| Objective: The Metabolic Syndrome (MS) consists of a combination of metabolic abnormalities, including abdominal obesity, high blood pressure, dislipidemia and impaired glucose metabolism. The components of MS were risk factors of Diabetes (DM), heart disease and the cerebrovascular atherosclerosis disease [1-3]. Thus, it's vital for preventing stroke to treat MS at the early stage.With the understanding of the relation of MS and the risk of DM practically, there were two proposed definitions to be made use of: one was IDF proposed by International Diabetes Federation [4], the other was Updated NCEP ATPâ…¢revised by the National Heart, Lung, and Blood Institute/American Heart Association [5].A cross-sectional study from 9,669 community population-based in Greece [6] indicated, MS by Updated NCEP ATPâ…¢played a more role on predicting ischemic events. However, based on the data of European, this result may be unsuitable for Chinese to screen the high risk group of ischemic events. Given race, genetic factors and lifestyle, there was a significance difference on diagnosing MS because of different cutoffs of obesity. Thus, Chinese Medical Association [7] had proposed MS definition (CDS) after summarizing characteristics of the prevalent of MS in China. There was rare survey to obtain which one was best in Chinese among CDS, IDF and Updated NCEP ATPâ…¢at home and aboard.Based on above, our study observed the prevalence of MS depending on CDS,IDF and Updated NCEP ATPâ…¢, and further compared the degree of association between MS by different definitions and ischemic events in individuals for health physical examination to obtain which one was more suitable for Chinese.Methods: 1903 individuals for health physical examination from June 2009 to September 2009 were enrolled. The individuals with pregnance, Hyper/Hypo-thyroidism, Primary/Secondary hyperaldosteronism, long-time use of steroids, a variety of chronic and wasting disease were excluded.Information obtained from all subjects including demoghaphic features, associated history/family history and laboratory investigation was registered.Transcranial Doppler (TCD) was done in all subjects to screen atherosclerosis occlusive disease according to diagnostic criterion [11, 12, 13].Definitions of MS: CDS [7], IDF [4] and Updated NCEP ATPâ…¢[5].In the whole people, MS individuals were divided into three groups according to CDS, IDF and Updated NCEP ATPâ…¢definitions of MS; then all people were done Transcranial Doppler (TCD) to understand whether there is the intra-and extra-cranial atherosclerotic occlusive diseases. The later was considered as the risk factor of ischemic events (including coronary artery disease /stroke history). Further, we analyzed the association between MS and the risk of ischemic events in order to assess which definition was optimal for Chinese.Result: 1908 individuals initially were enrolled, 5 with poor acoustic windows and data incomplete were excluded. Finally, only 1903 subjects were included. Among of them, men were 712, women were 1191.The prevalence of MS in community population was 14.14 %( 269/1903), 27.33 %( 520/1903), 29.69 %( 565/1903) respectively according to CDS, IDF and Updated NCEP ATPâ…¢definition.By Simple logistic regression analysis, MS diagnosed by CDS,IDF and Updated NCEP ATPâ…¢all increased the risk of ischemic events with OR value 4.882(95%CI 3.317~7.186),4.687(95%CI 3.213~6.840)and 4.432(95%CI 3.031~6.479)respectivelyBy Multiple logistic regression analysis, MS diagnosed by CDS,IDF and Updated NCEP ATPâ…¢all increased the risk of ischemic events with OR value 1.799(95%CI 1.052~2.778),1.608(95%CI 1.036~2.494) and 1.703(95%CI 1.110~2.611) respectively. Further adjusting for MS components, the effect of MS on predicting ischemic events depended on hyperglycemia and hypertension.The association between MS components with different MS definitions and the risk of ischemic events: high TG, low-HDL level and abdominal obesity didn't increase the risk of ischemic events. Considering for the different cutoff value of high blood glucose and hypertension in above three kinds definitions, the association between high blood glucose and the risk of ischemic events was 4.006(95%CI 2.497~6.427), 2.602(95%CI 1.663~4.070)and 2.600(95%CI 1.670~4.049)respectively according to CDS,IDF and Updated NCEP ATPâ…¢. Likewise, hypertension also increased the risk of ischemic events with OR value 2.239(95%CI 1.387~3.617), 1.845 (95%CI 1.108~3.071)and 1.836(95%CI 1.118~3.015)respectively according to CDS,IDF and Updated NCEP ATPâ…¢.By correlation analysis, the coefficient R between hyperglycemia resulted from CDS, IDF and Updated NCEP ATPâ…¢definition and ischemic events was 0.734, 0.651 and 0.651 respectively. After comparing correlated correlation coefficients, there were significance difference between CDS and IDF, Updated NCEP ATPâ…¢(Z value all =2.02, P<0.05). Similar results was obtained about the association of hypertension and ischemic events with Z value 1.97(P<0.05).Conclusion: The effect of MS diagnosed by above three kinds of definitions on ischemic events depended on MS components. The cutoff value of hyperglycemia and hypertension in CDS were more suitable of Chinese for screening the high risk group of ischemic events. |
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