Should central obesity be an optional or essential component of the metabolic syndrome? Ischemic heart disease risk in the Singapore Cardiovascular Cohort Study
Should central obesity be an optional or essential component of the metabolic syndrome? Ischemic heart disease risk in the Singapore Cardiovascular Cohort Study
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DOI：
10.2337/dc06-1866
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发表时间：
2007-02-01
期刊：
影响因子：
16.2
通讯作者：
Tai, E-Shyong
中科院分区：
文献类型：
--
作者：
Lee, Jeannette;Ma, Stefan;Tai, E-Shyong
目的 - 国际糖尿病联合会 (IDF) 提出中心性肥胖是代谢综合征的“基本”组成部分，而美国心脏协会/国家心肺血液研究所 (AHA/NHLBI) 则提出中心性肥胖是代谢综合征的“可选”组成部分。本研究探讨了患有或不患有中心性肥胖的代谢综合征对患有缺血性心脏病 (IHD) 的亚洲人群的影响。 研究设计和方法 - 根据基于人群的队列研究（基线 1992-1995），4,334 名健康个体根据是否存在代谢综合征和中心性肥胖进行分组，并通过与三个国家登记机构的联系进行平均 9.6 年的随访。 Cox 比例风险模型用于获得首次 IHD 事件风险的调整后风险比 (HR)。 结果 - 根据 IDF 标准，代谢综合征的患病率为 17.7%，根据 AHA/NHLBI 标准，使用中心性肥胖的亚洲腰围截止点，代谢综合征的患病率为 26.2%。亚裔印度人的发病率高于华人和马来人。共有 135 场首次 IHD 赛事。与无代谢综合征的个体相比，患有中心性肥胖/代谢综合征和无中心性肥胖/代谢综合征的人患 IHD 的风险显着增加，调整后的 HR 分别为 2.8 (95% CI 1.8-4.2) 和 2.5 (1.5-4.0)。 结论 - 患有代谢综合征，无论是否伴有中心性肥胖，都会带来 IHD 风险。然而，将中心性肥胖作为“可选”而非“必要”标准，可以确定该亚洲人群中有更多的个体面临 IHD 风险。
OBJECTIVE - The International Diabetes Federation (IDF) proposes that central obesity is an "essential" component of the metabolic syndrome, while the American Heart Association/ National Heart, Lung, and Blood Institute (AHA/NHLBI) proposes that central obesity is an "optional" component. This study examines the effect of the metabolic syndrome with and without central obesity in an Asian population with ischemic heart disease (IHD).RESEARCH DESIGN AND METHODS - From the population-based cohort study (baseline 1992-1995), 4,334 healthy individuals were grouped by the presence or absence of the metabolic syndrome and central obesity and followed up for an average of 9.6 years by linkage with three national registries. Cox's proportional hazards model was used to obtain adjusted hazard ratios (HRs) for risk of a first IHD event.RESULTS - The prevalence of metabolic syndrome was 17.7% by IDF criteria and 26.2% by AHA/NHLBI criteria using Asian waist circumference cutoff points for central obesity. Asian Indians had higher rates than Chinese and Malays. There were 135 first IHD events. Compared with individuals without metabolic syndrome, those with central obesity/metabolic syndrome and no central obesity/metabolic syndrome were at significantly increased risk of IHD, with adjusted HRs of 2.8 (95% CI 1.8-4.2) and 2.5 (1.5-4.0), respectively.CONCLUSIONS - Having metabolic syndrome either with or without central obesity confers IHD risk. However, having central obesity as an "optional" rather than "essential" criterion identifies more individuals at risk of IHD in this Asian cohort.