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Utility of the metabolic syndrome and its components in the prediction of incident cardiovascular disease: a prospective cohort study.
Eur J Cardiovasc Prev Rehabil. 2009 Apr; 16(2):235-41.EJ

Abstract

BACKGROUND

To investigate the prognostic importance of the metabolic syndrome (MetS) on incident cardiovascular disease (CVD).

DESIGN

Prospective cohort study.

METHODS

The study was based on 10-year follow-up of 3041 men and women aged 25-84 years without CVD or diabetes who participated in the 1994/1995 Busselton Health Survey. Hazards ratio (HRs) from Cox regression models were used to describe the effect of the MetS as a dichotomous classification and as the number of risk components on incident coronary heart disease (CHD), stroke and all CVD events.

RESULTS

All cardiovascular and metabolic risk factors studied showed a strong association with the number of MetS risk components. The age-adjusted and sex-adjusted HR for the MetS was 1.70 (95% confidence interval: 1.15-2.51) for incident CHD but this was reduced to almost unity after adjustment for cardiovascular risk factors or the homoeostasis model assessment measure of insulin resistance. However, the number of MetS risk components remained significant (P<0.01) with those having 3+ risk components with a three-fold increase in risk compared with those with no risk components (adjusted HR: 3.59, 95% confidence interval: 1.43-8.99).

CONCLUSION

Consideration of the number of MetS risk components seems to be more informative than the (dichotomous) MetS classification when determining risk in clinical practice. Identification of people without any MetS risk components is clinically valuable, as these people seem to have a substantially reduced risk of developing CHD.

Authors+Show Affiliations

School of Population Health, University of Western Australia, Nedlands, Western Australia, Australia. Matthew.Knuiman@uwa.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19238082

Citation

Knuiman, Matthew W., et al. "Utility of the Metabolic Syndrome and Its Components in the Prediction of Incident Cardiovascular Disease: a Prospective Cohort Study." European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups On Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology, vol. 16, no. 2, 2009, pp. 235-41.
Knuiman MW, Hung J, Divitini ML, et al. Utility of the metabolic syndrome and its components in the prediction of incident cardiovascular disease: a prospective cohort study. Eur J Cardiovasc Prev Rehabil. 2009;16(2):235-41.
Knuiman, M. W., Hung, J., Divitini, M. L., Davis, T. M., & Beilby, J. P. (2009). Utility of the metabolic syndrome and its components in the prediction of incident cardiovascular disease: a prospective cohort study. European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups On Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology, 16(2), 235-41. https://doi.org/10.1097/HJR.0b013e32832955fc
Knuiman MW, et al. Utility of the Metabolic Syndrome and Its Components in the Prediction of Incident Cardiovascular Disease: a Prospective Cohort Study. Eur J Cardiovasc Prev Rehabil. 2009;16(2):235-41. PubMed PMID: 19238082.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Utility of the metabolic syndrome and its components in the prediction of incident cardiovascular disease: a prospective cohort study. AU - Knuiman,Matthew W, AU - Hung,Joseph, AU - Divitini,Mark L, AU - Davis,Timothy M, AU - Beilby,John P, PY - 2009/2/25/entrez PY - 2009/2/25/pubmed PY - 2009/6/20/medline SP - 235 EP - 41 JF - European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology JO - Eur J Cardiovasc Prev Rehabil VL - 16 IS - 2 N2 - BACKGROUND: To investigate the prognostic importance of the metabolic syndrome (MetS) on incident cardiovascular disease (CVD). DESIGN: Prospective cohort study. METHODS: The study was based on 10-year follow-up of 3041 men and women aged 25-84 years without CVD or diabetes who participated in the 1994/1995 Busselton Health Survey. Hazards ratio (HRs) from Cox regression models were used to describe the effect of the MetS as a dichotomous classification and as the number of risk components on incident coronary heart disease (CHD), stroke and all CVD events. RESULTS: All cardiovascular and metabolic risk factors studied showed a strong association with the number of MetS risk components. The age-adjusted and sex-adjusted HR for the MetS was 1.70 (95% confidence interval: 1.15-2.51) for incident CHD but this was reduced to almost unity after adjustment for cardiovascular risk factors or the homoeostasis model assessment measure of insulin resistance. However, the number of MetS risk components remained significant (P<0.01) with those having 3+ risk components with a three-fold increase in risk compared with those with no risk components (adjusted HR: 3.59, 95% confidence interval: 1.43-8.99). CONCLUSION: Consideration of the number of MetS risk components seems to be more informative than the (dichotomous) MetS classification when determining risk in clinical practice. Identification of people without any MetS risk components is clinically valuable, as these people seem to have a substantially reduced risk of developing CHD. SN - 1741-8275 UR - https://www.unboundmedicine.com/medline/citation/19238082/Utility_of_the_metabolic_syndrome_and_its_components_in_the_prediction_of_incident_cardiovascular_disease:_a_prospective_cohort_study_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=19238082.ui DB - PRIME DP - Unbound Medicine ER -