Is the diagnosis of metabolic syndrome useful for predicting cardiovascular disease in Asian diabetic patients? Analysis from the Japan Diabetes Complications Study
Is the diagnosis of metabolic syndrome useful for predicting cardiovascular disease in Asian diabetic patients? Analysis from the Japan Diabetes Complications Study
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DOI：
10.2337/diacare.28.6.1463
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发表时间：
2005-06-01
期刊：
影响因子：
16.2
通讯作者：
Yamada, N
中科院分区：
文献类型：
--
作者：
Sone, H;Mizuno, S;Yamada, N
目的：代谢综合征(METS)被认为与心血管疾病(CVD)的风险增加有关。虽然它在糖尿病患者中的患病率非常高，但在那些没有心血管疾病病史的人中，它的患病率尚未确定。此外，发表的关于甲硫氨酸与糖尿病人群心血管事件之间关系的前瞻性研究只使用了世界卫生组织(WHO)对甲硫氨酸的定义，只包括欧洲白人受试者。这项研究的目的是确定WHO和国家胆固醇教育计划(NCEP)定义的METS的患病率，及其在长期、前瞻性设置中对亚洲糖尿病患者心血管疾病的预测价值。研究设计和方法-根据WHO(WHO-METS)或NCEP的定义，对1,424名日本2型糖尿病患者的心血管事件(冠心病和中风)的基线特征和发病率/风险比进行了测定。在8年的研究期间，只有WHO-METS是女性患者心血管疾病的预测因子。在男性患者中，尽管两种定义的Mets都是心血管疾病的显著预测因子，但Mets的个别成分，如高脂血症或高血压，是相同或更好的预测因子。结论--我们发现Mets在没有心血管病史的糖尿病患者中相对常见。我们认为，通常使用的甲硫氨酸定义，至少在目前的形式，对亚洲糖尿病患者的临床实用性有限，可能需要针对种族特定的修改才能在全球使用。
OBJECTIVE - The metabolic syndrome (MetS) is believed to be associated with an increased risk of cardiovascular disease (CVD). Although its prevalence is extremely high among diabetic patients, its prevalence in those with no history of CVD has not been determined. Moreover, prospective studies published on the association between MetS and cardiovascular events in diabetic populations have used only the World Health Organization (WHO) definition of MetS and included only white European subjects. The aim of this study was to determine the prevalence of MetS, as defined by both the WHO and the National Cholesterol Education Program (NCEP), and its predictive value for CVD in Asian diabetic patients in a long-term, prospective setting.RESEARCH DESIGN AND METHODS - The baseline characteristics and incidence/hazard ratio of cardiovascular events (coronary heart disease and stroke) were determined in 1,424 Japanese type 2 diabetic patients with and without MetS, as defined by WHO (WHO-MetS) or the NCEP.RESULTS - A high prevalence (38-53%, depending on sex and definition) of MetS was found among diabetic patients, even those with no history of CVD. During the 8-year study period, only WHO-MetS was a predictor for CVD in female patients. In male patients, although both definitions of MetS were significant predictors for CVD, individual components of MetS, such as hyperlipidemia or hypertension, were equivalent or better predictors.CONCLUSIONS - We found that MetS is relatively common in diabetic patients with no history of CVD. We suggest that the commonly used definitions of MetS, at least in their present forms, have limited clinical usefulness for Asian diabetic patients and may need some ethnic group-specific modifications for global use.