Gender discrepancy in the predictive effect of metabolic syndrome and its components on newly onset cardiovascular disease in elderly from rural China

Abstract

Background To evaluate the possible predictive effect of metabolic syndrome (MetS) and its components on cardiovascular disease (CVD) in a longitudinal analysis according to different criteria of MetS among rural Chinese elderly. Method A population-based sample of 2486 rural elderly Chinese residents aged ≥ 60 years at baseline were followed up from 2012–2013 to 2015–2017. CVD included stroke, coronary heart disease (CHD) diagnosed by clinicians were self-reported and were confirmed by medical records. MetS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and the international Diabetes Federation (IDF) criterion respectively. Result Hazard ratio adjusting for CHD, Stroke and CVD in those with MetS using NCEP ATP III criteria in female were 1.27 (95%CI 0.73, 2.21), 1.54 (95%CI 0.99, 2.40) and 1.45 (95%CI 1.00, 2.10); 1.33 (95%CI 0.77, 2.32), 1.44 (95%CI 0.92, 2.25) and 1.36 (95%CI 0.94, 1.97) with the AHA/NHLBI criteria; and 1.10 (95%CI 0.89,1.36), 1.62 (95%CI 1.03, 2.55) and 1.36 (95%CI 0.93, 1.97) with IDF criteria. Besides, abdominal obesity using the AHA/NHLBI criteria was significantly associated with the incidence of stroke (HR: 1.60; 95%CI 1.01, 2.52). However, among rural male elderly, neither MetS nor its components were capable of predicting newly onset CVD. Conclusion MetS is significantly associated with high incidence of CVD among rural female elderly only, and the incidence of CVD was evident only when MetS was defined using NCEP ATP III criterion. In order to reduce CVD among elderly in rural China, effective strategies to prevent, diagnose, and treating MetS should be made in time, especially among female.