Cardiovascular Morbidity and Mortality Associated With the Metabolic Syndrome
Article Figures & Tables
Tables
- Table 1 —
Clinical and metabolic characteristics in 35–70-year-old subjects with NGT, IFG/IGT, and diabetic (type 2) glucose tolerance
NGT IFG/IGT Type 2 diabetes n (F/M) 1,988 (1133/855) 798 (397/401) 1,697 (804/893) Age (years) 50.5 ± 9.7 53.5 ± 10.0 58.6 ± 8.5 BMI (kg/m2) 25.9 ± 3.7 27.3 ± 4.4 29.5 ± 4.9 WHR Men 0.95 ± 0.06 0.96 ± 0.06 0.99 ± 0.06 Women 0.83 ± 0.07 0.84 ± 0.08 0.90 ± 0.07 Fasting plasma glucose (mmol/l) 5.4 ± 0.5 6.1 ± 0.6 9.8 ± 3.3 HbA1c (%) 5.3 ± 0.6 5.4 ± 0.6 7.5 ± 1.8 Fasting insulin (mU/l)* 7.5 ± 4.5 10.4 ± 6.0 15.2 ± 11.2 HOMAIR* 1.80 ± 1.13 2.83 ± 1.69 6.58 ± 5.87 Cholesterol (mmol/l) 5.7 ± 1.1 5.8 ± 1.1 5.8 ± 1.1 HDL cholesterol (mmol/l) 1.38 ± 0.36 1.27 ± 0.32 1.15 ± 0.3 Triglycericdes (mmol/l) 1.29 ± 0.80 1.58 ± 0.86 2.08 ± 1.60 LDL cholesterol (mmol/l) 3.77 ± 1.00 3.88 ± 0.99 3.78 ± 0.97 Lipid-lowering medication 0.5 1.4 1.7 Antihypertensive treatment 15.5 21.9 46.3 Systolic blood pressure† 126.3 ± 16.2 132.8 ± 16.6 137.2 ± 17.0 Diastolic blood pressure† 77.9 ± 9.5 79.9 ± 9.5 80.5 ± 9.8 History of MI Men 3.2 7.1 13.4 Women 1.0 1.3 5.8 Previous stroke 1.3 2.3 5.2 Current smoking Men 23 17 16 Women 12 12 11 - Table 2 —
Prevalence of the metabolic syndrome and the different components of the metabolic syndrome* in male and female subjects of different age decades with NGT, abnormal IFG/IGT, and diabetic glucose tolerance
NGT IFG/IGT Type 2 diabetes† Male Female Male Female Male Female Metablic syndrome all 35–70 years 15 10 64 42 84 78 40–49 years 12 6 59 38 87 78 50–59 years 20 9 67 44 83 74 60–69 years 20‡ 19∥ 66 52‡ 84 81 Obesity all 35–70 years 76 36 86 51 92 78 40–49 years 76 34 87 49 95 80 50–59 years 81 32 86 56 93 79 60–69 years 80 44‡ 89 53 92 78 Dyslipidemia all 35–70 years 29 16 45 31 54 56 40–49 years 31 13 51 25 66 64 50–59 years 28 17 46 31 55 51 60–69 years 23 21‡ 39 37‡ 50§ 57 Hypertension all 35–70 years 23 24 31 35 55 59 40–49 years 20 17 19 31 42 47 50–59 years 27 29 41 34 55 53 60–69 years 35∥ 41∥ 39§ 47‡ 59§ 67∥ Microalbuminuria all 35–70 years 4 3 7 6 22 12 40–49 years 3 4 1 6 14 18 50–59 years 3 2 8 8 19 12 60–69 years 8 1 9‡ 9 26 11 Insulin resistance¶ all 35–70 years 25 25 58 59 87 89 40–49 years 23 19 53 52 87 89 50–59 years 28 24 65 57 87 89 60–69 years 29 35∥ 59 68‡ 86 90 Data are %.
- *
↵* The definition of the metabolic syndrome was based on the recent WHO proposal (17);
- †
↵† P < 0.001 for differences in all variables between subjects with diabetes and NGT/IFG/IGT when men and women aged 35–70 years were compared separately;
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↵‡ P < 0.05;
- §
↵§ P < 0.01;
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↵∥ P < 0.001 when age decade 60–69 was compared to age decade 40–49;
- ¶
¶ highest quartile of HOMAIR.
