摘要
目的比较美国国家胆固醇教育计划成人治疗指南Ⅲ（NCEP ATPⅢ）代谢综合征定义与心血管病传统危险因素对我国中年男性总死亡率的预测价值。方法本研究在＂中国多省市心血管病前瞻性队列研究＂上海市人群队列基础上进行。1992年,上海市共有808名35-60岁的中年男性完成了心血管病传统危险因素的基线调查。随访1992-2007年该队列的全死因死亡。利用Cox比例风险模型评估基线NCEP-ATPⅢ代谢综合征定义〔血压升高：收缩压〉130 mm Hg或舒张压〉85 mm Hg;空腹血糖升高：空腹血糖〉6.105 mmol/L（110 mg/d l）;甘油三酯（TG）升高：〉1.695 mmol/L（150 mg/d l）;高密度脂蛋白胆固醇（HDL-C）降低：男性〈1.04 mmol/L（40 mg/d l）,女性〈1.30 mmol/L（50 mg/d l）;腰围增大：男性腰围〉102 cm;女性〉88 cm〕及其5个组成成分对全死因的预测价值。调整的混杂因素包括年龄和吸烟。结果基线808名40-60岁男性中,NCEP ATPⅢ定义代谢综合征的患病率为17.5%。在15年的随访中,共发生各种原因的死亡27例。代谢综合征对总死亡率风险比（HR）及95%可信区间（CI）为1.35（0.57,3.23）。把代谢综合征5个组成成分引入同一模型后,血压升高是总死因死亡的强预测因素,HR与95%CI为3.14（1.29-7.66）。高血糖、高甘油三酯、腰围增大和低HDL水平的HR与95%CI依次为1.48（0.52-4.24）,1.51（0.59-3.89）,1.59（0.60-4.24）和1.14（0.43-3.04）。结论在我国中年男性中,血压水平升高较NCEP ATPⅢ定义代谢综合征对总死亡率的预测价值更大。
Objective To investigate whether the diagnosis of metabolic syndrome （ MetS）, compared with conventional cardiovascular risk factors, can further predict high risk of death in middle - aged Chinese men. Methods In 1992, 808 mid- die- aged men in Shanghai （aged 40 to 60 years） were enrolled into the Shanghai Cohort Study. Traditional cardiovascular risk factors were measured in the baseline survey, including the components of MetS defined by NCEP - ATP Ⅲ criteria. All - cause deaths during the subsequent 15 years were followed. Cox regression model was carried out to estimate the hazard ratios （HRs） of death attributable to MetS components （elevated blood pressure, elevated plasma glucose, elevated blood triglyceride, increased waist circumference, and low HDL cholesterol）. Results Among the total of 808 men at baseline survey, the prevalence of MetS was 17.5%. In 15 yeras＇ follow- up, a total of 27 deaths occurred. All analyses were adjusted for age and cigarette smoking. It was found that the diagnosis of the MetS did not pose the higher risk for all cause mortality [ HR = 1.35 （0. 57, 3.23） ], when included all five MetS components into a single model, only elevated blood pressure was a strong risk factor for all cause mortality [ HR = 3. 14 （ 1.29, 7.66） ] ; the HRs and 95 % CI for elevated plasma glucose, elevated blood triglyceride, increased waist circumference （ using modified criteria, 〉 90 era） , and low HDL cholesterol were 1.48 （0. 52, 4. 24） , 1.51 （ 0. 59, 3.89）, 1.59 （0. 60, 4. 24）, and I. 14 （0. 43, 3. 04）, respectively. Conclusion In middle - aged Chinese men, the prevalence of the MetS is lower than that in North American. Elevated blood pressure is the strongest predictor in all cause mortality beyond the diagnosis of MetS.
出处
《中国预防医学杂志》
CAS
2009年第7期561-564,共4页
Chinese Preventive Medicine
基金
国家"八五"科技攻关课题(85-915-01-02)
"十一五"国家科技支撑计划(2006BAI01A01)合作分课题资助
关键词
代谢综合征
血压升高
全死因死亡率
Metabolic syndrome
Elevated blood pressure
All cause mortality
