Metabolic syndrome: major impact on coronary risk in a population with low cholesterol levels—a prospective and cross-sectional evaluation

Onat, Altan; Ceyhan, Köksal; Başar, Ömer; Erer, Burak; Toprak, Sadık; Sansoy, Vedat

doi:10.1016/s0021-9150(02)00236-8

Cited by 278 publications

(173 citation statements)

References 25 publications

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“…Differences across studies may also be related to the underlying study populations, particularly gender distribution. Only a limited number of studies have included both men and women, enabling a direct comparison between the sexes [13,[25][26][27][28]. In agreement with our results, most of these studies found higher RRs associated with MetS in women than in men [13,[25][26][27].…”

Section: Discussionsupporting

confidence: 91%

Inflammation, the metabolic syndrome, and risk of coronary heart disease in women and men

Pischon

Rexrode

et al. 2008

Atherosclerosis

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Objective-This study examined whether inflammation adds to the prediction of coronary heart disease (CHD) beyond Metabolic Syndrome (MetS), and whether these associations differ between sexes.Methods and Results-Among 30,111 women from the Nurses' Health Study and 16,695 men from the Health Professionals Follow-up Study without prior cardiovascular disease, 249 women and 266 men developed nonfatal myocardial infarction or fatal CHD during 8 and 6 years of followup, respectively. Controls were selected 2:1 within each cohort matched on age, smoking, and date of blood draw. Subjects with MetS had a significantly increased relative risk (RR) of CHD compared to individuals without MetS, and this RR was significantly higher in women (3.01; 95%-CI 1.98-4.57) than in men (1.62; 95%-CI 1.13-2.33; p interaction = 0.03). Adjustment for most inflammatory markers did not substantially attenuate the risk estimates, although the association was no longer significant in men after adjustment for CRP. Vice versa, associations of inflammatory markers with CHD risk among women were no longer significant after further adjustment for MetS. Among men, CRP and sICAM remained significant predictors of CHD independent of MetS.Conclusions-MetS is a stronger predictor of CHD in women than in men. Most inflammatory markers did not add appreciable information beyond MetS to predict CHD; only CRP and sICAM remained independently predictive of CHD among men. The basis for these sex-based differences warrants further study.

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Section: Discussionsupporting

confidence: 91%

Inflammation, the metabolic syndrome, and risk of coronary heart disease in women and men

Pischon

Rexrode

et al. 2008

Atherosclerosis

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“…16,18,25 In a seminal study by Lemieux et al 14 (n ¼ 287 men), HTGW was predictive of angiographically assessed CAD with an odds ratio (OR) of 3.6 (1.2-10.9) compared to the low WC/ low TG group as reference. In another study by the same authors, the cross-sectional relationships of the HTGW phenotype with CAD were analyzed according to fasting glucose level.…”

Section: Discussionmentioning

confidence: 99%

“…In a crosssectional analysis in Turkish men, HTGW was also predictive of age-adjusted fatal and non-fatal CAD risk. 18 In a subsample of the Cross-Cultural Activity Participation Study (CAPS), a trend for higher 10-year Framingham risk score was observed among HTGW women, compared to those classified as non-HTGW. 26 However, the Framingham risk score may not always capture the risk associated with an atherogenic profile if subjects with HTGW do not have deleterious traditional risk factor levels.…”

Section: Discussionmentioning

confidence: 99%

“…14,16 Similar findings were reported in a few other cross-sectional studies. 17,18 Evidence of the relationship between HTGW with CVD risk in prospective studies is scarce. To our knowledge, there is only one recent study that found, in postmenopausal women followed up for 8.5 years, that HTGW was associated with a 4.7-fold increased risk for fatal CVD events.…”

Section: Introductionmentioning

confidence: 99%

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Hypertriglyceridemic waist and 7.5-year prospective risk of cardiovascular disease in asymptomatic middle-aged men

et al. 2006

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Background: Few studies suggest that the combined increase in plasma triglycerides (TG) and in waist circumference (WC), termed 'hypertriglyceridemic waist' (HTGW), is an interesting marker of risk for cardiovascular disease (CVD). Objective: Using cutoffs used for defining HTGW, we examined the prospective association of HTGW with CVD risk in a French cohort of men. Design: Men were participants in the SU.VI.MAX study, an intervention trial testing the impact of an antioxidant supplementation on chronic diseases. Data were collected in 1994-1996 in 3430 men followed up for 7.5 years. Cutoffs used for defining HTGW were WC X90 cm and TG X2 mmol/l. We assessed the relative risk (RR) (95% confidence interval (CI)) of CVD in groups defined according to both WC and TG levels. Results: In this population, 41.2% of the subjects were classified as low WC/low TG, 43.2% as high WC/low TG, 3.5% as low WC/high TG and 12.1% as HTGW. During follow-up, 122 subjects had a CVD event. In this group, HTGW prevalence was 26.2%. After adjustment for age, RR (95% CI) for CVD for the HTGW group showed the highest association with CVD risk: 2.13 (1.21-3.76), using low WC/ low TG as the reference group. Conclusion: HTGW was associated with the risk of CVD after 7.5 years of follow-up in a low-risk middle-aged men population. This marker may be used as a useful clinical tool to screen for men at risk of CVD.

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“…[1][2][3][4][5][6] Cardiovascular mortality was reported to be markedly increased in subjects with the MS, 7,8 and a measurement of CRP adds an important prognostic information to the syndrome. 9 In addition to the increased vascular events among subjects with the MS, nonalcoholic fatty liver disease (NAFLD), an additional feature of the MS with specific hepatic insulin resistance, 10 has become the second or third commonest liver disease.…”

Section: Introductionmentioning

confidence: 99%

Metabolic syndrome and ALT: a community study in adult Koreans

Nam

et al. 2004

Int J Obes

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OBJECTIVE:To investigate an association between the metabolic syndrome (MS) and alanine aminotransferase (ALT) of normal ranges. DESIGN: A population-based cross-sectional survey in three rural communities, South Korea. SUBJECTS: A total of 1248 men and 2157 women aged 30 y and older. MEASUREMENTS: Body mass index (BMI), waist circumference, fasting blood lipid and glucose, resting blood pressure, and ALT. RESULTS: ALT and BMI increased with an addition of the MS components. A consistent association between ALT more than 15 IU/l and the MS was found in both sexes, independently of age, education, BMI, smoking, alcohol drinking, and sedentary life style. The odds ratios for the MS in the highest quintiles of ALT were 7.1-fold higher than the reference quintile in men and 2.1-fold higher in women. The likelihood ratio tests for trend were also significant with ALT increments (Po0.001 for trend). CONCLUSION: The MS is significantly associated with the higher quintiles of normal ALT in both genders. ALT could be a sensitive marker of hepatic dysfunction associated with the MS, even in the range below the current limit.

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Metabolic syndrome: major impact on coronary risk in a population with low cholesterol levels—a prospective and cross-sectional evaluation

Cited by 278 publications

References 25 publications

Inflammation, the metabolic syndrome, and risk of coronary heart disease in women and men

Inflammation, the metabolic syndrome, and risk of coronary heart disease in women and men

Hypertriglyceridemic waist and 7.5-year prospective risk of cardiovascular disease in asymptomatic middle-aged men

Metabolic syndrome and ALT: a community study in adult Koreans

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