- Table 3 —
Prevalence of different combinations of the individual components of the metabolic syndrome* in 35–70-year-old male and female subjects with NGT, IFG/IGT, and diabetic glucose tolerance
NGT IFG/IGT Type 2 diabetes Male Female Male Female Male Female Obesity + dyslipidemia 25 9 41 21 51 49 Obesity + hypertension 20 11 28 23 50 50 Obesity + hypertension + dyslipidemia 7 3 15 10 29 31 Hypertension + dyslipidemia 8 5 16 14 31 36 Obesity + microalbuminuria 3 2 6 3 21 11 Hypertension + microabluminuria 2 2 3 3 16 10 Dyslipidemia + microabluminuria 1 1 4 2 14 9 - Table 4 —
Prevalence and RR of CHD*, MI, and stroke in relation to the presence of the metabolic syndrome†
Metabolic syndrome RR‡ P‡ Yes No NGT (n = 1,808) CHD 9.2 4.1 1.73 (1.01–2.95) 0.04 Previous MI 3.1 1.6 1.24 (0.52–2.97) 0.62 Previous stroke 2.2 1.6 1.31 (0.48–3.62) 0.59 IFG/IGT (n = 685) CHD 11.0 5.3 1.82 (0.98–3.38) 0.06 Previous MI 5.8 2.2 2.03 (0.81–5.08) 0.13 Previous stroke 3.6 0.9 3.64 (1.01–13.13) 0.05 Type 2 DM (n = 1,430) CHD 27.1 13.5 2.23 (1.52–3.26) <0.001 Previous MI 11.2 4.7 2.26 (1.25–4.10) 0.007 Previous stroke 5.7 2.9 1.79 (0.85–3.79) 0.13 All subjects (n = 3,928) CHD 21.4 5.5 2.96 (2.36–3.72) <0.001 Previous MI 9.0 2.1 2.63 (1.86–3.72) <0.001 Previous stroke 4.8 1.4 2.27 (1.47–3.50) <0.001 - Table 5 —
Multiple logistic regression analysis with CHD, previous MI, or stroke as dependent variables and the metabolic syndrome and its components as independent variables in subjects with complete data
Independent variables CHD (n = 2,401) MI (n = 2,404) Stroke (n = 2,395) RR P RR P RR P The metabolic syndrome* 2.96 <0.001 2.63 <0.001 2.27 <0.001 Obesity 1.44 0.07 1.31 0.43 1.26 0.59 Dyslipidemia 1.73 <0.001 1.71 0.01 1.30 0.40 Hypertension 1.57 0.002 1.31 0.22 1.34 0.34 Microalbuminuria 0.94 0.77 0.76 0.37 0.85 0.73 Insulin resistance† 1.53 0.01 2.02 0.009 1.39 0.36 - Table 6 —
Multiple logistic regression anaysis with CHD as a dependent variable and the presence of the metabolic syndrome* or its individual components as independent variables in subjects with complete data (n = 2,401)
NGT (n = 1,136) IFG/IGT (n = 488) Type 2 diabetes (n = 777) RR P RR P RR P The metabolic syndrome* 1.73 0.04 1.82 0.06 2.23 <0.001 Obesity 1.15 0.68 1.79 0.26 1.48 0.20 Dyslipidemia 1.68 0.13 1.34 0.41 1.84 0.001 Hypertension 2.33 <0.001 1.08 0.82 1.31 0.16 Microabluminuria 0.65 0.59 0.59 0.44 0.94 0.81 Insulin resistance† 1.13 0.71 2.18 0.06 0.76 0.34 - Table 7 —
Multiple logistic regression analysis with cardiovascular mortality as a dependent variable and the metabolic syndrome* or its components as independent variables
All subjects (209 deaths) Diabetic patients (168 deaths) RR (95% CI) P RR (95% CI) P The metabolic syndrome* 1.81 (1.24–2.65) 0.002 1.15 (0.68–1.94) 0.60 Obesity 1.10 (0.63–1.96) 0.76 0.87 (0.43–1.76) 0.70 Dyslipidemia 0.99 (0.63–1.58) 0.98 0.93 (0.54–1.61) 0.80 Hypertension 1.78 (1.09–2.91) 0.02 1.43 (0.76–2.68) 0.27 Microalbuminuria 2.80 (1.62–4.83) <0.001 3.17 (1.70–5.91) <0.001 Insulin resistance† 1.53 (0.88–2.64) 0.13 1.44 (0.56–3.71) 0.45
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