不同代谢综合征诊断标准对上海市华阳社区40岁以上代谢综合征人群心脑血管事件发生风险的评估

The evaluation of the risks of cardio-and cerebro-vascular events associated with metabolic syndrome in the cohort aged over 40 years in Huayang community of Shanghai by the different MS diagnostic criteria

目的 比较WHO( 1999)、NCEP ATPⅢ ( 2 0 0 1)两种工作定义诊断的代谢综合征 (MS)对于心脑血管事件发生的风险预测作用。探讨适合于中国人群的MS诊断定义 ,分析其对于心脑血管事件发生的预测价值。 方法 对 1998～ 1999年上海华阳社区 4 0岁以上人群 ,具有完整的代谢综合征基线调查资料和心脑血管疾病的 5年随访资料共 971例进行分析。分别应用WHO( 1999)、NCEP ATPⅢ ( 2 0 0 1)、中国建议Ⅰ和中国建议Ⅱ诊断MS ,比较MS对于心脑血管事件发生的风险预测。 结果 WHO( 1999)与NCEP ATPⅢ ( 2 0 0 1)定义的MS对于心血管事件的相对风险率分别为3 92和 2 6 6 ;中国建议定义Ⅰ与Ⅱ对心血管事件的相对风险率分别为 6 5 9和 5 4 3,脑血管事件为2 6 1和 2 4 4。 结论 四种定义的MS( 1999WHO、2 0 0 1NCEP ATPⅢ、中国建议定义Ⅰ和中国建议定义Ⅱ )均能预测心脑血管事件的发生 ,而中国建议定义Ⅰ的MS预测作用最强 ;中国建议定义Ⅰ方便易行 ,具有较大的实用性和较好的可推广价值。

Objective To compare the risk of incidence of cardiovascular events associated with the metabolic syndrome defined by WHO(1999) and NCEP ATPⅢ(2001) and to explore an available diagnostic definition of MS in China, and to assess its value on the prediction of cardiovascular events Methods A total of 971 subjects aged over 40 years with a follow up of 5 years in Huayang community of Shanghai were included The metabolic syndrom predicted cardiovascular risks were compared among the four MS definitions of the WHO(1999), ATPⅢ(2001), Chinese suggested definition Ⅰ and Ⅱ Results The relative risks(RR) of cardiovascular events associated with the metabolic syndrome using WHO(1999) and ATPⅢ(2001) definitions were 3 92 and 2 66 respectively Using Chinese suggested definition Ⅰ and Ⅱ, the RR of cardiovascular events associated with the metabolic syndrome were 6 59 and 5 43 respectively and the RR of stroke were 2 61 and 2 44 Conclusion Among four definitions of the metabolic syndrome(WHO,ATPⅢ, Chinese suggested definition Ⅰ and Ⅱ ), Chinese suggested definition Ⅰ predicts the risk of cardiovascular events most strongly In addition, the Chinese suggested definition Ⅰ is more simple, practical and easy to popularize