代谢综合症:预防心脏病的前景

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'代谢综合症:预防心脏病的前景'
Zhao Dong Department of EpidemiologyBeijing Institute of Heart, Lung & Blood Vessel Diseases Beijing Anzhen Hospital Bjorntorp P J Clin Hypertension 1986 2:163 Human obesity …… is due to an excess production of free fatty acids from these lipolytically active depots. This, in turn, might cause hyperinsulinemia via reduced hepatic insulin uptake, followed by peripheral hyper- insulinemia, insulin resistance and, perhaps, diabetes mellitus and hypertension. Golay A J Lipid Res 1987 28:10-18 …….These data strongly support the view that insulin play an important role in regulationof HDL metabolism.Banting Lecture: Reaven GM 1988 AtheroscleroticDiabetes 37:1595 CVD BP? IGT Type 2 DM dyslipidemia FFA ? TG? HDL-C? %50 47 3940 3330 1920 1210 6 0 0 1 2 3 4 5% Insulin normal Hyperinsulinaemia 不同FFA和胰岛素抵抗水平时 各种代谢综合征组份异常的患病率(%) 高 腹 T 部 G 肥 血 胖 症C-L 低 高D 高H 血 血 糖血 压症 不同FFA和胰岛素抵抗水平时 代谢综合征的患病率(%)代谢综合征患病 胰岛素抵抗率 四分位分层% FFA四分位分层 腹部肥胖 高TG血症 低HDL-C 高血糖 高血压 血症 FFA Ⅰ ─ ─ ─ ─ ─ Ⅱ 2.0 2.8 NS 1.5 1.7 Ⅲ 1.7 2.4 NS 2.1 2.1 Ⅳ 2.1 3.9 NS 3.7 2.7 HOMA_IR Ⅰ ─ ─ ─ ─ ─ Ⅱ 1.5 2.4 1.6 2.8 NS Ⅲ 2.5 3.8 1.9 5.4 NS Ⅳ 2.1 7.0 3.4 28.9 NS调整年龄、性别、吸烟、饮酒、BMI、胰岛素抵抗指数 / FFANS:无统计学显著性,未进入方程 OR 95%CI FFA Ⅰ ─ ─ Ⅱ 3.1 (1.9-5.2) Ⅲ 3.1 (1.9-5.1) Ⅳ 4.1 (2.5-6.7) HOMA_IR Ⅰ ─ ─ Ⅱ 1.8 (1.1-3.0) Ⅲ 2.4 (1.4-3.9) Ⅳ 7.0 (4.2-11.8)调整年龄、性别、吸烟、饮酒、BMI、胰岛素抵抗指数 / FFA Studies of the Association between MS and All-cause Mortality Year Follow-up Author Of Study Sample size Publish (years) Kuopio Ischaemic Heart Lakka 2002 Disease Risk Factor Study, 1209 11.4 FinlandKatzmarzy Aerobics Center 2004 19223 10.2k Longitudinal StudyHunt 2004 San Antonio Heart Study 2815 12.7 National Health and Ford 2004 Nutrition Examination 2431 13.5 Survey II Mortality Study Studies of the Associatio n between MS and CVD Year Sample Follow-up Author of Study publish size (years) Turkish Adult Risk Factor Onat 2002 2398 3 Study, Turkey Kuopio Ischemic Heart Lakka 2002 Disease Risk Factor Study, 1209 11.4 FinlandResnick 2003 Strong Heart Study 2283 7.6Katzmarzy Aerobics Center 2004 19223 10.2k Longitudinal StudyBonora 2004 Bruneck Study, Italy 888 5 Framingham Offspring Rutter 2004 3037 6.9 StudyStudies of the Associatio n b
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