老年人群代谢综合征的患病率及其与心脑血管病的关系

目的调查北京城区老年人群中代谢综合征(MS)的患病率,并探讨其与心血管疾病的关系。方法人群为基础的横断面现况研究。2 334例老年人(年龄60~95岁;男性943例,女性1 391例)为北京市海淀区万寿路地区分层整群抽样样本,占万寿路地区老年人口的11.4%。MS的诊断标准为美国胆固醇教育计划(NCEP ATPⅢ)和国际糖尿病联盟(IDF)2005标准。冠心病和脑卒中的定义为WHO-MONICA标准。结果北京城区老年人群中MS患病率:NCEP标准为30.5%(男性17.6%,女性39.2%);IDF标准为46.3%(男性34.8%,女性54.1%)。无论采用NCEP或IDF诊断标准,具有MS的人群中,冠心病和脑卒中的患病危险均明显增高约50%。在符合IDF标准而不符合NCEP标准的人群中(n=436,18.7%),冠心病和脑卒中的危险度亦有显著增高,其OR(95%CI)分别是1.65(1.31~2.09)和1.53(1.13~2.06)。结论MS在北京城市老年人群中(尤其是女性)患病率较高。IDF标准比NCEP更适合评估和筛选中国MS中的心血管病危险人群。

Metabolic syndrome and its relation to cardiovascular disease in an elderly Chinese population

Objective To assess the prevalence of metabolic syndrome(MS) and its association with cardiovascular disease(CVD) in elderly Chinese.Methods A population-based cross-sectional study was conducted in 2?334 participants aged 60～95 years(943 men and 1?391 women) in an urban district of Beijing.The National Cholesterol Education Program(NCEP) and the International Diabetes Federation(IDF) criteria for MS were used in the study.CVD included diagnosed coronary heart disease(CHD) and stroke.Results The prevalence rate of MS by the NCEP criteria was 30.5%(17.6% in men and 39.2% in women).Use of the new IDF definition significantly increased the prevalence rate to 46.3%(34.8% in men and 54.1% in women).The risk for CHD and stroke in those with MS using the NCEP or IDF criteria increased by about 50%.Those who met the IDF but not the NCEP criteria(n=436,18.7%) had significantly elevated odds ratios of CHD(1.66,95%CI 1.31～2.10) and stroke(1.53,95%CI 1.13～2.06).Conclusions MS is highly prevalent in the elderly in Beijing,particularly among women.Individuals with MS defined by either criteria are at significantly elevated risk for CHD and stroke.The IDF criteria appear to be better suited than the NCEP criteria for screening and estimating risk of MS in the Chinese.