Dynamic Changes of Metabolic Syndrome Alter the Risks of Cardiovascular Diseases and All-Cause Mortality: Evidence From a Prospective Cohort Study

Abstract

Background: Metabolic syndrome (MetS) at baseline increases the risks of cardiovascular diseases (CVD) and all-cause mortality. However, MetS status is changeable during follow-up. The associations of dynamic changes of MetS with CVD and all-cause mortality remain unclear.Methods: Thirty-one thousand four hundred eighty-one eligible subjects were included from the Kailuan cohort. Dynamic changes of MetS were divided into four patterns as MetS-free, MetS-developed, MetS-recovery and MetS-stable. The outcomes were CVD, all-cause mortality, and the subtypes of CVD as myocardial infarction (MI), stroke and heart failure. Multiple Cox regression models were used to calculate the adjusted hazard ratios (HRs) and confidence intervals (95% CIs).Results: Altered risks of CVD, the subtypes of CVD, and all-cause mortality were observed among different dynamic patterns of MetS. Compared with the MetS-free group, MetS-developed group increased the risks of CVD (HR = 1.78, 95% CI = 1.51–2.11), MI (HR = 1.54, 95% CI = 1.01–2.34), stroke (HR = 1.78, 95% CI = 1.45–2.18), and heart failure (HR = 1.63, 95% CI = 1.11–2.39). MetS-recovery group decreased these risks with the HRs of 0.59 (95% CI = 0.48–0.72) for CVD, 0.62 (95% CI = 0.41–0.96) for MI, 0.59 (95% CI = 0.46–0.75) for stroke, and 0.56 (95% CI = 0.34–0.91) for heart failure compared with the MetS-stable group. However, the increased risk in the MetS-developed group and the decreased risk in the MetS-recovery group were not significant for all-cause mortality. When stratified by the onset age of MetS status change, early development of MetS (<50 years) had higher risks of CVD (HR = 2.20, 95% CI = 1.58–3.05), MI (HR = 2.35, 95% CI = 1.00–5.50), stroke (HR = 2.05, 95% CI = 1.38–3.05), heart failure (HR = 2.63, 95% CI = 1.15–6.04), and all-cause mortality (HR = 1.61, 95% CI = 1.13–2.30) than late development (≥50 years). Early recovery of MetS had lower risks with the HRs of 0.38 (95% CI = 0.24–0.59) for CVD, 0.43 (95% CI = 0.18–1.06) for MI, 0.37 (95% CI = 0.21–0.64) for stroke, 0.30 (95% CI = 0.09–1.04) for heart failure, and 0.68 (95% CI = 0.43–1.06) for all-cause mortality than late recovery.Conclusion: Dynamic changes of MetS altered the risks of CVD and all-cause mortality, especially in individuals with an early onset age. These findings highlight the importance of dynamic changes of MetS and onset age on the prevention and control for CVD.

Correlation Analysis of Gut Microbiota and Serum Metabolome With Porphyromonas gingivalis-Induced Metabolic Disorders

“…With the global epidemic of obesity and diabetes, the incidence of metabolic disorders has skyrocketed, which will bring huge social and economic burdens ( Miranda et al., 2005 ). Metabolic syndrome (MetS), also known as insulin resistance syndrome, refers to a cluster of physical risk factors (including abdominal obesity; elevated triglycerides, fasting glucose, and blood pressure; and reduced high-density lipoprotein cholesterol) that are associated with increased risks of cardiovascular disease ( Broekhuizen et al, 2011 ; Zomer et al, 2014 ; Khalil et al, 2018 ), T2D ( Wannamethee et al., 2005 ; Rohm et al., 2022 ) and even mortality ( Kassi et al., 2011 ; He et al, 2021 ). Accumulating evidence has recognized MetS to be a systemic proinflammatory state with gut flora dysbiosis and adipose inflammation as putative pathogenic mechanisms.…”

Changes in Impaired Fasting Glucose and Borderline High Low-Density Lipoprotein-Cholesterol Status Alter the Risk of Cardiovascular Disease: A 9-Year Prospective Cohort Study

“…The development of IFG and borderline high LDL-C from normality was associated with non-significantly higher risks of CVD and its subtypes than long-term normal concentrations (HR: 1.26, 95% CI: 0.98-1.61), perhaps because of insufficient sample size, but implying that these abnormalities may cause significant harm. Similarly, He et al (45) found that differing patterns of changes in metabolic parameters were associated with different risks of CVD. The effects of particular risk factors on CVD depend on the intensity and duration of exposure (46), and because serum FBG and LDL-C concentrations tend to increase with age (47), the risk of CVD would be expected to be higher in individuals with IFG and borderline high LDL-C. We also found no increase in the risk of CVD in those participants who had at least one abnormality at baseline, but none subsequently (HR: 1.00, 95% CI: 0.82-1.20).…”

Prospective 5-year follow-up of patients with acute coronary syndrome and percutaneous coronary intervention

“…Швец и соавт., в котором наибольший вклад в риск летального исхода внесли инсульт в анамнезе и 3-я стадия ХБП наряду с возрастом, перенесённым ранее инфарктом миокарда и отсутствием ЧКВ [7]. Наши результаты подтвердили данные литературы о том, что сахарный диабет -фактор, увеличивающий смертность от сердечно-сосудистых заболеваний, несмотря на своевременную реваскуляризацию и оптимальную терапию [8]. Артериальную гипертензию регистрировали в 89% случаев, что соответствует средним показателям в других регистрах [1,5].…”