Metabolic syndrome vs. its components for prediction of cardiovascular mortality: A cohort study in Chinese elderly
Dong-Ling Sun1, Jian-Hua Wang, Bin Jiang
1Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
Insights
Metabolic syndrome (MetS) predicts higher all-cause and cardiovascular disease (CVD) mortality in Chinese elderly adults. However, counting MetS components offers no additional CVD risk information beyond a dichotomous MetS classification.
Area of Science:
- Gerontology
- Epidemiology
- Cardiovascular Disease Research
Background:
- The predictive value of metabolic syndrome (MetS) for mortality in Chinese populations remains unclear.
- Understanding MetS and its components' impact on mortality is crucial for public health strategies in aging societies.
Purpose of the Study:
- To compare the predictive value of MetS versus its individual components for all-cause and cardiovascular disease (CVD) mortality.
- To investigate mortality risks associated with MetS and its components in Chinese elderly adults.
Main Methods:
- A cohort of 1,535 Chinese adults aged 50+ was followed from 1994 to 2009.
- Cox models were employed to estimate hazard ratios (HRs) for mortality based on MetS and its individual components.
Main Results:
- MetS prevalence was 28.0% in men and 48.4% in women.
- MetS was associated with increased all-cause (HR=1.47) and CVD mortality (HR=1.96).
- Only hypertension and impaired glucose independently predicted higher mortality; the number of MetS components did not significantly enhance CVD risk prediction.
Conclusions:
- Dichotomous classification of MetS is as informative as counting components for CVD risk assessment in this Chinese cohort.
- Hypertension and impaired glucose are key individual predictors of mortality within the MetS framework.
Objective:
The predictive value of the metabolic syndrome (MetS) for mortality from all-cause and cardiovascular disease (CVD) in the Chinese population is unclear. The aim of this present study was to compare MetS with its individual components as predictors of mortality in Chinese elderly adults.
Methods:
A cohort of 1,535 subjects (994 men and 541 women) aged 50 years or older was selected from employees of a machinery factory in 1994 and followed until 2009. Cox models were used to estimate the hazard ratios (HRs) predicted by MetS according to the harmonized definition and by its individual components.
Results:
The baseline prevalence of MetS was 28.0% in men and 48.4% in women. During a median follow-up of 15 years, 414 deaths occurred, of these, 153 participants died from CVD. Adjusted for age and gender, the HRs of mortality from all-cause and CVD in participants with MetS were 1.47 (95% confidence interval (CI): 1.20-1.80) and 1.96 (95%CI: 1.42-2.72), respectively, compared with those without MetS. Non-significant higher risk of CVD mortality was seen in those with one or two individual components (HR = 1.22, 95%CI: 0.59-2.50; HR = 1.82, 95%CI: 0.91-3.64, respectively), while a substantially higher risk of CVD mortality only appeared in those with 3, 4, or 5 components (HR = 2.81-3.72), compared with those with no components. On evaluating the MetS components individually, we found that, independent of MetS, only hypertension and impaired glucose predicted higher mortality.
Conclusions:
The number of positive MetS components seems no more informative than classifying (dichotomous) MetS for CVD risks assessment in this Chinese cohort.
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