代谢症候群盛行率稳定但仍影响约50%的年长者


  【24drs.com】根据最新的「全国健康与营养检视调查(NHANES)」资料显示,美国的代谢症候群盛行率在2003-2012年间看来是稳定的,不过,有三分之一的美国成人仍患有代谢症候群,60岁以上者几乎有半数受到影响。
  
  最新的数据指出,代谢症候群的盛行率随著年龄而增加:20-39岁者为18.3%、40-59岁者为33%、60岁以上者有46.7%患有代谢症候群。
  
  加州奥克兰Alameda Health System-Highland Hospital的Maria Aguilar医师等人在发表于5月19日美国医学会期刊的研究通讯写道,了解更新的盛行率趋势或许是重要的,因为代谢症候群本身的潜在影响,以及它与美国年长人口的健康并发症有关,而这些结果被视为「相关的」。
  
  资深作者、Alameda Health System-Highland Hospital的Robert J Wong医师表示,如果这趋势继续,对于我们的健康照护体系将会是巨大的公卫问题。
  
  因此,健康照护提供者必须更积极筛检病患、以发现高血压、高胆固醇、胰岛素阻抗性,如果你可以治疗和优化血压、胆固醇、与[糖尿病前期]这些因素,或许不能消除[代谢症候群],但你可以大幅降低心脏病、糖尿病、与脂肪肝的风险。
  
  1999-2006年的NHANES资料显示,美国的代谢症候群盛行率为34%,Aguilar医师等人的目标是,使用更多最近的NHANES数据、确认这个盛行率是否没变。
  
  他们将代谢症候群定义为有以下几点的其中三点:腰围男性大于102公分(40英寸)、女性大于88公分(34英寸);血清三酸甘油脂达150 mg/dL以上;高密度脂蛋白男性低于40 mg/dL、女性低于50 mg/dL;血压130/85 mm Hg以上或者有服用高血压药物;空腹血浆葡萄糖值大于100 mg/dL或有服用第二型糖尿病药物。
  
  Wong医师指出,腰围比身体质量指数更能测出身体的内脏脂肪。
  
  在2007-2008年与2011-2012年这两段期间之间,代谢症候群的整体盛行率没有显著差异,分别是36.1%与34.7%,不过女性的盛行率显著降低,从39.4%减少到36.6%。
  
  研究者指出,深入了解代谢症候群与它的健康后遗症,将有助于改善高血压与糖尿病这些风险因素的最佳治疗。
  
  他们观察发现,再者,最近的NHANES资料显示,美国的肥胖盛行率看起来也趋于稳定;或许代谢症候群的盛行率是因此而趋于稳定。
  
  Wong医师指出,尽管如此,这篇研究发现,相当高比率的成年人受到代谢症候群影响(超过30%)。
  
  盛行率在种族方面也有所不同。在2003-2012年,西班牙裔的代谢症候群整体盛行率最高(35.4%),其次依序是:非西班牙裔白人(33.4%)与黑人(32.7%)。
  
  根据Wong医师表示,这篇研究再度强调「更佳地控制共病症以及生活型态上更健康的饮食与运动,可以大幅降低风险。」
  
  资料来源:http://www.24drs.com/
  
  Native link:Metabolic Syndrome Stabilizes but Still Affects 50% of Seniors

Metabolic Syndrome Stabilizes but Still Affects 50% of Seniors

By Marlene Busko
Medscape Medical News

New data show that the prevalence of metabolic syndrome in the United States appears to have stabilized between the time periods 2003 to 2012. But a third of US adults still had metabolic syndrome, based on the most recent National Health and Nutritional Examination Survey (NHANES), and almost half of those over 60 were affected.

The newest figures indicate that the overall prevalence of metabolic syndrome rose with age: 18.3% of 20- to 39-year-olds, 33% of 40- to 59-year-olds, and 46.7% of people aged 60 and older had metabolic syndrome.

Understanding updated prevalence trends may be important, given the potential effect of the metabolic syndrome and its associated health complications on the aging US population, and as such the results are "concerning," Dr Maria Aguilar (Alameda Health System-Highland Hospital, Oakland, CA) and colleagues write, in a research letter published in the May 19 issue of the Journal of the American Medical Association.

"If this trend continues, it's going to be a huge public-health problem for our healthcare system," senior author Dr Robert J Wong (Alameda Health System-Highland Hospital) told Medscape Medical News.

Thus, healthcare providers need to be more aggressive in screening patients to detect hypertension, high cholesterol levels, and insulin resistance, and "if you can treat and optimize these factors — the blood pressure, cholesterol, and [prediabetes] — you won't eliminate [metabolic syndrome] but you can dramatically reduce the risk of heart disease, diabetes, and fatty liver," he said.

Trends in Metabolic Syndrome in the Past Decade

Previous NHANES data from 1999 to 2006 showed the prevalence of metabolic syndrome in the United States was 34%, and Dr Aguilar and colleagues aimed to determine whether the prevalence was still the same, using more recent NHANES figures.

They defined metabolic syndrome as having three or more of the following: waist circumference larger than 102 cm (40 inches) in men or larger than 88 cm (34 inches) in women; serum triglycerides of 150 mg/dL or higher; HDL cholesterol below 40 mg/dL in men or below 50 mg/dL in women; blood pressure of 130/85 mm Hg or greater or taking hypertension medications; or fasting plasma glucose of 100 mg/dL or greater or taking medications for type 2 diabetes.

Waist circumference provides a better measure of visceral adiposity than body mass index, Dr Wong noted.

There was no significant difference in the overall prevalence of metabolic syndrome between 2007–2008 and 2011–2012, at 36.1% vs 34.7%, respectively, although the prevalence in women decreased significantly, from 39.4% to 36.6%.

The researchers note that greater awareness of the metabolic syndrome and its health consequences may have contributed to improvements in optimizing treatment of risk factors such as hypertension and diabetes.

"Furthermore, recent NHANES data demonstrate that obesity prevalence in the United States also appears to have stabilized," which may have contributed to the plateau seen in the prevalence of metabolic syndrome, they observe.

Nevertheless, the study does reveal that "a huge proportion of adults are affected by metabolic syndrome (over 30%)," Dr Wong noted.

It also identified ethnic differences. During 2003 to 2012, Hispanics had the highest overall prevalence of metabolic syndrome (35.4%), followed by non-Hispanic whites (33.4%) and blacks (32.7%).

According to Dr Wong, this study once again emphasizes that "better management of comorbid diseases and possibly increased emphasis on lifestyle — a better healthy diet and exercise —can achieve the greatest risk reduction."

The authors report having no relevant financial relationships.

JAMA. 2015;313:1973-1974.

    
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