Download - 指導教授 ︰ 周碧瑟教授 、 蔡世澤醫師 研究生 ︰ 吳秀英
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Components of Metabolic Syndrome as Predictors of Total and Cardiovascular Disease Mortality Kinmen study
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923.8
4011-13%
35-749.0 -9.8/1,000
4%6%(1998)
19986.2%
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1923
1988ReavenSyndrome X(Metabolic Syndrome, MS)
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(MS)1998WHO (1999BP160/90140/90mmHg)
2001National Cholesterol Education Program Adult Treatment Panel (NCEP/ATP )
1999The European Group for the study of Insulin Resistance (EGIR) (p.6) MSmorbiditymortality (components of MS, no. of abnormalities)
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DM,HPBMIWHRTGChol.HDLSBPDBPHbA1cinsulin
Wang YY (2004)MSWBC, RBC (RBC, WBC MS3-4)Lin RT (2004) (non-DM+CADMS52%non-DM+non-CADMS19%)Chuang SY (2002)MSChien KL (1999)high LDL_Clow HDL_C
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MSmortality
1976-92,NHANES II(925230-7513.5)MSCVD(OR=1.2)CHD(OR=1.7)(OR=1.2)
1978-87, (41,05620-697)MSCVDHazard ratio(1,2,3,4,5HR11.21.41.82)
1984-89,(120942-6011.6)ATP IIIMSCHD(RR=4.3) CVA(RR=2.3)(RR=1.7)
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()MS()MS()MS()MS()MS()
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1991-9312,49030
1991-95 1996-01
1997DMHP
9,117 ()
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MS HDL-CTg()
() (DM=32)
logistic regressionC statistic
> =3
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C Haffner et al (69) 95 mmHg / 58.565.0Liese et al (71)/ 140/90 mmHg/ 62.967.7Cook et al (44)90 percentile(160/97.4 mmHg)58.263.4Wilson et al (54) (quintile)( 148 mmHg 146.7 mmHg)61.567.4
Chen et al (73)
(quartile)( 144/90.7 mmHg 140.7/86.7 mmHg )61.467.6
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ATP III
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MS MS 5. MS
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1.
Chart1
26.8423.5
24.4223.24
20.5227.27
17.5217.25
10.718.74
Sheet1
P
No.%No.%No.%
30-39230525.28130826.899723.5
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> > >CVD+DM > CVD > CHD
Chart3
10.966.78
3.551.63
2.912.75
2.592.22
0.440.23
Sheet1
10.966.78
3.551.63
CVD+DM2.912.75
CVD2.592.22
CHD0.440.23
Sheet1
Sheet2
Sheet3
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2. MS
- MS MS
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MS > > >Tg > HDL-C ATP III: > =Tg > > HDL-C
Chart1
1.471.52
1.681.45
1.061.07
1.371.44
1.411.16
ATP III
OR
Sheet1
ATP III
1.471.52
1.681.45
HDL_C1.061.07
TG1.371.44
1.411.16
Sheet1
00
00
00
00
00
ATP III
OR
Sheet2
Sheet3
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3. MS
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MS
OR
Chart3
1.261.21
1.651.42
2.031.41
32.07
ATP III
multivariate-adjusted OR
Sheet1
123>=4
1.261.652.033
ATP III1.211.421.412.07
Sheet1
ATP III
Number of MS disorders
multivariate-adjusted OR
Sheet2
Sheet3
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4. MS
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ATP III
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50 MSC
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50MS50140/90 mmHg98 cm
3.5
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140/90 mmHg98 cm
1/2premature death
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>= 140/85 mmHg>=98 cm(45%) >= 140/85 mmHg>=98 cm(87%)
10,000(50+120)*10,000 =1,700,000
1.5509(55%)5509(50+120)*5509=936,53055%(936,530/1,700,000=55%)
2.1,340 (13.4%)(50+120)*1340=227,80013.4%
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12372.4%
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ATP MSMSCHD(OR=2.8) (OR=2.3) OR=1.7MS(OR=1.7) (OR=1.5) (OR=1.4)(0=4.41=9.02=14.63=19.04=31.1)MS3(OR: 0=11=1.32=1.73=2.04=3)
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