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

Thomas, G. Neil; Phillips, Anna C.; Galé, Catharine R.; Batty, G. David

doi:10.1016/j.atherosclerosis.2009.10.045

Cited by 12 publications

(9 citation statements)

References 28 publications

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“…To the best of our knowledge, this is the first study to show that optimal levels of 25(OH)D substantially reduce the risk of all-cause and cardiovascular mortality in subjects with the metabolic syndrome, a population well-known to exhibit excess mortality (1–4). We observed a 75% and 69% reduction in all-cause and cardiovascular disease mortality, respectively, in those with optimal levels compared with those with severe 25(OH)D deficiency.…”

Section: Discussionmentioning

confidence: 87%

“…Metabolic syndrome in adults was defined using the consensus statement from the International Diabetes Federation Task Force on Epidemiology and Prevention; the National Heart, Lung, and Blood Institute; the American Heart Association; the World Heart Federation; the International Atherosclerosis Society; and the International Association for the Study of Obesity (21). Specifically, it was identified in those having 3 or more of the following (1): blood pressure ≥130/85 mmHg or receiving antihypertensive medication (2); fasting glucose ≥5.6 mmol/L or receiving drug treatment for diabetes (3); triglycerides ≥1.7 mmol/L or receiving specific drug treatment (4); HDL cholesterol <1.03 mmol/L in men or <1.30 mmol/L in women or receiving specific drug treatment (5); or waist circumference >102 cm in men or >88 cm in women (21). …”

Section: Methodsmentioning

confidence: 99%

“…The cluster of cardiovascular risk factors termed the metabolic syndrome is an important determinant of vascular disease (1–4), which is the major cause of morbidity and mortality worldwide. Available pharmacologic and lifestyle interventions have been shown to attenuate the hazard associated with the syndrome and its components (5,6).…”

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confidence: 99%

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Vitamin D Levels Predict All-Cause and Cardiovascular Disease Mortality in Subjects With the Metabolic Syndrome

et al. 2012

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OBJECTIVEOptimal vitamin D levels are associated with reduced cardiovascular and all-cause mortality. We investigated whether optimal 25-hydroxyvitamin D (25[OH]D) is protective in individuals with the metabolic syndrome.RESEARCH DESIGN AND METHODSThe Ludwigshafen Risk and Cardiovascular Health (LURIC) study is a cohort study of subjects referred for coronary angiography between 1997 and 2000, from which 1,801 with the metabolic syndrome were investigated. Mortality was tracked for a median of 7.7 years. Multivariable survival analysis was used to estimate the association between 25(OH)D levels and mortality.RESULTSMost subjects (92%) had suboptimal levels of 25(OH)D (<75 nmol/L), with 22.2% being severely deficient (<25 nmol/L). During follow-up, 462 deaths were recorded, 267 (57.8%) of which were cardiovascular in origin. After full adjustment, including the metabolic syndrome components, those with optimal 25(OH)D levels showed a substantial reduction in all-cause (hazard ratio [HR] 0.25 [95% CI 0.13–0.46]) and cardiovascular disease mortality (0.33 [0.16–0.66]) compared with those with severe vitamin D deficiency. For specific cardiovascular disease mortality, there was a strong reduction for sudden death (0.15 [0.04–0.63]) and congestive heart failure (0.24 [0.06–1.04]), but not for myocardial infarction. The reduction in mortality was dose-dependent for each of these causes.CONCLUSIONSOptimal 25(OH)D levels substantially lowered all-cause and cardiovascular disease mortality in subjects with the metabolic syndrome. These observations call for interventional studies that test whether vitamin D supplementation provides a useful adjunct in reducing mortality in these subjects.

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Section: Discussionmentioning

confidence: 87%

Section: Methodsmentioning

confidence: 99%

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Vitamin D Levels Predict All-Cause and Cardiovascular Disease Mortality in Subjects With the Metabolic Syndrome

et al. 2012

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“…In studies of adult persons, all‐cause mortality risk incrementally increases with the number of MetS components [35,36]. On the contrary, in studies of older person, both a dose–effect in both genders [13] and no association at all in either [17,20] were reported.…”

Section: Discussionmentioning

confidence: 99%

Metabolic syndrome and all‐cause mortality in older men and women

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Pirazzoli

Maltoni

et al. 2012

Eur J Clin Investigation

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“…etabolic abnormalities, whether assessed as metabolic syndrome (MetS) [1] or as their single components (central obesity, impaired glucose metabolism, hypertension, hypertriglyceridaemia and lower high-density lipoprotein cholesterol (cHDL)) have been shown to increase cardiovascular (CV) morbidity and mortality [2][3][4][5]. Central obesity seems to play a crucial role in the origin of metabolic disruption, but many other mechanisms have also been considered responsible [6].…”

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Obstructive sleep apnoea and metabolic impairment in severe obesity

et al. 2011

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Obstructive sleep apnoea (OSA) seems to worsen metabolism. This effect has not been evaluated in morbid obesity (MO). We hypothesised that the metabolic profile is more impaired in MO patients with OSA than in those without, and investigated whether any specific metabolic dysfunction is related to OSA in MO.A prospective multicentre cross-sectional study was conducted in consecutive subjects before bariatric surgery. OSA was defined as apnoea/hypopnoea index (AHI) o15 by overnight polysomnography. Anthropometrical, blood pressure (BP) and fasting blood measurements were obtained the morning after. Metabolic syndrome (MetS) was defined according to National Cholesterol Education Program Adult Treatment Panel III modified criteria.159 patients were studied: 72% were female and 72% had OSA. MetS prevalence was 70% in OSA versus 36% in non-OSA (p,0.001). As AHI severity increased, metabolic parameters progressively worsened, even in those without type 2 diabetes (DM2). AHI was independently associated with systolic and diastolic BP, triglycerides and the percentage of glycosylated haemoglobin (HbA1c) in the total sample, and with systolic BP, high-density lipoprotein cholesterol and HbA1c in those samples without DM2. OSA increased the adjusted odds ratio of having MetS by 2.8 (95% CI 1.3-6.2; p50.009).In MO, OSA is associated with major metabolic impairment caused by higher BP and poorer lipid and glucose control, independent of central obesity or DM2.

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

Cited by 12 publications

References 28 publications

Vitamin D Levels Predict All-Cause and Cardiovascular Disease Mortality in Subjects With the Metabolic Syndrome

Vitamin D Levels Predict All-Cause and Cardiovascular Disease Mortality in Subjects With the Metabolic Syndrome

Metabolic syndrome and all‐cause mortality in older men and women

Obstructive sleep apnoea and metabolic impairment in severe obesity

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