Components of the Metabolic Syndrome and Risk of Cardiovascular Disease and Diabetes in Beaver Dam

Abstract

OBJECTIVE—To determine whether components of the metabolic syndrome precede the 5-year incidence of cardiovascular disease and diabetes. RESEARCH DESIGN AND METHODS—A population of individuals aged 43–84 years was evaluated from 1988 to 1990 and again 5 years later. Medical history, blood pressure, and laboratory measures were obtained at both examinations following the same protocols. Subjects without diabetes were classified according to level of glycemia, high blood pressure, high-risk lipid levels, high uric acid levels, and proteinuria at baseline. History of incident myocardial infarction, angina, stroke, and diabetes was obtained at follow-up. RESULTS—Of the 4,423 subjects without diabetes, 6.9% had elevated levels of glycemia, 18.4% had high blood pressure, 82.7% had high-risk lipid levels (either high serum total cholesterol or low HDL cholesterol or high ratio of these two levels), 27% had elevated uric acid levels, 33.2% had high BMI, and 3.3% had proteinuria (≥30 mg/dl). The risk of incident cardiovascular disease 5 years later increased with the number of the components present; 2.5% of those with one component developed cardiovascular disease, whereas 14.9% of those with four or more components developed cardiovascular disease. Of those with one component, diabetes developed in 1.1% 5 years later, whereas diabetes developed in 17.9% of those with four or more components. CONCLUSIONS—Components of the metabolic syndrome are common and are associated with incident cardiovascular disease and diabetes after 5 years. Interventions to alter BMI, lipid levels, and blood pressure may decrease incident diabetes and cardiovascular disease.

Effect of metabolic syndrome or type II diabetes mellitus on the occurrence of recurrent vascular events in hypertensive patients

“…13 Presence of metabolic syndrome amplifies the risk of developing type II diabetes mellitus 3-to 30-fold, depending on the criteria used. [14][15][16][17][18] In populations free of cardiovascular disease at baseline, cardiovascular morbidity and mortality increased 1.5-to 3-fold in the presence of metabolic syndrome 10,[19][20][21] and two-to fourfold in the presence of type II diabetes. 22 In spite of the use of different and modified definitions, the metabolic syndrome is associated with more extensive vascular damage and increased risk for subsequent events in patients with prevalent cardiovascular disease.…”

Metabolic Syndrome Amplifies the LDL-Cholesterol Associated Increases in Carotid Atherosclerosis

“…Epidemiologic studies have shown that metabolic syndrome is quite common, affecting 13.3 24.4% of Japanese men > = 30 years of age (3,4), and that it is a predictor of adverse cardiovascular events (5)(6)(7)(8). Several other metabolic disorders have also been associated with this syndrome, including microalbuminuria, and abnormalities in fibrinolysis and coagulation (9,10).…”

Efficacy of a continuous metabolic syndrome score in Indian children for detecting subclinical atherosclerotic risk

“…15 Moreover, risk is a progressive function and cannot simply be assumed as present or absent, depending on whether thresholds are exceeded or not. The fact that cardiovascular risk is a progressive function of several MS risk factors, and that the risk increases with increasing numbers of MS risk factors, 14,16 holds importance in continuous metabolic scoring such that cMetS, which considers all the components irrespective of any two or three combinations, thus attenuates the identification of early risk, especially in children.…”