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2019, vol. 25, br. 3-4, str. 58-69
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Učestalost i značaj metaboličkog sindroma i njegovih komponenata u ambulantnih pacijenata
Frequency and importance of metabolic syndrome and its components in outpatients
Sažetak
Uvod. Metabolički sindrom (MS) predstavlja grupu kardiovaskularnih faktora rizika koji uključuje hiperglikemiju, povišen krvni pritisak, povišene nivoe triglicerida, centralnu gojaznost i sniženi HDL holesterol. Rezultati populacionih studija pokazuju da je MS koristan u prognozi kardiovaskularnog morbiditeta i mortaliteta. Cilj rada. Ispitati učestalost i značaj metaboličkog sindroma i njegovih pojedinačnih komponenata u ambulantnih pacijenata. Metod. Studija je obuhvatila 178 (71,26±8,93) ambulantnih pacijenata odabranih metodom slučajnog uzorka, 67 (71,24±9,5) muškaraca i 111 (71,28±11,29) žena (p>0,05). Stanje uhranjenosti je ocenjeno na osnovu antropometrijskih parametara (telesna visina, telesna težina, obim struka). Kod svih ispitanika određivani su glikemija, HDL holesterol, trigliceridi i izmerene su vrednosti krvnog pritiska. Za postavljanje dijagnoze MS korišćeni su kriterijumi Američkog udruženja za srce (American Heart Association - AHA) i Nacionalnog instituta za srce, pluća i krv (National Heart, Lung and Blood Institute - NHLBI). Rezultati. Metabolički sindrom je dijagnostikovan kod 42,7% pacijenata, 31,6% muškaraca i 68,4% žena. Učestalost MS je bila veća kod žena (47,7%) u odnosu na muškarce (35,8%) (p>0,05); tri komponente MS imalo je 51,3%, četiri 42,1% i pet 6,6% ispitanika. Od pojedinačnih komponenata MS, najčešće je zastupljen povećan obim struka (92,1%). Sa koronarnom bolešću bilo je ukupno 10,5% pacijenata sa MS, a u grupi pacijenata bez MS 1,96% (p<0,01). U posmatranom periodu umrlo je 10,5% pacijenata sa MS i 0,98% bez MS (p<0,01). Zaključak. Učestalost metaboličkog sindroma u populaciji ambulantnih pacijenata je 42,7%, muškaraca 35,8% i žena 46,8%. Povećan obim struka je najčešća pojedinačna komponenta metaboličkog sindroma. Pacijenti sa metaboličkim sindromom imaju značajno veću učestalost koronarne bolesti i veći mortalitet nego pacijentini bez MS, što ukazuje da je MS značajan faktor rizika za nastanak i razvoj koronarne bolesti i lošiju prognozu ovih pacijenata, zbog čega moraju biti na odgovarajući način podvrgnut kontroli radi efikasne primarne i sekundarne prevencije.
Abstract
Introduction: Metabolic syndrome (MS) is a group of cardiovascular risk factors including hyperglycemia, elevated blood pressure, elevated triglycerides levels, central obesity, and low HDL cholesterol. Population studies results show MS to be useful in predicting cardiovascular morbidity and mortality. Objective: Examine the frequency and importance of metabolic syndrome and its components in outpatients. Methods: The study included 178 (71.26±8.93) outpatients, selected by random sample, 67 (71.24±9.5) men and 111 (71.28±11.29) women (p>0.05). Nutrition status was estimated based on anthropometric parameters (body height, body weight, waist circumference). Glycemia, HDL cholesterol, triglycerides, and blood pressure values were measured in all participants. The criteria of the American Heart Association (AHA/NHLBI) were used to diagnose MS. Results: MS was diagnosed in 42.7% of the patients, 31.6% of men and 68.4% of women. The incidence of MS was higher in women (47.7%) than men (35.8%) (p>0.05). In subjects with MS, three components were found in 51.3%, four components in 42.1% and five in 6.6%. Considering individual MS components, the increased waist circumference had the highest incidence of 92.1%. Among the patients with coronary heart disease (CHD), 10.2% had MS, and among those without MS only 1.96% (p<0.01). During the observation period, 10.5% of patients with MS died, compared to the group without MS, where 0.98% died (p<0.01). Conclusion: The incidence of the metabolic syndrome among the outpatients in our group was 42.7%, of whom 35.8% were men and 46.8% were women. Increased waist circumference was the most frequent individual MS component among the participants. Patients with metabolic syndrome have got a significantly higher incidence of coronary artery disease and mortality rates, compared to those without MS, which indicates MS is an important risk factor for the occurrence and development of the coronary heart disease. The patients with MS have got a worse medical prognosis and that's why they should have regular checkups, for the sake of primary and secondary prevention.
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