The Metabolic Syndrome and 11-Year Risk of Incident Cardiovascular Disease in the Atherosclerosis Risk in Communities Study

McNeill, Ann; Rosamond, Wayne D.; Girman, Cynthia J.; Golden, Sherita Hill; Schmidt, María Inês; East, Honey E.; Ballantyne, Christie M.; Heiss, Gerardo

doi:10.2337/diacare.28.2.385

Cited by 872 publications

(626 citation statements)

References 35 publications

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“…Initial studies adjusting for traditional cardiovascular risk factors suggested that the metabolic syndrome construct carries prognostic weight 7, 25, 26. More recent studies accounting for the actual components of the metabolic syndrome imply that the metabolic syndrome construct does not add explanatory power beyond that afforded by its components 27. The current analysis supports the latter notion with regard to sudden cardiac death.…”

Section: Discussionsupporting

confidence: 57%

The Metabolic Syndrome and Risk of Sudden Cardiac Death: The Atherosclerosis Risk in Communities Study

Hess

Al‐Khalidi

Friedman

et al. 2017

JAHA

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BackgroundPrior studies have demonstrated a link between the metabolic syndrome and increased risk of cardiovascular mortality. Whether the metabolic syndrome is associated with sudden cardiac death is uncertain.Methods and ResultsWe characterized the relationship between sudden cardiac death and metabolic syndrome status among participants of the ARIC (Atherosclerosis Risk in Communities) Study (1987–2012) free of prevalent coronary heart disease or heart failure. Among 13 168 participants, 357 (2.7%) sudden cardiac deaths occurred during a median follow‐up of 23.6 years. Participants with the metabolic syndrome (n=4444) had a higher cumulative incidence of sudden cardiac death than those without it (n=8724) (4.1% versus 2.3%, P<0.001). After adjustment for participant demographics and clinical factors other than components of the metabolic syndrome, the metabolic syndrome was independently associated with sudden cardiac death (hazard ratio, 1.70, 95% confidence interval, 1.37–2.12, P<0.001). This relationship was not modified by sex (interaction P=0.10) or race (interaction P=0.62) and was mediated by the metabolic syndrome criteria components. The risk of sudden cardiac death varied according to the number of metabolic syndrome components (hazard ratio 1.31 per additional component of the metabolic syndrome, 95% confidence interval, 1.19–1.44, P<0.001). Of the 5 components, elevated blood pressure, impaired fasting glucose, and low high‐density lipoprotein were independently associated with sudden cardiac death.ConclusionsWe observed that the metabolic syndrome was associated with a significantly increased risk of sudden cardiac death irrespective of sex or race. The risk of sudden cardiac death was proportional to the number of metabolic syndrome components.

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Section: Discussionsupporting

confidence: 57%

The Metabolic Syndrome and Risk of Sudden Cardiac Death: The Atherosclerosis Risk in Communities Study

Hess

Al‐Khalidi

Friedman

et al. 2017

JAHA

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“…Although justification by the same cutoff point during fasting is still under debate, the data of non-fasting triglycerides can be used because it is a significant predictor for ischemic heart disease. 33 Therefore, we assessed HbA 1c instead of fasting glucose, non-fasting triglycerides and HDL cholesterol and used a 'modified' MS definition rather than the standard definition. Third, we could not compare the adiponectin levels before and after medication in the present cross-sectional, observational study of chronic hemodialysis patients.…”

Section: Discussionmentioning

confidence: 99%

Potential impact of renin–angiotensin system inhibitors and calcium channel blockers on plasma high-molecular-weight adiponectin levels in hemodialysis patients

