社区中老年人群代谢综合征与颈动脉粥样硬化的关系  

A community-based study on relations between metabolic syndrome and carotid atherosclerosis in a middle-aged population

作　　者：邹晓璇[1] 李莹[1] 张红菊[2] 陈祚[1] 王浩[2] 郭敏[1] 王倩倩[3] 赵连成[1] 杨英[3] 郑润平[4] 蔡玉岭 顾东风[3] 

机构地区：[1]北京协和医学院中国医学科学院心血管病研究所阜外心血管病医院防治网络部,100037 [2]北京协和医学院中国医学科学院心血管病研究所阜外心血管病医院超声科,100037 [3]北京协和医学院中国医学科学院心血管病研究所阜外心血管病医院循证医学部,100037 [4]北京大学首钢医院古城社区卫生服务中心心血管病防治所 [5]北京市石景山区西黄村社区卫生服务站

出　　处：《中华流行病学杂志》2010年第4期361-365,共5页Chinese Journal of Epidemiology

基　　金：国家“十一五”科技支撑计划（2006BA101A01）

摘　　要：目的探讨代谢综合征（MS）与颈动脉粥样硬化的关系，初步了解不同诊断标准的预测效果。方法于2008年对北京市两组中老年社区人群进行横断面调查，纳入分析者共1266人（男性598人，女性668人），年龄45。69岁。分别采用国际糖尿病联盟（IDF）、美国国家胆固醇教育计划成年人治疗组报告Ⅲ修订版（ATPⅢ修订版）和2007年公布的中国成人血脂异常防治指南（“指南”）标准诊断MS。结果IDF、ATPⅢ修订版和“指南”定义的MS患病率分别为39．0％、43．3％和30．9％。三种标准两两之间一致性测量Kappa系数分别为0．911、0．719和0．730。调整了年龄、性别、LDL—C、吸烟、饮酒后，三种定义的MS组CCA—IMT均显著高于非MS组（P〈0．001）。调整上述变量后，三种定义的MS均显著增加颈动脉内中膜斑块检出的危险性，OR值分别为1．499（95％CI：1．157～1．942）、1．696（95％CI：1．314～2．189）、1．763（95％CI：1．344～2．312）。结论三种标准定义的MS在吸烟、LDL-C等传统心血管病危险因素以外仍对颈动脉粥样硬化有独立预测作用，不同标准定义的MS与斑块检出风险关联强度可能存在性别差异。Objective To explore the association between metabolic syndromes （MS） and carotid atherosclerosis and to estimate the predictive effects of MS under 3 different definitions. Methods A cross-sectional study was conducted in 2 community-based populations in Beijing, in 2008. 1266 subjects （598 men, 668 women）, aged 45-69, were included in the analyses. MS was defined by the criteria of International Diabetes Federation （IDF）, the revised NCEP ATP III （ATP III -R） and ＂The Guidelines of Dyslipidemia Control for Chinese Adult＂ （＂Guidelines＂） in 2007. Results The prevalence rates of MS by the 3 criteria were 39.0%, 43.3% and 30.9% respectively. The Kappa value for the measure of the agreement between each pair of the 3 definitions were 0.911, 0.719 and 0.730 respectively. The intima-media thickness in common carotid artery （CCA-IMT） was significantly higher （P〈0.001） in all MS groups than in non-MS groups, diagnosed with the 3 criteria independent of age, gender, LDL-C, and current smoking status. After adjustment of age,gender, LDL-C, and current smoking status, the classification of MS significantly increased the risk of prevalence of carotid atherosclerotic plaques, compared to the non-MS group. OR value were 1.499 （95% CI： 1.157-1.942） for IDF, 1.696 （95% CI： 1.314-2.189） for NCEP-R, 1.763 （95% CI： 1.344-2.312）for ＂Guideline＂ respectively. Conclusion Our research findings indicated that, when MS were defined with the 3 definitions, prediction on the risk of sub-clinical atherosclerosis would work beyond some of the conventional cardiovascular risk factors such as smoking, LDL-C. There might exist some differences in gender issue on the strength of association between MS when diagnosed by different criteria and carotid plaque.

关 键 词：代谢综合征 颈动脉粥样硬化 社区人群 

分 类 号：R589[医药卫生—内分泌] R543[医药卫生—内科学]