ÖZET

Amaç:

Metabolik sendrom (MetS) varlığı diabetes mellitus (DM) ve aterosklerotik kardiyovasküler hastalık (ASKVH) oluşumunu tetikler. MetS gelişimi açısından yüksek risk altında olan bireylerin öngörülmesi önemlidir. Vasküler risk yaşı (VRA) kardiyovasküler riskin klinik bir göstergesidir. Bu çalışmada, VRA’nın MetS'nin bir göstergesi olup olmadığını tespit etmeyi amaçladık.

Yöntem:

Çalışmaya daha önce ASKVH ve DM tanısı olmayan 169 kişi (96 kadın, 73 erkek, yaşları 40-83) dahil edildi. ATP III-2005 ve IDF-2009 kriterleri aracılığıyla MetS tanısı koyuldu. SCORE2/SCORE2-OP 10 yıllık ölümcül KVH riski ve VRA tüm katılımcılar için hesaplandı.

Bulgular:

ATP III kriterlerine göre MetS sıklığı tüm popülasyonda %40,2, kadınlarda %39,6 ve erkeklerde %41,1 olarak saptanırken, IDF- 2009 kriterlerine göre tüm popülasyonda %47,9, kadınlarda %43,8 ve erkeklerde 53,4 olarak saptandı. VRA MetS saptanan bireylerde MetS saptanmayan bireylere göre anlamlı olarak yüksek saptandı (p<0,001). Ayrıca VRA ile tüm MetS komponentleri arasında ilişki saptandı (WC, r=0,194, p=0,011; SBP, r=0,434, p<0,001; BDP, r=0,262, p=0,001; total-C, r=0,223, p=0,003; yüksek yoğunluklu lipoprotein-C, r=-0,307, p<0,001; TG, r=0,324, p<0,001; ve FPG, r=0,196, p=0,011). Eğri altında kalan (AUC)-ROC analizinde VRA’nın MetS’nin güçlü bir öngörücüsü olduğu görüldü [AUC=0,658, %95 güven aralığı (CI)=0,576-0,740; for a cut-off of 54,0 yaş, Youden indeks=0,19, sensitivite=%75,0, and spesifik %45,0], and logistic regresyon (olasılık oranı: 1,086, p=0,041, %95, CI=1,003-1,175).

Sonuç:

VRA, MetS’ninn önemli ve bağımsız bir belirleyicisidir ve klinik amaçlarla düşünülebilir.

References

Groenewegen KA, den Ruijter HM, Pasterkamp G, Polak JF, Bots ML, Peters SA. Vascular age to determine cardiovascular disease risk: A systematic review of its concepts, definitions, and clinical applications. Eur J Prev Cardiol 2016;23(3):264-274.

Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009;120(16):1640-1645.

Ranasinghe P, Mathangasinghe Y, Jayawardena R, Hills AP, Misra A. Prevalence and trends of metabolic syndrome among adults in the asia-pacific region: a systematic review. BMC Public Health 2017;17(1):101.

Abacı A, Kılıçkap M, Göksülük H, Karaaslan D, Barçın C, Kayıkçıoğlu M, et al. Türkiye’de metabolik sendrom sıklığı verileri: Kardiyovasküler risk faktörlerine yönelik epidemiyolojik çalışmaların sistematik derleme, meta-analiz ve meta-regresyonu [Data on prevalence of metabolic syndrome in Turkey: Systematic review, meta-analysis and meta-regression of epidemiological studies on cardiovascular risk factors]. Turk Kardiyol Dern Ars 2018;46(7):591-601. Turkish.

Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med 2003;163(4):427-436.

das Merces MC, Santana AIC, Lua I, da Silva DAR, E Silva DS, Gomes AMT, et al. Metabolic Syndrome Among Primary Health Care Nursing Professionals: A Cross-Sectional Population-Based Study. Int J Environ Res Public Health 2019;16(15):2686.

Elguezabal-Rodelo R, Ochoa-Précoma R, Vazquez-Marroquin G, Porchia LM, Montes-Arana I, Torres-Rasgado E, et al. Metabolic age correlates better than chronological age with waist-to-height ratio, a cardiovascular risk index. Med Clin (Barc) 2021;157(9):409-417. English, Spanish.

D'Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 2008;117(6):743-753.

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112(17):2735-2752. Erratum in: Circulation 2005;112(17):e297. Erratum in: Circulation 2005;112(17):e298.

SCORE2 working group and ESC Cardiovascular risk collaboration. SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe. Eur Heart J 2021;42(25):2439-2454.

SCORE2-OP working group and ESC Cardiovascular risk collaboration. SCORE2-OP risk prediction algorithms: estimating incident cardiovascular event risk in older persons in four geographical risk regions. Eur Heart J 2021;42(25):2455-2467.

Stein JH, Fraizer MC, Aeschlimann SE, Nelson-Worel J, McBride PE, Douglas PS. Vascular age: integrating carotid intima-media thickness measurements with global coronary risk assessment. Clin Cardiol 2004;27(7):388-392.

Schisterman EF, Whitcomb BW. Coronary age as a risk factor in the modified Framingham risk score. BMC Med Imaging 2004;4(1):1.

Mini GK, Sarma PS, Thankappan KR. Overweight, the major determinant of metabolic syndrome among industrial workers in Kerala, India: Results of a cross-sectional study. Diabetes Metab Syndr 2019;13(5):3025-3030.

Kim TH, Kim DJ, Lim S, Jeong K, Son HS, Chung CH, et al. Prevalence of the metabolic syndrome in type 2 diabetic patients. Korean Diabetes J 2009;33(1):40-47.

Gouveia ÉR, Gouveia BR, Marques A, Peralta M, França C, Lima A, et al. Predictors of Metabolic Syndrome in Adults and Older Adults from Amazonas, Brazil. Int J Environ Res Public Health 2021;18(3):1303.

Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2010;122(25):e584-636.

Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012;33(13):1635-1701. Erratum in: Eur Heart J 2012;33(17):2126.

Kuk JL, Ardern CI. Age and sex differences in the clustering of metabolic syndrome factors: association with mortality risk. Diabetes Care 2010;33(11):2457-2461.

De Socio GV, Martinelli C, Ricci E, Orofino G, Valsecchi L, Vitiello P, et al. Relations between cardiovascular risk estimates and subclinical atherosclerosis in naive HIV patients: results from the HERMES study. Int J STD AIDS 2010;21(4):267-272.

Metabolik Sendromun Yeni Bir Klinik Belirleyicisi: Vasküler Risk Yaşı

ÖZET

References