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纽约（路透社健康专栏）12月27日—据《糖尿病护理》杂志12月刊上一篇文章称，代谢综合征是糖尿病中微血管或大血管并发症的独立临床预测因素。该综合征可能参与血管并发症的病理过程。

意大利维罗纳Ospedale Civile Maggiore的Bonnadonna Riccardo博士（Metascreen书写委员会的负责人）对8497名患者中代谢综合征对血管并发症的作用进行分析。其中，有7859名2型糖尿病患者，638名1型糖尿病患者。该委员会根据两种不同的定义（一种为国际心肺血液研究所/美国心脏病协会（NHLBI/AHA）定义，另一种为国际糖尿病联合会（IDF）定义）对代谢综合征和血管并发症之间的关系进行分析。

NHLBI/AHA的代谢综合征定义的诊断标准为腹部肥胖、致动脉粥样硬化性血脂障碍、血压升高和血糖升高。IDF代谢综合征定义的诊断标准为腹部肥胖、诊断阈值降低以及更加模糊的心血管风险预测因素。研究人员报道，1型糖尿病中肾病和神经病变以及所有类型的心血管并发症（包括2型糖尿病中的视网膜病变）验证了“每一种代谢综合征定义均为独立统计学的预测因子”。

“该研究是横断面研究；因此，研究证据表明，代谢综合征仅仅是两种类型糖尿病伴发的特异或非特异性并发症的风险预测因子，” Riccardo博士对路透社健康专栏说道。“但是，从我们当前所掌握的信息看，所谓糖尿病患者中的“代谢综合征”的存在揭示了以后发生糖尿病并发症的高风险。代谢综合征的各种定义造成理解混乱以及“一定程度上需要精确定义” ，需要更进一步研究来重新定义代谢综合征，更强和更广泛的支持其临床适应症及利用其进行评估的可行性。

“该研究结果实际上有助于当前临床中普遍认可的”代谢综合征“定义。的确，该研究中不同分类的代谢综合征（是/不是），只要其构成部分能够引起糖尿病并发症的出现，均可认为是有效的,”意大利研究人员说。

Metabolic Syndrome Independently Predicts Vascular Complications in Diabetes

By Martha Kerr

NEW YORK (Reuters Health) Dec 27 - The metabolic syndrome is an independent clinical indicator of micro- or macrovascular complications in diabetes, according to a report in the December issue of Diabetes Care. The syndrome may even be involved in the pathogenesis of vascular complications.

The Metascreen Writing Committee, headed by Dr. Bonnadonna Riccardo of Ospedale Civile Maggiore in Verona, Italy, analyzed the effect of the metabolic syndrome on vascular complications in 8,497 patients. Of these, 7,859 had type 2 diabetes and 638 had type 1 diabetes.

The Committee analyzed the link according to two different definitions: that of the National Heart, Lung, and Blood Institute/American Heart Association (NHLBI/AHA) and definition accepted by the International Diabetes Federation (IDF).

The diagnostic criteria for the NHLBI/AHA definition are abdominal obesity, atherogenic dyslipidemia, elevated blood pressure and elevated blood glucose. The IDF definition consists of abdominal obesity, using a lower diagnostic threshold, and somewhat more ambiguous indicators of cardiovascular risk.

"Either definition of the metabolic syndrome was an independent statistical indicator" of nephropathy and neuropathy in type 1 diabetes and of all types of cardiovascular complications, including retinopathy, in type 2 diabetes, the investigators report.

"This study is cross-sectional; hence, it provides evidence that the metabolic syndrome is only a risk indicator of concomitant specific and non-specific complications in both types of diabetes," Dr. Riccardo told Reuters Health. "However, from all we know, the presence of the entity we call today 'metabolic syndrome' in a patient with diabetes conveys a higher risk of developing diabetic complications over time."

The various definitions of metabolic syndrome cause confusion and "are somewhat wanting," Dr. Riccardo said. "Further studies will be needed to refine them and to give stronger and wider support to their clinical applicability and use."

"The findings of the present study are actually in favor of the clinical usefulness of the 'metabolic syndrome' as currently defined. Indeed, in this study the dichotomous categorization metabolic syndrome yes/no is as effective as the component parts of the syndrome in marking the presence of diabetic complications," the Italian investigator said.

Diabetes Care 2006;29:2701-2707.

http://www.medscape.com/viewarticle/549957

编辑：蓝色幻想