代謝症候群盛行率穩定但仍影響約50%的年長者


  【24drs.com】根據最新的「全國健康與營養檢視調查(NHANES)」資料顯示,美國的代謝症候群盛行率在2003-2012年間看來是穩定的,不過,有三分之一的美國成人仍患有代謝症候群,60歲以上者幾乎有半數受到影響。
  
  最新的數據指出,代謝症候群的盛行率隨著年齡而增加:20-39歲者為18.3%、40-59歲者為33%、60歲以上者有46.7%患有代謝症候群。
  
  加州奧克蘭Alameda Health System-Highland Hospital的Maria Aguilar醫師等人在發表於5月19日美國醫學會期刊的研究通訊寫道,瞭解更新的盛行率趨勢或許是重要的,因為代謝症候群本身的潛在影響,以及它與美國年長人口的健康併發症有關,而這些結果被視為「相關的」。
  
  資深作者、Alameda Health System-Highland Hospital的Robert J Wong醫師表示,如果這趨勢繼續,對於我們的健康照護體系將會是巨大的公衛問題。
  
  因此,健康照護提供者必須更積極篩檢病患、以發現高血壓、高膽固醇、胰島素阻抗性,如果你可以治療和優化血壓、膽固醇、與[糖尿病前期]這些因素,或許不能消除[代謝症候群],但你可以大幅降低心臟病、糖尿病、與脂肪肝的風險。
  
  1999-2006年的NHANES資料顯示,美國的代謝症候群盛行率為34%,Aguilar醫師等人的目標是,使用更多最近的NHANES數據、確認這個盛行率是否沒變。
  
  他們將代謝症候群定義為有以下幾點的其中三點:腰圍男性大於102公分(40英吋)、女性大於88公分(34英吋);血清三酸甘油脂達150 mg/dL以上;高密度脂蛋白男性低於40 mg/dL、女性低於50 mg/dL;血壓130/85 mm Hg以上或者有服用高血壓藥物;空腹血漿葡萄糖值大於100 mg/dL或有服用第二型糖尿病藥物。
  
  Wong醫師指出,腰圍比身體質量指數更能測出身體的內臟脂肪。
  
  在2007-2008年與2011-2012年這兩段期間之間,代謝症候群的整體盛行率沒有顯著差異,分別是36.1%與34.7%,不過女性的盛行率顯著降低,從39.4%減少到36.6%。
  
  研究者指出,深入瞭解代謝症候群與它的健康後遺症,將有助於改善高血壓與糖尿病這些風險因素的最佳治療。
  
  他們觀察發現,再者,最近的NHANES資料顯示,美國的肥胖盛行率看起來也趨於穩定;或許代謝症候群的盛行率是因此而趨於穩定。
  
  Wong醫師指出,儘管如此,這篇研究發現,相當高比率的成年人受到代謝症候群影響(超過30%)。
  
  盛行率在種族方面也有所不同。在2003-2012年,西班牙裔的代謝症候群整體盛行率最高(35.4%),其次依序是:非西班牙裔白人(33.4%)與黑人(32.7%)。
  
  根據Wong醫師表示,這篇研究再度強調「更佳地控制共病症以及生活型態上更健康的飲食與運動,可以大幅降低風險。」
  
  資料來源: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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