Cardiovascular risk factors are really linked in the metabolic syndrome: this phenomenon suggests clustering rather
Yoshifusa Aizawa1, Norihito Kamimura, Hiroshi Watanabe
1Niigata University Graduate School of Medical and Dental Science Division of Cardiology, Japan. aizaways@med.niigata-u.ac.jp
Insights
Cardiovascular risk factors, including obesity and insulin resistance, cluster together more often than chance would predict. This suggests a non-coincidental link in metabolic syndrome development within the general population.
Area of Science:
- Cardiology
- Metabolic Health
- Public Health
Background:
- Cardiovascular risk factors can coexist in individuals.
- The frequency of co-occurrence may exceed random chance.
Purpose of the Study:
- To determine if combinations of cardiovascular risk factors occur more frequently than expected by coincidence.
- To investigate the clustering patterns of metabolic syndrome components.
Main Methods:
- Analysis of clinical and biochemical data from 119,412 adults aged 40+ undergoing annual health examinations.
- Determined the prevalence of 3 or more metabolic syndrome factors (obesity, hypertension, high triglycerides, low HDL cholesterol, abnormal glucose metabolism).
- Predicted the prevalence of factor combinations assuming coincidental occurrence.
Main Results:
- Metabolic syndrome (≥3 risk factors) was present in 14.9% of participants.
- The actual prevalence of combined risk factors was significantly higher than predicted by coincidence (P < 0.001).
- Obesity and insulin resistance showed stronger clustering within metabolic syndrome compared to hypertension and high triglycerides.
Conclusions:
- Combinations of metabolic syndrome risk factors occur more frequently than by chance in the general population.
- These findings support the concept of risk factor clustering in metabolic syndrome.
- Obesity and insulin resistance appear more closely linked to metabolic syndrome than hypertension or high triglycerides.
Background:
The accumulation of cardiovascular risk factors can be seen in a single person but it needs to be determined if this occurs more frequently than might be explained by mere coincidence.
Methods:
This study involved 119,412 adults: 41,819 males and 77,593 females, who were 40 years of age or older and who underwent an annual health examination. From the clinical and biochemical data, the actual prevalence of a combination of 3 or more factors: abnormal body mass index (> or =25.0), hypertension, high triglyceride (> or =150 mg/dl), low HDL cholesterol (<40 mg/dl) and abnormal fasting glucose metabolism (fasting blood sugar > or =110 mg/dl or HbA1c. > or =5.5%) was determined. Then, the prevalence of a corresponding combination of 3-5 factors was predicted from the prevalence of each factor on the assumption that their combination occurs as a result of coincidence.
Results:
The criteria of metabolic syndrome (> or =3 risk factors) was met in 17,842 (14.9%) of the examinees. The actual prevalence of any combination of 3-5 factors of metabolic syndrome was more frequent than those expected to occur by coincidence (P < 0.001). When compared with the prevalence of the total examinees, the prevalence of obesity and insulin resistance was 2.5 and 2.9 times higher in metabolic syndrome compared to that in the total examinees but it was 1.7 to 2.1 times higher in hypertension and high triglyceride. The former two were clustering more than hypertension or high triglyceride in metabolic syndrome. Abnormal levels of serum creatinine and total cholesterol were found more often in metabolic syndrome.
Conclusion:
Combinations of risk factors of metabolic syndrome were found more frequently than coincidental phenomenon in the subjects from the general population. These finding suggest that these risk factors do cluster and obesity and insulin resistance were suggested to be linked with metabolic syndrome more than hypertension or high triglyceride.
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