Metabolic Syndrome, Obesity, and Mortality

Abstract

OBJECTIVE -To determine in normal weight, overweight, and obese men the risk of allcause and cardiovascular disease (CVD) mortality associated with the metabolic syndrome (MetS) and the influence of cardiorespiratory fitness (CRF). RESEARCH DESIGN AND METHODS -This observational cohort study included 19,173 men who underwent a clinical examination, including a maximal exercise test. MetS was defined according to National Cholesterol Education Program guidelines.RESULTS -At baseline 19.5% of the men had MetS. The ORs of the metabolic syndrome at baseline were 4.7 (95% CI 4.2-5.3) in overweight and 30.6 (26.7-35.0) in obese men compared with normal weight men. A total of 477 deaths (160 CVD) occurred in 10.2 years of follow-up. The risks of all-cause mortality were 1.11 (0.75-1.17) in normal weight, 1.09 (0.82-1.47) in overweight, and 1.55 (1.14 -2.11) in obese men with MetS compared with normal weight healthy men. The corresponding risks for CVD mortality were 2.06 (0.92-4.63) in normal weight, 1.80 (1.10 -2.97) in overweight, and 2.83 (1.70 -4.72) in obese men with the MetS compared with normal weight healthy men. After the inclusion of CRF in the model, the risks associated with obesity and MetS were no longer significant.CONCLUSIONS -Obesity and MetS are associated with an increased risk of all-cause and CVD mortality; however; these risks were largely explained by CRF. Diabetes Care 28:391-397, 2005T he metabolic syndrome (MetS) is a constellation of hypertension, dyslipidemia, and diabetes risk factors that cluster within individuals. It is currently recommended that individuals with MetS be targeted for therapeutic lifestyle changes, which consist mainly of increases in physical activity and improvements in diet (1,2). The aggressive treatment of MetS is important because it is associated with an increased risk of type 2 diabetes (3,4), cardiovascular disease (CVD) (3,5), and premature mortality (5-7).It is commonly observed that the probability of having metabolic abnormalities, including MetS, increases with the level of obesity. For example, by comparison with normal weight men, the odds of having MetS ranged from 5.2 to 25.2 to 67.7 times across overweight, moderately obese, and severely obese men in the National Health and Nutrition Examination Survey III (NHANES III) (8). It is also known that the risk of having MetS is higher in those with lower levels of cardiorespiratory fitness (CRF) (9,10) and that overweight and obese individuals have lower levels of CRF than normal weight individuals (11,12). Further, recent studies have demonstrated that physically fit men and women, as compared with physically unfit men and women, have a lower amount of total and abdominal fat for a given BMI (13-15). Thus, CRF may play an important role in explaining the increased risk of morbidity and mortality associated with MetS across levels of body weight.To our knowledge no studies have examined differences in the risk of mortality due to MetS across normal weight, overweight, and obese categories. We have previously ...

Avaliação do programa de promoção da atividade física Academia da Cidade de Recife, Pernambuco, Brasil: percepções de usuários e não-usuários

“…A falta de atividades físicas regulares vem sendo considerada um fator de risco primário e independente para muitos agravos à saúde, particularmente as doenças cardiovasculares e metabólicas 2,3,4 . Apesar das evidências acumuladas sobre os benefícios da atividade física regular para a saúde, estudos têm indicado baixos ní-veis desse comportamento na população 5,6,7,8,9 .…”

Comparison of Usefulness of Body Mass Index Versus Metabolic Risk Factors in Predicting 10-Year Risk of Cardiovascular Events in Women

“…A clustering of related metabolic abnormalities including insulin resistance or diabetes, hypertension, and dyslipidemia, defined as the metabolic syndrome (MS), has been recognized as a major contributor to the development of CVD 3-5 and is also thought to be an underlying mechanism for the adverse consequences of adiposity 6 . Although there is a well-defined gradient relationship between the level of BMI and the probability of having MS 7,8 , most obese individuals do not have MS and, conversely, many individuals with the MS are not overweight or obese 6,7 . In this study we examined joint associations of BMI with individual MSassociated risk factors and the MS as an entity in relation to the incidence of CVD over 10 years of follow-up of a large cohort of initially healthy women.…”

Metabolically obese normal-weight subjects. Part two: prognosis and management

“…Dans une autre cohorte américaine de 7 505 sujets de poids normal, 4,7 % présentent un syndrome métabolique ; ce dernier confère un RR ajusté de mortalité cardiovasculaire de 1,60, non significatif cependant, en raison d'un nombre relativement faible d'événements [8].…”