CAJ | 학술논문

目的探讨代谢综合征对高血压前期人群心脑血管事件的影响.方法采用前瞻性队列研究方法,以参加2006年7月至2007年10月健康查体的101 510名开滦集团在职及离退休职工中30 ～70岁的高血压前期者(符合JNC-7诊断标准,29 968例)作为观察队列,并依据中国成人血脂异常防治指南对2004年中华医学会糖尿病学分会建议的修订将其分为代谢综合征阴性组和代谢综合征阳性组.随访38 ～53(47.35 ±4.68)月,随访期间每半年收集1次新发心脑血管事件情况.用Kaplan-Meier法计算代谢综合征阴性组和代谢综合征阳性组心脑血管事件的累积发病率,并用logrank法检验.采用多变量Cox比例风险回归模型分析影响心脑血管事件发生的因素.结果 (1)随访期间,代谢综合征阳性组总心脑血管事件、心肌梗死、脑梗死的累积发病率均高于代谢综合征阴性组,分别为1.80％比1.28％、0.35％比0.29％、1.10％比0.57％,其中总心脑血管事件、脑梗死事件组间差异有统计学意义(P＜0.01)；(2)校正相关因素后,与代谢综合征阴性组相比,代谢综合征阳性组总心脑血管事件和脑梗死事件的相对危险度(RR)分别为1.45(95％口CI:1.10 ～1.92)、1.84(95％ CI:1.27 ～2.67).结论代谢综合征可增加高血压前期人群发生心脑血管疾病的危险.
목적 탐토대사종합정대고혈압전기인군심뇌혈관사건적영향.방법 채용전첨성대렬연구방법,이삼가2006년7월지2007년10월건강사체적101 510명개란집단재직급리퇴휴직공중30 ～70세적고혈압전기자(부합JNC-7진단표준,29 968례)작위관찰대렬,병의거중국성인혈지이상방치지남대2004년중화의학회당뇨병학분회건의적수정장기분위대사종합정음성조화대사종합정양성조.수방38 ～53(47.35 ±4.68)월,수방기간매반년수집1차신발심뇌혈관사건정황.용Kaplan-Meier법계산대사종합정음성조화대사종합정양성조심뇌혈관사건적루적발병솔,병용logrank법검험.채용다변량Cox비례풍험회귀모형분석영향심뇌혈관사건발생적인소.결과 (1)수방기간,대사종합정양성조총심뇌혈관사건、심기경사、뇌경사적루적발병솔균고우대사종합정음성조,분별위1.80％비1.28％、0.35％비0.29％、1.10％비0.57％,기중총심뇌혈관사건、뇌경사사건조간차이유통계학의의(P＜0.01)；(2)교정상관인소후,여대사종합정음성조상비,대사종합정양성조총심뇌혈관사건화뇌경사사건적상대위험도(RR)분별위1.45(95％구CI:1.10 ～1.92)、1.84(95％ CI:1.27 ～2.67).결론 대사종합정가증가고혈압전기인군발생심뇌혈관질병적위험.
Objective This study investigated the impact of metabolic syndrome on the development of cardio-cerebral vascular (CVD) events in a pre-hypertensive population.Methods The data used in this prospective study was derived from the Kailuan study cohort ( n =101 510).Prehypertension was diagnosed in 29 968 (mean age:50 ±9 years and 23 744 males) individuals by the JNC Ⅶ criteria and these subjects were further classified into metabolic syndrome positive ( MS +,n =3447) and MS negative ( MS -,n =26521 ) groups according to the modified 2004 Chinese Diabetes Society criteria.Subjects were followed up for 38- 53 (mean 47 ± 5 ) months and first-ever CVD events were recorded.Baseline anthropometric and laboratory features were obtained by physical examination from June 2006 to October 2007 and the last follow-up day was December 31,2010.Multivariable Cox proportional hazards regression models were used to analyze the risk factors of first-ever CVD events.Results There were 354 CVD events during follow up.The incidences of CVD events ( 1.80％ vs. 1.28％ ) and cerebral infarction ( 1.10％ vs.0.57％ ) were significantly higher in the MS + group than in the MS - group ( all P ＜ 0.05 ).After adjustment for other established CVD risk factors,the hazards ratio was 1.45 (95％CI:1.10 -1.92) for total CVD events and 1.84 ( 95％ CI:1.27 - 2.67 ) for cerebral infarction events in MS + group.Conclusions In this cohort,metabolic syndrome is linked with increased risk for CVD events.