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- Title
The Metabolic Syndrome and Total and Cardiovascular Disease Mortality in Middle-aged Men.
- Authors
Lakka, Hanna-Maaria; Laaksonen, David E.; Lakka, Timo A.; Niskanen, Leo K.; Kumpusalo, Esko; Tuomilehto, Jaakko; Salonen, Jukka T.
- Abstract
Context: The metabolic syndrome, a concurrence of disturbed glucose and insulin metabolism, overweight and abdominal fat distribution, mild dyslipidemia, and hypertension, is associated with subsequent development of type 2 diabetes mellitus and cardiovascular disease (CVD). Despite its high prevalence, little is known of the prospective association of the metabolic syndrome with cardiovascular and overall mortality. Objective: To assess the association of the metabolic syndrome with cardiovascular and overall mortality using recently proposed definitions and factor analysis. Design, Setting, and Participants: The Kuopio Ischaemic Heart Disease Risk Factor Study, a population-based, prospective cohort study of 1209 Finnish men aged 42 to 60 years at baseline (1984-1989) who were initially without CVD, cancer, or diabetes. Follow-up continued through December 1998. Main Outcome Measures: Death due to coronary heart disease (CHD), CVD, and any cause among men with vs without the metabolic syndrome, using 4 definitions based on the National Cholesterol Education Program (NCEP) and the World Health Organization (WHO). Results: The prevalence of the metabolic syndrome ranged from 8.8% to 14.3%, depending on the definition. There were 109 deaths during the approximately 11.4-year follow-up, of which 46 and 27 were due to CVD and CHD, respectively. Men with the metabolic syndrome as defined by the NCEP were 2.9 (95% confidence interval [CI], 1.2-7.2) to 4.2 (95% CI, 1.6-10.8) times more likely and, as defined by the WHO, 2.9 (95% CI, 1.2-6.8) to 3.3 (95% CI, 1.4-7.7) times more likely to die of CHD after adjustment for conventional cardiovascular risk factors. The metabolic syndrome as defined by the WHO was associated with 2.6 (95% CI, 1.4-5.1) to 3.0 (95% CI, 1.5-5.7) times higher CVD mortality and 1.9 (95% CI, 1.2-3.0) to 2.1 (95% CI, 1.3-3.3) times higher all-cause mortality. The NCEP definition less consistently predicted CVD and all-cause mortality. Factor...
- Subjects
METABOLIC disorders; TYPE 2 diabetes; CARDIOVASCULAR diseases; CORONARY disease; DISEASE risk factors; DIABETES; ENDOCRINE diseases; ISOPENTENOIDS
- Publication
JAMA: Journal of the American Medical Association, 2002, Vol 288, Issue 21, p2709
- ISSN
0098-7484
- Publication type
Article
- DOI
10.1001/jama.288.21.2709