Relation of the Number of Metabolic Syndrome Risk Factors With All-Cause and Cardiovascular Mortality

Ho, John S.; Cannaday, John J.; Barlow, Carolyn E.; Mitchell, Tedd L.; Cooper, Kenneth H.; FitzGerald, Shannon J.

doi:10.1016/j.amjcard.2008.05.010

Cited by 84 publications

(64 citation statements)

References 12 publications

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“…Individual metabolic components, defined as an endpoint in our study, are important predictors for diabetes and future cardiovascular events. 30 --33 Previous studies have shown that having even one metabolic component is a risk factor for cardiovascular mortality, 34,35 with each additional component increasing this risk incrementally. 35 In the present study, obesity was positively correlated with a higher incidence of metabolic abnormalities in MHO individuals over time compared with MHNW subjects.…”

Section: Discussionmentioning

confidence: 99%

“…30 --33 Previous studies have shown that having even one metabolic component is a risk factor for cardiovascular mortality, 34,35 with each additional component increasing this risk incrementally. 35 In the present study, obesity was positively correlated with a higher incidence of metabolic abnormalities in MHO individuals over time compared with MHNW subjects. This suggests that over time, many of MHO individuals undergo adverse metabolic changes associated with obesity.…”

Section: Discussionmentioning

confidence: 99%

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Impact of BMI on the incidence of metabolic abnormalities in metabolically healthy men

et al. 2011

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OBJECTIVES: Although the existence of metabolically healthy obese (MHO) individuals has been recognized, little is known regarding metabolic health status in these subjects over time. Thus, we evaluated longitudinal changes in metabolic parameters among MHO subjects compared with metabolically healthy, normal-weight (MHNW) subjects. METHODS: A cohort study was performed on 2599 Korean men, 30 --59 years of age, with no evidence of fatty liver disease on ultrasound and no traits of metabolic syndrome at baseline. BMI was categorized based on criteria for Asian population. Study participants were followed annually or biennially between 2002 and 2009. At each visit, the fatty liver on ultrasound was assessed and metabolic abnormalities were measured. Parametric Cox models and a pooled logistic regression models were used to evaluate the relationships of BMI with incident metabolic abnormalities. RESULTS: During 9647.1 person-years of follow-up, 1673 participants developed metabolic abnormalities. After adjusting for age, smoking, alcohol intake and exercise, higher baseline BMI categories predicted increased incidences of metabolic abnormalities in a dose-response manner. The hazard ratios (95% confidence intervals) for hypertriglyceridemia, prediabetes, pre-hypertension, low high-density lipoprotein-cholesterol, fatty liver, elevated high sensitivity-C reactive protein, elevated homeostasis model assessment of insulin resistance, any metabolic abnormality and metabolic syndrome among the MHO subjects compared with the MHNW subjects were 1.51 (1. Keywords: body mass index; risk factors; insulin resistance; metabolic syndrome X; follow-up studies INTRODUCTIONObesity is a risk factor for cardiometabolic disorders such as type 2 diabetes mellitus and cardiovascular disease. 1,2 However, the incidence of obesity-related metabolic disturbances varies widely among obese individuals. 3,4 A unique subset of obese individuals that appears to be protected from obesity-related metabolic abnormalities has been identified. 3,5 These individuals, referred to as metabolically healthy but obese (MHO), are relatively insulin sensitive and have a favorable cardiovascular risk profile despite excessive body fat. 6 Previous studies indicate that MHO individuals, regardless of body mass index, are not at increased risk for cardiovascular diseases compared with normal-weight subjects without insulin resistance. 7,8 Therefore, weight loss may not be deemed necessary among these individuals.Recent longitudinal studies have observed that obese men without metabolic syndrome were at an increased risk for cardiovascular events or death compared with normal-weight individuals without metabolic syndrome. 9,10 Other studies observed that the MHO subset had an intermediate cardiovascular risk between healthy non-obese subjects and insulin resistant subjects. 11,12 Furthermore, recent intervention studies showed that lifestyle-induced weight loss among MHO individuals was associated with improved insulin sensitivity. 13,14

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of BMI on the incidence of metabolic abnormalities in metabolically healthy men

et al. 2011

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“…In the current study, as the number of metabolic syndrome components deaths also found incremental risk commencing from one risk factor for cardiovascular disease mortality and two components for all-cause mortality consistent with our findings. 2 These data show a continuum of risk, as seen with the individual components, rather than there being a threshold effect occurring at the level used to define the metabolic syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…As such, our results are consistent with the vast bulk of previous studies. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] The main outcomes were not attenuated following adjustment for a wide-range of potential confounders. The metabolic syndrome proved to be a stronger predictor of all-cause mortality than its individual components, a result for which there is precedent.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] Most studies have focussed on whether the presence of the metabolic syndrome increases all-cause or cardiovascular disease mortality and often do not appear to exclude existing cardiovascular disease, 15 a major determinant of subsequent events. 16 Additionally, the utility of using three or more components to identify the condition, given that a significant proportion of the non-affected population may have up to two risk factors, has yet to be determined, as has the advantage of using the metabolic syndrome over its individual components.…”

Section: Introductionmentioning

confidence: 99%

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The metabolic syndrome adds utility to the prediction of mortality over its components: The Vietnam Experience Study

et al. 2010

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Impact of Obesity During Adulthood on Chronic Disease: Diabetes, Hypertension, Metabolic Syndrome, Cardiovascular Disease, and Cancer

Albu

2012

Textbook of Obesity

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Relation of the Number of Metabolic Syndrome Risk Factors With All-Cause and Cardiovascular Mortality

Cited by 84 publications

References 12 publications

Impact of BMI on the incidence of metabolic abnormalities in metabolically healthy men

Impact of BMI on the incidence of metabolic abnormalities in metabolically healthy men

The metabolic syndrome adds utility to the prediction of mortality over its components: The Vietnam Experience Study

Impact of Obesity During Adulthood on Chronic Disease: Diabetes, Hypertension, Metabolic Syndrome, Cardiovascular Disease, and Cancer

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