How well does the metabolic syndrome defined by five definitions predict incident diabetes and incident coronary heart disease in a Chinese population?

Wang, Jianjun; Li, Hongbing; Kinnunen, Leena; Hu, Gang; Järvinen, Tiina M.; Miettinen, Maija E.; Yuan, Shen-Yuan; Tuomilehto, Jaakko

doi:10.1016/j.atherosclerosis.2006.04.027

Cited by 53 publications

(54 citation statements)

References 30 publications

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“…One point of interest of the present analysis is that despite a shorter follow-up period than in other studies, the impact of metabolic syndrome on all-cause mortality was confirmed with similar intensity. Another point is that the results observed in the present study showed a higher risk of all-cause mortality with the NCEP 2001 definition compared with the other two definitions, confirming the results found by Katzmarzyk et al (9), Lawlor et al (7), and Wang et al (8).…”

Section: Discussionsupporting

confidence: 91%

“…Recently, a few studies have suggested that the IDF definition is similar to the NCEP definition for women aged Ͼ60 years with coronary heart disease (CHD) (7), is not associated with CHD mortality and morbidity in a Chinese population (8), or is similar to the NCEP and NCEP-R definitions for the impact on all-cause mortality (9) and for the impact on cardiovascular mortality in European men but not in women (10).…”

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confidence: 99%

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All-Cause Mortality Associated With Specific Combinations of the Metabolic Syndrome According to Recent Definitions

Guize

Thomas²,

Pannier³

et al. 2007

Diabetes Care

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OBJECTIVE -The aim was to evaluate the impact of specific component combinations of the metabolic syndrome on all-cause mortality risk in a large French cohort.RESEARCH DESIGN AND METHODS -The population was composed of 39,998 men (aged 52.6 Ϯ 8.3 years) and 20,756 women (aged 54.7 Ϯ 9.2 years) who were examined at the Investigations Préventives et Cliniques Center from 1999 to 2002. Mean follow-up was 3.57 Ϯ 1.12 years. Metabolic syndrome was defined according to three definitions: the National Cholesterol Educational Program (NCEP 2001), the revised NCEP (NCEP-R; American Heart Association/National Heart, Lung, and Blood Institute 2005), and the International Diabetes Federation (IDF 2005). Subjects with metabolic syndrome were compared with subjects without metabolic syndrome and with subjects with no metabolic syndrome components using Cox regression models.RESULTS -The prevalence of metabolic syndrome increased from 10.3% (NCEP) to 17.7% (NCEP-R) and 23.4% (IDF). After adjustment for age, sex, classical risk factors, and socioprofessional categories, and compared with subjects without metabolic syndrome, the risk of allcause mortality was 1.79 (95% CI 1.35-2.38), 1.46 (1.14 -1.88), and 1.32 (1.04 -1.67) with the NCEP, NCEP-R, and IDF definitions, respectively. Among the combinations significantly associated with all-cause mortality, the following three-component combinations and the fourcomponent combination were more highly significant than other combinations (P Ͻ 0.05): elevated waist circumference plus elevated glucose, plus either elevated blood pressure or elevated triglycerides, and the combination of all four of these.CONCLUSIONS -In a large middle-aged French population, four specific components of metabolic syndrome are associated with a much higher mortality risk. These results may have a significant impact on detecting high-risk subjects suffering from metabolic disorders and underline the fact that metabolic syndrome is a nonhomogeneous syndrome. Diabetes Care 30:2381-2387, 2007D escribed by Reaven in 1988 (1), the metabolic syndrome, defined as a constellation of several cardiometabolic risk factors, has been the focal point of a large number of studies that have attempted to elucidate the pathophysiological and epidemiological aspects of this syndrome.Recently, several expert groups have developed simple diagnostic criteria to be used in clinical practice to identify subjects with a metabolic syndrome profile (2). Until very recently, the principle definitions used to define metabolic syndrome were those established by the World Health Organization and the Third Report of the National Cholesterol Educational Program's Adult Treatment Panel (NCEP) (3). Because criteria included in the NCEP definition could easily be recorded, a large number of studies used this definition when examining different epidemiological aspects of the metabolic syndrome.New criteria for identifying subjects with metabolic syndrome were published in 2005 by the International Diabetes Federation (IDF) (4) and by the Amer...

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

All-Cause Mortality Associated With Specific Combinations of the Metabolic Syndrome According to Recent Definitions

Guize

Thomas²,

Pannier³

et al. 2007

Diabetes Care

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“…In this context, the present study adds data to the literature by comparing the performance of the most widely promoted definitions with and without concomitant insulin resistance. Prior data from MexicanAmerican, white, black, and Chinese samples suggest that ATP III and IDF metabolic syndrome definitions confer roughly equivalent risk for diabetes (9,10), an observation that we confirm in a large, unselected community-based white sample. We extend this observation to show that metabolic syndrome alone, but perhaps not the uncommon insulin resistance alone, increases risk for diabetes and that metabolic syndrome and insulin resistance have additive effects increasing diabetes risk.…”

Section: Discussionsupporting

confidence: 78%

“…There are few population-based data comparing how well the ATP III or IDF metabolic syndrome definitions identify subjects with insulin resistance (8) or comparing how well ATP III, IDF, or EGIR metabolic syndrome definitions predict subsequent risk for incident diabetes (9,10) or CVD (11)(12)(13). In addition, while it has been implied that the presence of the metabolic syndrome is a surrogate for the presence of insulin resistance, there are few data on diabetes or CVD risk associated with metabolic syndrome in the absence of insulin resis-tance or in the presence of both metabolic syndrome and insulin resistance.…”

Section: Diabetes Care 30:1219 -1225 2007mentioning

confidence: 99%

Impact of Insulin Resistance on Risk of Type 2 Diabetes and Cardiovascular Disease in People With Metabolic Syndrome

et al. 2007

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“…Our results show that the prevalence of each of the 10 possible combinations of three MetS risk factor components using the modATPIII MetS definition varies from 0 to 10.5%. It has been shown previously with all MetS definitions, that there is a variable association between the individual MetS components and outcomes such as incident coronary heart disease, incident diabetes, and cardiovascular diseases [15,16]. In addition there is accumulating evidence that certain combinations of risk factors are associated with greater cardiovascular risk than other combinations.…”

Section: Discussionmentioning

confidence: 99%

The metabolic syndrome identifies a heterogeneous group of metabolic component combinations in the Asia-Pacific region

Lee

Huxley

Woodward

et al. 2008

Diabetes Research and Clinical Practice

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How well does the metabolic syndrome defined by five definitions predict incident diabetes and incident coronary heart disease in a Chinese population?

Cited by 53 publications

References 30 publications

All-Cause Mortality Associated With Specific Combinations of the Metabolic Syndrome According to Recent Definitions

All-Cause Mortality Associated With Specific Combinations of the Metabolic Syndrome According to Recent Definitions

Impact of Insulin Resistance on Risk of Type 2 Diabetes and Cardiovascular Disease in People With Metabolic Syndrome

The metabolic syndrome identifies a heterogeneous group of metabolic component combinations in the Asia-Pacific region

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