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1、UpdateontheMetabolicSyndromeStevenHaffner,MDExpertPanelonDetection,Evaluation,andTreatmentofHighBloodCholesterolinAdults.JAMA2001;285:2486-2497.MetabolicSyndromeIncreasesRiskforCHDandType2DiabetesCoronaryHeartDiseaseType2 DiabetesHigh LDL-CMetabolic SyndromeAt discharge3mo laterAt dischargeHigh
2、RiskofImpairedGlucoseToleranceandType2DiabetesbyOGTTinPost-MIPatientswithoutKnownDiabetesIGT%ofPatients3mo laterNewDM35%40%31%25%n=181NorhammarAetal.Lancet2002;359:2140-2144.ConversionStatusatFollow-upDiabetes(n=18)Normal(n=490)PBMI(kg/m2)28.2?1.127.2?0.2.472Centrality*1.38?0.091.16?0.2.472TG(m
3、mol)1.83?0.121.26?0.10.006HDL-C(mmol)1.14?0.071.28?0.02.045SBP(mmHg)116.8?3.0108.8?0.8.004Fastingglucose(mmol)5.28?0.15.00?0.02.032Fastinginsulin(pmol)157?2781?5.006IncreasedMetabolicSyndromeinPrediabeticSubjects:BaselineRiskFactorsinSubjectswithNormalGlucoseToleranceatBaselineaccordingtoConver
4、sionStatusat 8-YearFollow-up:SanAntonioHeartStudyHaffnerSMetal.JAMA1990;263:2893-2898.*RatioofsubscapulartotricepsskinfoldsNondiabeticthroughout thestudyPriorto diagnosisof diabetesElevatedRiskofCVDPriortoClinicalDiagnosisofType2Diabetes:Nurses’HealthStudyCopyright?2002AmericanDiabetesAssociati
5、onFromDiabetesCare,Vol.25,2002;1129-1134ReprintedwithpermissionfromTheAmericanDiabetesAssociation.RelativeRisk12.823.715.02Afterdiagnosisof diabetesDiabetic at baselineRiskofMajorCHDEventAssociatedwithInsulinQuintilesinNondiabeticSubjects:HelsinkiPolicemenStudyYears5102001525Py?r?l?Metal.Circul
6、ation1998;98:398-404.Logrank:OverallP=.001Q5vs.Q1P<.001Q1Q2Q3Q4Q5ProportionwithoutMajorCHDEvent0HOMA-IRQ1Q2Q3Q4Q5HDL-C(mg/dl)51.749.347.845.041.2LDL-C(mg/dl)115.7119.3125.0128.1124.8Cholesterol(mg/dl)188.0191.6197.9200.8199.0Triglyceride(mg/dl)105.7116.6129.7145.4187.2SystolicBP(mmHg)114.9116.5
7、118.3119.3123.0DiastolicBP(mmHg)69.070.471.973.175.4CVDRiskFactorsacrossHOMA-IRQuintiles:SanAntonioHeartStudy(PhaseII)Allp(trend)<0.0001;quintilecutpoints:1.0,1.6,2.5,4.8Adjustedforage,sex,ethnicityCopyright?2002AmericanDiabetesAs
