Gender differences in changes in metabolic syndrome status and its components and risk of cardiovascular disease: a longitudinal cohort study

Abstract

Background We aimed to investigate the gender difference in the association between changes in metabolic syndrome (MetS) and its components with the risk of cardiovascular disease (CVD) and coronary heart disease (CHD) among adult participants in the Tehran lipid and glucose study cohort. Methods A total of 4624 adults (aged ≥ 30 years) who participated in two Phases 2 (2002–2005) and 3 (2005–2008) were included and followed up until 2018. Based on the status of MetS and its components in two phases, we divided participants into four groups: MetS-free, MetS-developed, MetS-recovery and MetS-stable groups, and similar categories were defined for MetS components. Multiple Cox regression models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs), and women-to-men ratios of HRs (RHRs). Results During a median follow-up of 11.6 years, 619 CVD events (292 women) and 512 CHD events (230 women) occurred. In both genders, the MetS-stable group had the highest risk of CVD and CHD, compared with the MetS-free group, but the associations were stronger in women than men: the HR (95% CI) were (2.76, 2.00-3.82) and (3.08, 2.15–4.40) for CVD and CHD, respectively, in women, and (1.60, 1.23–2.09) and (1.74, 1.30–2.31) for men. The multivariate adjusted women-to-men RHRs were (1.72, 1.16–2.56) for CVD and (1.77, 1.14–2.73) for CHD. Only among women, the risks for CVD in MetS-recovery group (1.67, 1.06–2.63) and MetS-developed group (1.89, 1.16–3.06|) were higher than MetS-free group. For CHD, women in MetS-developed group (1.86, 1.07–3.22) had higher risk than MetS-free group. However, no evidence of gender difference was observed in these associations. Among MetS components, persistent high blood pressure (BP) conferred greater risk for CVD and CHD in women than men; the women-to-men RHRs of CVD and CHD for high BP-stable groups were 1.54 (1.05–2.26) and 1.62 (1.07–2.47), respectively. For CHD events, persistent high fasting plasma glucose was associated with greater risk in women than men with women-to-men RHRs of 1.62 (1.09–2.40). Conclusion Change in MetS and its key components were associated with different risks for CVD events in both genders, with generally stronger associations in women than men.

Fat distribution measurements by chemical shift‐encoded transition region extraction predict the risk of hyperglycaemia, dyslipidaemia and metabolic syndrome in mice

“…The sex difference played a more important role in metabolic disorders. Several studies have identified that the incidence of MetS, obesity, diabetes and cardiovascular diseases is higher in males when comparing with females in humans 42–44 . Consistent with what is observed in humans, male mice are also prone to obesity and MetS 45 .…”

“…Several studies have identified that the incidence of MetS, obesity, diabetes and cardiovascular diseases is higher in males when comparing with females in humans. [42][43][44] Consistent with what is observed in humans, male mice are also prone to obesity and MetS. 45 Besides differences in lifestyle, such as smoking, the main determinant might be sex hormones.…”

Coronary Artery Disease Incidence, Risk Factors, Awareness, and Medication Utilization in a 10-Year Cohort Study

“…Among these countries, we had the highest prevalence of HTN with 29.5%, higher than Somalia with 26.4%.Additionally we had the lowest respective medication use with only 40.9%, lower than Pakistan with 52.9% [6]. As most patients believe that their medications are being used correctly [28], these statistics may be worse than they appear. Hypertension was associated with CAD in both sexes, but pre-hypertension was associated with CAD in women only.…”

Metabolic risk factors attributed burden in Iran at national and subnational levels, 1990 to 2019

“…It is worth mentioning that the diverse population of Iran comprises different ethnicities with distinct lifestyles and genetic backgrounds, which jointly might cause disparities in this country ( 4 , 5 , 12 , 13 ). Therefore, it would be of great importance to report and evaluate the burden of different diseases and risk factors in this country and compare results among its provinces to elucidate possible differences and inequalities and gain a clearer understanding of possible disparities.…”

“…Therefore, it would be of great importance to report and evaluate the burden of different diseases and risk factors in this country and compare results among its provinces to elucidate possible differences and inequalities and gain a clearer understanding of possible disparities. Recent publications have provided the evidence on burden of diseases and risk factor trends in Iran and its provinces showing various disparities in this regard ( 5 , 12 , 14 ); however, a closer look at the attributable burden to MRFs is essential to reveal the trends and disparities.…”