A Comparison Of Components of Two Definitions of the Metabolic Syndrome Related to Cardiovascular Disease and All-Cause Mortality in a Cohort Study in Thailand
- Supachai Tanomsup, MD1,
- Wichai Aekplakorn, MD, PHD1,
- Piyamitr Sritara, MD1,
- Mark Woodward, PHD2,
- Sukit Yamwong, MD1,
- Supoch Tunlayadechanont, MD1,
- Aninthita Tatsaneeyapan, MD3,
- Stephen Lim, PHD4 and
- Rajata Rajatanavin, MD1
- 1Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- 2Mount Sinai Medical Center, New York, New York
- 3Medical and Health Office, Electricity Generating Authority of Thailand, Bangkok, Thailand
- 4School of Population Health, University of Queensland, Brisbane, Australia
- Address correspondence and reprint requests to Wichai Aekplakorn, Community Medicine Center, Ramathibodi Hospital, Rama 6 Rd., Rajdevi, Bangkok 10400, Thailand. E-mail: rawap{at}mahidol.ac.th
- ATP, Adult Treatment Panel
- AUC, area under receiver-operating characteristics curve
- CVD, cardiovascular disease
- EGAT, Electricity Generating Authority of Thailand
- FPG, fasting plasma glucose
- IDF, International Diabetes Federation
- MI, myocardial infarction
The metabolic syndrome, a clustering of metabolic risk factors, has been reported to be associated with the risk of cardiovascular disease (CVD) (1). Questions have been raised about which components of the metabolic syndrome are more strongly associated with CVD (2), whether other combinations of the components have stronger associations (3), and the role of waist circumference in the definition of metabolic syndrome in Asian populations (4), where obesity is typically less common than in the West. We address these questions using data from the Electricity Generating Authority of Thailand (EGAT) Study.
RESEARCH DESIGN AND METHODS—
Details of the EGAT study have been reported elsewhere (5,6). Briefly, a total of 3,499 employees (2,702 men) aged 35–54 years were surveyed in 1985; blood samples were obtained after a 12-h overnight fast. The current analysis is limited to 2,545 men and 671 women with complete baseline data on metabolic and anthropometric measurements and for whom outcomes were available. No subjects had a history of myocardial infarction (MI) or stroke at entry.
According to the Adult Treatment Panel (ATP) III (7), the metabolic syndrome is present if an individual has three or more of the following: high triglycerides, low HDL cholesterol, high blood …