Nakagawa

Yao²,

Hirayama³

et al. 2011

Hypertens Res

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Although metabolic syndrome confers an increased risk of cardiovascular disease in the general population, little is known about the alteration of abdominal adiposity and its association with adipocytokines in hemodialysis patients. We investigated the plasma high-molecular-weight (HMW) adiponectin level and its relationship to visceral fat area (VFA) and various markers of atherosclerosis in hemodialysis patients. In a cross-sectional study, conventional cardiovascular risk factors, plasma total and HMW adiponectin, the number of components of the metabolic syndrome and, using computed tomography, the distribution of abdominal adiposity were assessed in 144 hemodialysis patients (90 men and 54 women; mean age, 60.7 years) and 30 age-and sex-matched patients with chronic kidney disease (CKD). Plasma HMW adiponectin levels in hemodialysis patients were significantly higher than those in patients with CKD, negatively associated with VFA and serum triglycerides and positively associated with plasma total adiponectin, as well as the HMW-to-total adiponectin ratio in men and women (all Po0.05) in a simple regression analysis. In a multiple regression analysis, VFA was a significant determinant of HMW adiponectin in hemodialysis patients. Furthermore, after adjustment for classical risk factors, HMW adiponectin levels were significantly higher in patients undergoing treatment with renin-angiotensin system inhibitors or calcium channel blockers compared with patients not undergoing such treatment. This study shows that plasma HMW adiponectin levels were negatively associated with VFA and positively associated with treatment with blockade of the renin-angiotensin system and of the calcium channel. Therefore, these drugs might be effective for improving adipocytokine-related metabolic abnormalities in hemodialysis patients.

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“…Low‐density lipoprotein was calculated using the Friedewald equation. Serum glucose was measured by the hexokinase‐6‐phosphate dehydrogenase method 26. Trained clinical staff measured waist circumference at the umbilical level to the nearest cm.…”

Section: Methodsmentioning

confidence: 99%

Assessing Baseline and Temporal Changes in Cardiometabolic Risk Using Metabolic Syndrome Severity and Common Risk Scores

Gurka

Filipp

Pearson

et al. 2018

JAHA

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BackgroundType 2 diabetes mellitus (T2DM) is considered a cardiovascular disease (CVD) risk equivalent, thereby linking assessment of cardiometabolic risk with that of CVD risk over time. Our goal was to determine how commonly used CVD risk scores and metabolic syndrome (MetS) severity performed in predicting T2DM with and without ultimate CVD.Methods and ResultsWe assessed data from 8273 participants of the ARIC (Atherosclerosis Risk in Communities) Study, using the pooled cohort atherosclerotic CVD risk score, the Framingham Risk Score, and a MetS severity Z score to assess their association with future risk for CVD alone, T2DM alone, or both over 20 years of follow‐up. Baseline levels of all scores were significantly associated with isolated incident T2DM (odds ratios [ORs] for each 1‐SD increase: atherosclerotic CVD=1.7, Framingham risk score=1.7, MetS Z score=5.1). All 3 baseline scores were also significantly associated with isolated incident CVD (atherosclerotic CVD OR=2.4, Framingham risk score OR=2.3, MetS Z‐score OR=1.8), with the 2 CVD scores remaining significant independent of MetS severity. MetS severity was strongly associated with future T2DM leading to CVD (MetS Z‐score OR=7.0, atherosclerotic CVD OR=3.9, Framingham risk score OR=3.5). Furthermore, changes in MetS severity were independently associated with future T2DM‐CVD progression.Conclusions CVD risk scores are associated with risk for future isolated T2DM in addition to isolated CVD. However, MetS severity (both baseline and changes over time) was more strongly associated with T2DM, including T2DM ultimately leading to CVD. Following MetS severity within patients over time may identify those at greatest risk of combined cardiometabolic disease.

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The Metabolic Syndrome and 11-Year Risk of Incident Cardiovascular Disease in the Atherosclerosis Risk in Communities Study

Cited by 872 publications

References 35 publications

The Metabolic Syndrome and Risk of Sudden Cardiac Death: The Atherosclerosis Risk in Communities Study

The Metabolic Syndrome and Risk of Sudden Cardiac Death: The Atherosclerosis Risk in Communities Study

Potential impact of renin–angiotensin system inhibitors and calcium channel blockers on plasma high-molecular-weight adiponectin levels in hemodialysis patients

Assessing Baseline and Temporal Changes in Cardiometabolic Risk Using Metabolic Syndrome Severity and Common Risk Scores

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