Metabolic Syndrome, Its Components, and Mortality in the Elderly
Metabolic Syndrome, Its Components, and Mortality in the Elderly
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DOI：
10.1210/jc.2010-0153
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发表时间：
2010-11-01
影响因子：
5.8
通讯作者：
Berr, Claudine
中科院分区：
文献类型：
--
作者：
Akbaraly, Tasnime N.;Kivimaki, Mika;Berr, Claudine
背景和目标：代谢综合征（MetS）已被证明可以预测中年人的死亡率，但对代谢综合征及其组分对老年人死亡风险的影响知之甚少。我们的目标是：1）研究与全因和原因特异性死亡率的风险，在法国老年社区居民队列和2），以确定驱动这些associations.Participants和方法的主要组成部分MetS的关联：前瞻性分析进行了7118名男性和女性年龄在65岁及以上的三个城市队列。MetS之间的关联（使用国家胆固醇教育计划成人治疗小组III标准定义）和死亡风险超过7年的后续评估使用考克斯比例风险模型。在调整了社会人口统计学变量、健康行为和健康状况后，观察到基线时有MetS的参与者与无MetS的参与者相比，全因死亡风险增加50%，风险比为1.54 [95%置信区间（CI）= 1.24-1.92]。空腹血糖升高、高甘油三酯和低高密度脂蛋白胆固醇是这种关联的主要贡献者，协同作用于死亡风险。对于冠心病死亡率和癌症死亡率，与代谢综合征相关的风险比为2.21（95% CI = 1.07-4.55）和1.49（95%CI = 1.04-2.14）。通过显示空腹血糖升高增强了与脂质异常相关的过度死亡风险，我们的研究支持代谢综合征是老年人死亡的危险因素。我们的研究结果强调代谢综合征筛查和管理血脂异常和高血糖症的老年人在一般的做法的重要性。（临床内分泌代谢杂志95：E327-E332，2010）
Context and Objective: The metabolic syndrome (MetS) has been shown to predict mortality in the middle-aged, but less is known on the impact of MetS and its components on mortality risk in the elderly. Our objectives were 1) to examine the association of MetS with the risk of all-cause and cause-specific mortality in a French elderly community-dweller cohort and 2) to determine the main components driving these associations.Participants and Methods: Prospective analyses were carried out on 7118 men and women aged 65 yr and over from the Three-City cohort. Association between MetS (defined using the National Cholesterol Education Program Adult Treatment Panel III criteria) and mortality risk over the 7-yr follow-up was assessed using Cox proportional hazards models.Results: After adjusting for sociodemographic variables, health behaviors, and health status, a 50% increased risk for all-cause mortality was observed in participants with MetS at baseline compared with those without, with a hazard ratio of 1.54 [95% confidence interval (CI) = 1.24-1.92]. Elevated fasting blood glucose, high triglycerides, and low high-density lipoprotein cholesterol were the major contributors to this association, acting synergistically on mortality risk. For coronary heart disease mortality and cancer mortality, the hazard ratios associated with MetS were 2.21 (95% CI = 1.07-4.55) and 1.49 (95% CI = 1.04-2.14), respectively.Conclusions: By showing that an elevated fasting blood glucose potentiates the excess mortality risk associated with lipid abnormality, our study supports the status of MetS as a risk factor for mortality in the elderly. Our findings emphasize the importance of MetS screening and managing dyslipidemia and hyperglycemia in older persons in general practice. (J Clin Endocrinol Metab 95: E327-E332, 2010)