The metabolic syndrome (MS) is a constellation of risk factors associated with diabetes
and cardiovascular disease. This syndrome consists of at least 3 parameters assessing
central obesity, hypertension, high-density lipoprotein cholesterol, triglycerides,
and impaired glucose metabolism. Whether persons with 4 or 5 risk factors are at higher
risk than those with 3 risk factors is unclear. Also unclear is whether those without
the MS but with 1 or 2 risk factors warrant therapy. We assessed cardiovascular and
all-cause mortality as a function of the number of these risk factors. We followed
30,365 men for a median follow-up of 13.6 years. During follow-up, 1,449 participants
died, 527 from cardiovascular causes. All of the individual parameters defining the
MS were significantly associated with both all-cause and cardiovascular mortality
(p <0.001). After adjustment for age and the other MS variables, hypertension was
the most potent risk factor whereas central obesity and hypertriglyceridemia remained
associated with both all-cause and cardiovascular mortality. A highly significant
trend was also noted between both all-cause or cardiovascular mortality and the number
of risk factors (p <0.001 for trend). Risk increased incrementally, beginning at 1
risk factor for cardiovascular mortality and at 2 risk factors for all-cause mortality.
In conclusion, there is a continuum of risk as the number of metabolic syndrome risk
factors increases. These findings add to the growing evidence that central obesity
can independently and adversely affect health.
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Article info
Publication history
Published online: July 01, 2008
Accepted:
May 1,
2008
Received in revised form:
May 1,
2008
Received:
March 21,
2008
Footnotes
The development of the Aerobics Center Longitudinal Study database was partially supported by Grants AG06945 and HL62508 and by the Communities Foundation of Texas on recommendation of Nancy Ann and Ray L. Hunt.
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
