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Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men.

Abstract

BACKGROUND

The purpose of this study was to investigate associations between combinations of body mass index (BMI) categories and metabolic syndrome (MetS) and the risk of cardiovascular disease and death in middle-aged men.

METHODS AND RESULTS

At age 50 years, cardiovascular risk factors were assessed in 1758 participants without diabetes in the community-based Uppsala Longitudinal Study of Adult Men (ULSAM). According to BMI-MetS status, they were categorized as normal weight (BMI <25 kg/m(2)) without MetS (National Cholesterol Education Program criteria; n=891), normal weight with MetS (n=64), overweight (BMI 25 to 30 kg/m(2)) without MetS (n=582), overweight with MetS (n=125), obese (BMI >30 kg/m(2)) without MetS (n=30), or obese with MetS (n=66). During follow-up (median 30 years), 788 participants died, and 681 developed cardiovascular disease (composite of cardiovascular death or hospitalization for myocardial infarction, stroke, or heart failure). In Cox proportional-hazards models that adjusted for age, smoking, and low-density lipoprotein cholesterol, an increased risk for cardiovascular disease was observed in normal-weight participants with MetS (hazard ratio 1.63, 95% confidence interval 1.11 to 2.37), overweight participants without MetS (hazard ratio 1.52, 95% confidence interval 1.28 to 1.80), overweight participants with MetS (hazard ratio 1.74, 95% confidence interval 1.32 to 2.30), obese participants without MetS (hazard ratio 1.95, 95% confidence interval 1.14 to 3.34), and obese participants with MetS (hazard ratio 2.55, 95% confidence interval 1.81 to 3.58) compared with normal-weight individuals without MetS. These BMI-MetS categories significantly predicted total mortality rate in a similar pattern.

CONCLUSIONS

Middle-aged men with MetS had increased risk for cardiovascular events and total death regardless of BMI status during more than 30 years of follow-up. In contrast to previous reports, overweight and obese individuals without MetS also had an increased risk. The present data refute the notion that overweight and obesity without MetS are benign conditions.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, SE-751 85 Uppsala, Sweden. johan.arnlov@pubcare.uu.se

    , ,

    Source

    Circulation 121:2 2010 Jan 19 pg 230-6

    MeSH

    Body Mass Index
    Cardiovascular Diseases
    Follow-Up Studies
    Humans
    Male
    Metabolic Syndrome
    Middle Aged
    Obesity
    Overweight
    Risk Factors
    Sweden

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    20038741

    Citation

    Arnlöv, Johan, et al. "Impact of Body Mass Index and the Metabolic Syndrome On the Risk of Cardiovascular Disease and Death in Middle-aged Men." Circulation, vol. 121, no. 2, 2010, pp. 230-6.
    Arnlöv J, Ingelsson E, Sundström J, et al. Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men. Circulation. 2010;121(2):230-6.
    Arnlöv, J., Ingelsson, E., Sundström, J., & Lind, L. (2010). Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men. Circulation, 121(2), pp. 230-6. doi:10.1161/CIRCULATIONAHA.109.887521.
    Arnlöv J, et al. Impact of Body Mass Index and the Metabolic Syndrome On the Risk of Cardiovascular Disease and Death in Middle-aged Men. Circulation. 2010 Jan 19;121(2):230-6. PubMed PMID: 20038741.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men. AU - Arnlöv,Johan, AU - Ingelsson,Erik, AU - Sundström,Johan, AU - Lind,Lars, Y1 - 2009/12/28/ PY - 2009/12/30/entrez PY - 2009/12/30/pubmed PY - 2010/3/20/medline SP - 230 EP - 6 JF - Circulation JO - Circulation VL - 121 IS - 2 N2 - BACKGROUND: The purpose of this study was to investigate associations between combinations of body mass index (BMI) categories and metabolic syndrome (MetS) and the risk of cardiovascular disease and death in middle-aged men. METHODS AND RESULTS: At age 50 years, cardiovascular risk factors were assessed in 1758 participants without diabetes in the community-based Uppsala Longitudinal Study of Adult Men (ULSAM). According to BMI-MetS status, they were categorized as normal weight (BMI <25 kg/m(2)) without MetS (National Cholesterol Education Program criteria; n=891), normal weight with MetS (n=64), overweight (BMI 25 to 30 kg/m(2)) without MetS (n=582), overweight with MetS (n=125), obese (BMI >30 kg/m(2)) without MetS (n=30), or obese with MetS (n=66). During follow-up (median 30 years), 788 participants died, and 681 developed cardiovascular disease (composite of cardiovascular death or hospitalization for myocardial infarction, stroke, or heart failure). In Cox proportional-hazards models that adjusted for age, smoking, and low-density lipoprotein cholesterol, an increased risk for cardiovascular disease was observed in normal-weight participants with MetS (hazard ratio 1.63, 95% confidence interval 1.11 to 2.37), overweight participants without MetS (hazard ratio 1.52, 95% confidence interval 1.28 to 1.80), overweight participants with MetS (hazard ratio 1.74, 95% confidence interval 1.32 to 2.30), obese participants without MetS (hazard ratio 1.95, 95% confidence interval 1.14 to 3.34), and obese participants with MetS (hazard ratio 2.55, 95% confidence interval 1.81 to 3.58) compared with normal-weight individuals without MetS. These BMI-MetS categories significantly predicted total mortality rate in a similar pattern. CONCLUSIONS: Middle-aged men with MetS had increased risk for cardiovascular events and total death regardless of BMI status during more than 30 years of follow-up. In contrast to previous reports, overweight and obese individuals without MetS also had an increased risk. The present data refute the notion that overweight and obesity without MetS are benign conditions. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/20038741/Impact_of_body_mass_index_and_the_metabolic_syndrome_on_the_risk_of_cardiovascular_disease_and_death_in_middle_aged_men_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.109.887521?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -