Background
The Metabolic Syndrome (MetS) predicts an increased risk of cardiovascular disease
and all-cause mortality. Is this prediction genuinely driven by the syndrome and independently
from its component variables?
Methods
A longitudinal cohort study in Dubbo, Australia of 2805 men and women ≥60 years followed
for 16 years from 1988. Cox proportional hazards models were calculated for coronary
heart disease (CHD), ischaemic stroke and all-cause mortality with MetS as an independent
variable. Separate models included the MetS variable, with or without the presence
of one of its five component variables.
Results
MetS was present in 33% of subjects. Obesity was present in 43% of those with MetS,
high blood pressure in 99%, elevated triglycerides in 83%, low HDL-C in 75% and glycaemia
in 48%. With respect to CHD and all-cause mortality, prediction by MetS was similar
in the presence or absence of individual component factors (e.g. hazard ratio (95%
CI) for CHD by MetS when low HDL-C present 1.60(1.39–1.84) and 1.67(1.37–2.04) when
low HDL-C absent). With stroke, prediction by MetS was lost in the absence of elevated
triglycerides or glycaemia factors (e.g. hazard ratio for stroke by MetS when glycaemia
present 1.59(1.24–2.05) and 1.08(0.82–1.42) when glycaemia absent).
Conclusions
The findings suggest that prediction of CHD and all-cause mortality is genuinely driven
by the MetS and independently of its component variables. Prediction of ischaemic
stroke is more complex, with some components providing prediction independently from
the MetS.
Keywords
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Article info
Publication history
Accepted:
December 18,
2010
Received in revised form:
December 17,
2010
Received:
August 30,
2010
Identification
Copyright
© 2011 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.
