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标题：The Prevalence of Metabolic Syndrome Among US Women of Childbearing Age
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作者：Rosemarie G. Ramos ; Kenneth Olden
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2008
卷号：98
期号：6
页码：1122-1127
DOI：10.2105/AJPH.2007.120055
语种：English
出版社：American Public Health Association
摘要：Objectives. We sought to determine whether the prevalence of metabolic syndrome among US women of childbearing age (18–44 years) has increased since 1988 and to estimate its current prevalence by race/ethnicity and risk that a maternal history of select metabolic syndrome characteristics imposes on offspring. Methods. We used survey-specific data analysis methods to examine data from the National Health and Nutrition Examination Surveys conducted from 1988 to 2004. Results. The prevalence of the metabolic syndrome phenotype and 2 of its clinical correlates significantly increased between 1988 and 2004 (increase for metabolic syndrome phenotype=7.6%, for obesity=13.3%, and for elevated C-reactive protein=10.6%; P <.001 for all 3). Hispanic women were more likely than were White women to possess the phenotype ( P = .004). Women who reported that their mothers had been diagnosed with diabetes were more likely to possess the phenotype than those whose mothers had not been so diagnosed (odds ratio=1.9; 95% confidence interval=1.3, 2.8). Conclusions. The current trends of metabolic syndrome among women of childbearing age demonstrate the need for additional rigorous investigations regarding its long-term effects in these women and their offspring. The third report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults defined metabolic syndrome as the “clustering of metabolic and cardiovascular disease (CVD) risk factors that independently increase the risk of Type 2 diabetes and endpoints of CVD (e.g., stroke, congestive heart failure, death).” 1 Guidelines for diagnosis and management of the metabolic syndrome phenotype 2 have identified the following as clinical components of metabolic syndrome: abdominal obesity, atherogenic dyslipidemia, hypertension, impaired fasting glucose, and a pro-inflammatory state. The prevalence of metabolic syndrome among US adults is reported to be 23.7%, 3 with an additional 30% of obese adults at risk for developing it. 4 For some racial/ethnic subgroups, the prevalence of metabolic syndrome is higher than the national average (25.7% among Blacks and 35.6% among Hispanics). 5 ^– 7 The prevalence of metabolic syndrome is reported to be similar for males and females, 8 although higher morbidity among females from metabolic syndrome has been reported. 9 Studies examining the prevalence of metabolic syndrome and its clinical correlates among women of childbearing age as a separate group, however, are lacking, in spite of its obvious importance. It is known from previous studies that exposure to a nutrient-restrictive intrauterine environment appears to reprogram the metabolism of the developing fetus, resulting in an altered phenotype during childhood or adult life (e.g., obesity, insulin resistance, increased risk for CVD). 10 ^– 12 A number of studies have also established an association between individual metabolic pathologies (e.g., gestational diabetes) in the mother and pregnancy or birth outcomes. 5 ^, 13 Other studies have identified critical periods of in utero exposure to maternal metabolic pathologies (including intrauterine nutrition restriction) that increase the risk of impaired glucose metabolism in the offspring. 14 ^, 15 Less is known, however, about the effects of intrauterine exposure to the “cluster” of the components of metabolic syndrome, the critical periods of fetal exposure (i.e., first trimester vs third trimester), and whether the fetus’s exposure to some factors of metabolic syndrome is more harmful than its exposure to others. Thus, studies examining the prevalence of metabolic syndrome phenotype women during the childbearing years (particularly during the preconception period) are urgently needed. If an association exists between intrauterine exposure and chronic disease later in life, the impact of this emerging public health issue and its implication for health disparities has yet to be realized. We investigated the change in prevalence of metabolic syndrome and its clinical components among US women aged 18 to 44 years since 1988. We also examined how the current prevalence of metabolic syndrome among Black and Hispanic women compared with that of non-Hispanic White women in this age group. Finally, we sought to estimate the risk for metabolic syndrome conferred from maternal disease history, specifically diabetes and cardiovascular disease. To the best of our knowledge, our study is the first to examine metabolic syndrome among women of childbearing age as a separate group.