代谢综合征（MetS）是一种常见的代谢紊乱疾病，其由肥胖的日益普遍成为一个近年来日益关注的现象所致。以前的证据表明，代谢综合征与死亡率相关；然而，使用了不同的代谢综合征定义。2005年，美国国家胆固醇教育计划（NCEP）成人治疗小组（ATP） III更新了代谢综合征的定义，此后被广泛采用。因此，有必要使用更新后的代谢综合征定义和死亡代码在其他人群和国家进行一项新的研究，该研究样本量更大，以检验代谢综合征与全因死亡和特定原因死亡的关联。我们的目标是研究代谢综合征与全因死亡和特定原因死亡的关联。本研究纳入了来自美国第三次全国健康与营养调查（NHANES）III（1988-1994年）和连续的NHANES（1999-2014年）的36,414名成人的数据。通过于2015年12月31日与国家死亡指数记录的关联确定了死亡结果。根据NCEP ATP III-2005标准定义了代谢综合征。包括样本权重、聚类和分层在内的复杂调查设计因素在所有分析中均予以考虑，并按照使用NHANES数据的指导进行。使用Cox比例风险模型估计了由于各种原因导致的死亡的危险比（HR）和95%的可信区间（CI）。我们在16.71年的随访中观察到8494例死亡。与无代谢综合征者相比，代谢综合征的个体与全因死亡、心脏病和糖尿病的多重调整危险比分别为1.24（95% CI 1.16-1.33）、1.44（95% CI 1.25-1.66）和5.15（95% CI 3.15-8.43），而对于癌症死亡未发现明显关联（HR 1.17，95% CI 0.95-1.43）。我们的研究为代谢综合征及其组分与全因死亡、心脏病和糖尿病死亡之间具有显著关联提供了额外证据，但与癌症死亡无明显关联。医务人员应更加关注代谢综合征及其各个组分。©Wenzhen Li, Dajie Chen, Ying Peng, Zuxun Lu, Mei-Po Kwan, Lap Ah Tse. 最初发表于《JMIR公共卫生与监测》（https://publichealth.jmir.org），2023年9月5日。

Metabolic syndrome (MetS) is a common metabolic disorder that results from the increasing prevalence of obesity, which has been an increasing concern in recent years. Previous evidence indicated that MetS was associated with mortality; however, different definitions of MetS were used. In 2005, the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III updated the definition of MetS, which has since been widely adopted. Therefore, it is necessary to conduct a novel study among other populations and countries with a larger sample size using the updated definition of MetS and death code to examine the association of MetS with all-cause and cause-specific mortality.We aimed to examine the associations of MetS with all-cause and cause-specific mortality.A total of 36,414 adults were included in this study, using data from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and the continuous NHANES (1999-2014) in the United States. Death outcomes were ascertained by linkage to National Death Index records through December 31, 2015. MetS was defined by the NCEP ATP III-2005 criterion. Complex survey design factors including sample weights, clustering, and stratification were considered for all analyses with instructions for using NHANES data. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for mortality from all causes, heart disease, diabetes, and cancer.We observed 8494 deaths during the 16.71 years of follow-up. Compared with those without MetS, individuals with MetS were associated with a significantly elevated multiadjusted HR of 1.24 (95% CI 1.16-1.33), 1.44 (95% CI 1.25-1.66), and 5.15 (95% CI 3.15-8.43) for all cause, heart diseases, and diabetes mellitus, respectively, whereas no significant association was found for cancer mortality (HR 1.17, 95% CI 0.95-1.43).Our study provides additional evidence that MetS and its components are significantly associated with all-cause, heart disease, and diabetes mortality, but not with cancer mortality. Health care professionals should pay more attention to MetS and its individual component.©Wenzhen Li, Dajie Chen, Ying Peng, Zuxun Lu, Mei-Po Kwan, Lap Ah Tse. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 05.09.2023.