Cardiovascular morbidity and mortality associated with the metabolic syndrome

Diabetes Care. 2001 Apr;24(4):683-9. doi: 10.2337/diacare.24.4.683.

Abstract

Objective: To estimate the prevalence of and the cardiovascular risk associated with the metabolic syndrome using the new definition proposed by the World Health Organization

Research design and methods: A total of 4,483 subjects aged 35-70 years participating in a large family study of type 2 diabetes in Finland and Sweden (the Botnia study) were included in the analysis of cardiovascular risk associated with the metabolic syndrome. In subjects who had type 2 diabetes (n = 1,697), impaired fasting glucose (IFG)/impaired glucose tolerance (IGT) (n = 798) or insulin-resistance with normal glucose tolerance (NGT) (n = 1,988), the metabolic syndrome was defined as presence of at least two of the following risk factors: obesity, hypertension, dyslipidemia, or microalbuminuria. Cardiovascular mortality was assessed in 3,606 subjects with a median follow-up of 6.9 years.

Results: In women and men, respectively, the metabolic syndrome was seen in 10 and 15% of subjects with NGT, 42 and 64% of those with IFG/IGT, and 78 and 84% of those with type 2 diabetes. The risk for coronary heart disease and stroke was increased threefold in subjects with the syndrome (P < 0.001). Cardiovascular mortality was markedly increased in subjects with the metabolic syndrome (12.0 vs. 2.2%, P < 0.001). Of the individual components of the metabolic syndrome, microalbuminuria conferred the strongest risk of cardiovascular death (RR 2.80; P = 0.002).

Conclusions: The WHO definition of the metabolic syndrome identifies subjects with increased cardiovascular morbidity and mortality and offers a tool for comparison of results from diferent studies.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Albuminuria / epidemiology
  • Blood Glucose / metabolism
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / mortality
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Family
  • Female
  • Finland / epidemiology
  • Glucose Intolerance / blood
  • Glucose Intolerance / complications
  • Glucose Intolerance / epidemiology
  • Glycated Hemoglobin A / analysis
  • Humans
  • Hyperlipidemias / blood
  • Hypertension / epidemiology
  • Insulin Resistance / physiology*
  • Male
  • Middle Aged
  • Morbidity
  • Obesity / epidemiology
  • Prevalence
  • Risk Factors
  • Sex Factors
  • Sweden / epidemiology
  • Triglycerides / blood

Substances

  • Blood Glucose
  • Cholesterol, HDL
  • Glycated Hemoglobin A
  • Triglycerides
  • Cholesterol