢综合征的受试者患进行性颈动脉粥样硬化和 CHD 的风险增加。
OBJECTIVE - The present study aimed at prospectively evaluating carotid atherosclerosis and coronary heart disease (CHD) in subjects with the metabolic syndrome.RESEARCH, DESIGN AND METHODS - Within a prospective population-based survey examining 888 subjects aged 40-79 years, 303 subjects were identified as fulfilling World Health Organization (WHO) criteria and 158 as fulfilling the National Cholesterol Education Program (NCEP)-Adult Treatment Panel (ATP)-III criteria for diagnosing the metabolic syndrome. The 5-year change in carotid status, as assessed by echo-duplex scanning, and incident fatal and nonfatal CHD, as assessed by medical history and death certificates, were compared in subjects with the metabolic syndrome and in the rest of the sample (control subjects).RESULTS - Compared with the control subjects, subjects with the metabolic syndrome by WHO criteria had an increased 5-year incidence and progression of carotid atherosclerosis: 51 vs. 35% developed new plaques (P = 0.021) and 34 vs. 19% developed carotid stenosis >40% (P = 0.002) after adjusting for several confounders. Subjects with the metabolic syndrome by these criteria also had an increased incidence of CHD during follow-up: 8 vs. 3% in control subjects (P = 0.012). Similar results were found when the NCEP-ATPIII criteria were used.CONCLUSIONS - Subjects with the metabolic syndrome are at increased risk for both progressive carotid atherosclerosis and CHD.