Table_1_Impact of Metabolic Syndrome and It's Components on Prognosis in Patients With Cardiovascular Diseases: A Meta-Analysis.docx

Background: Patients with metabolic syndrome (MetS) have a higher risk of developing cardiovascular diseases (CVD). However, controversy exists about the impact of MetS on the prognosis of patients with CVD.
Methods: Pubmed, Cochrane library, and EMBASE databases were searched. Cohort Studies and randomized controlled trials post hoc analyses that evaluated the impact of MetS on prognosis in patients (≥18 years) with CVD were included. Relative risk (RR), hazard rate (HR) and 95% confidence intervals (CIs) were calculated for each individual study by random-effect model. Subgroup analysis and meta-regression analysis was performed to explore the heterogeneity.
Results: 55 studies with 16,2450 patients were included. Compared to patients without MetS, the MetS was associated with higher all-cause death [RR, 1.220, 95% CI (1.103 to 1.349), P, 0.000], CV death [RR, 1.360, 95% CI (1.152 to 1.606), P, 0.000], Myocardial Infarction [RR, 1.460, 95% CI (1.242 to 1.716), P, 0.000], stroke [RR, 1.435, 95% CI (1.131 to 1.820), P, 0.000]. Lower high-density lipoproteins (40/50) significantly increased the risk of all-cause death and CV death. Elevated fasting plasma glucose (FPG) (>100 mg/dl) was associated with an increased risk of all-cause death, while a higher body mass index (BMI>25 kg/m2) was related to a reduced risk of all-cause death.
Conclusions: MetS increased the risk of cardiovascular-related adverse events among patients with CVD. For MetS components, there was an increased risk in people with low HDL-C and FPG>100 mg/dl. Positive measures should be implemented timely for patients with CVD after the diagnosis of MetS, strengthen the prevention and treatment of hyperglycemia and hyperlipidemia.

研究背景：罹患代谢综合征（metabolic syndrome, MetS）的患者发生心血管疾病（cardiovascular diseases, CVD）的风险更高。然而，目前关于MetS对CVD患者预后的影响仍存在争议。
研究方法：检索PubMed、Cochrane图书馆及EMBASE数据库。纳入评估MetS对≥18岁CVD患者预后影响的队列研究（cohort studies）及随机对照试验（randomized controlled trials）的事后分析。采用随机效应模型对每项独立研究计算相对危险度（relative risk, RR）、风险率（hazard rate, HR）及95%置信区间（confidence intervals, CI）。通过亚组分析及Meta回归分析探讨研究间异质性。
研究结果：共纳入55项研究，涉及162450例患者。与未合并MetS的CVD患者相比，合并MetS者的全因死亡风险更高[相对危险度（RR）=1.220，95%置信区间（CI）：1.103~1.349，P=0.000]、心血管死亡风险更高[RR=1.360，95%CI：1.152~1.606，P=0.000]、心肌梗死（Myocardial Infarction）风险更高[RR=1.460，95%CI：1.242~1.716，P=0.000]、卒中（stroke）风险更高[RR=1.435，95%CI：1.131~1.820，P=0.000]。低高密度脂蛋白（high-density lipoproteins, 40/50）可显著升高全因死亡及心血管死亡风险。空腹血糖升高（fasting plasma glucose, FPG>100mg/dl）与全因死亡风险增加相关，而较高的体质量指数（body mass index, BMI>25kg/m²）则与全因死亡风险降低相关。
研究结论：MetS可升高CVD患者心血管相关不良事件的发生风险。针对MetS各组分而言，低高密度脂蛋白胆固醇（high-density lipoprotein cholesterol, HDL-C）及空腹血糖>100mg/dl的人群不良事件风险更高。对于确诊合并MetS的CVD患者，应及时采取积极干预措施，加强高血糖与高脂血症的防治工作。