TY - JOUR
T1 - The metabolic syndrome adds utility to the prediction of mortality over its components: The Vietnam Experience Study
AU - Thomas, Graham
AU - Phillips, Anna
AU - Carroll, Douglas
AU - Gale, CR
AU - Batty, GD
PY - 2010/5/1
Y1 - 2010/5/1
N2 - BACKGROUND: The metabolic syndrome increases mortality risk. However, as "non-affected" individuals may still have up to two risk factors, the utility of using three or more components to identify the syndrome, and its predictive advantage over individual components have yet to be determined. METHODS: Participants, male Vietnam-era veterans (n=4265) from the USA, were followed-up from 1985/1986 for 14.7 years (61,498 person-years), and all-cause and cardiovascular disease deaths collated. Cox's proportional-hazards regression was used to assess the effect of the metabolic syndrome and its components on mortality adjusting for a wide range of potential confounders. RESULTS: At baseline, 752 participants (17.9%) were identified as having metabolic syndrome. There were 231 (5.5%) deaths from all-causes, with 60 from cardiovascular disease. After adjustment for a range of covariates, the metabolic syndrome increased the risk of all-cause, HR 2.03, 95%CI 1.52, 2.71, and cardiovascular disease mortality, HR 1.92, 95%CI 1.10, 3.36. Risk increased dose-dependently with increasing numbers of components. The increased risk from possessing only one or two components was not statistically significant. The adjusted risk for four or more components was greater than for only three components for both all-cause, HR 2.30, 95%CI 1.45, 3.66 vs. HR 1.70, 95%CI 1.11, 2.61, and cardiovascular disease mortality, HR 3.34, 95%CI 1.19, 9.37 vs. HR 2.81, 95%CI 1.07, 7.35. The syndrome was more informative than the individual components for all-cause mortality, but could not be assessed for cardiovascular disease mortality due to multicollinearity. Hyperglycaemia was the individual strongest parameter associated with mortality. CONCLUSIONS: The metabolic syndrome is informative in predicting mortality, with risk increasing as the number of components increase above the threshold required for diagnosis.
AB - BACKGROUND: The metabolic syndrome increases mortality risk. However, as "non-affected" individuals may still have up to two risk factors, the utility of using three or more components to identify the syndrome, and its predictive advantage over individual components have yet to be determined. METHODS: Participants, male Vietnam-era veterans (n=4265) from the USA, were followed-up from 1985/1986 for 14.7 years (61,498 person-years), and all-cause and cardiovascular disease deaths collated. Cox's proportional-hazards regression was used to assess the effect of the metabolic syndrome and its components on mortality adjusting for a wide range of potential confounders. RESULTS: At baseline, 752 participants (17.9%) were identified as having metabolic syndrome. There were 231 (5.5%) deaths from all-causes, with 60 from cardiovascular disease. After adjustment for a range of covariates, the metabolic syndrome increased the risk of all-cause, HR 2.03, 95%CI 1.52, 2.71, and cardiovascular disease mortality, HR 1.92, 95%CI 1.10, 3.36. Risk increased dose-dependently with increasing numbers of components. The increased risk from possessing only one or two components was not statistically significant. The adjusted risk for four or more components was greater than for only three components for both all-cause, HR 2.30, 95%CI 1.45, 3.66 vs. HR 1.70, 95%CI 1.11, 2.61, and cardiovascular disease mortality, HR 3.34, 95%CI 1.19, 9.37 vs. HR 2.81, 95%CI 1.07, 7.35. The syndrome was more informative than the individual components for all-cause mortality, but could not be assessed for cardiovascular disease mortality due to multicollinearity. Hyperglycaemia was the individual strongest parameter associated with mortality. CONCLUSIONS: The metabolic syndrome is informative in predicting mortality, with risk increasing as the number of components increase above the threshold required for diagnosis.
KW - Veterans
KW - Mortality
KW - All-cause
KW - Metabolic syndrome
KW - Cardiovascular disease
U2 - 10.1016/j.atherosclerosis.2009.10.045
DO - 10.1016/j.atherosclerosis.2009.10.045
M3 - Article
C2 - 20004895
VL - 210
SP - 256
EP - 261
JO - Atherosclerosis
JF - Atherosclerosis
IS - 1
ER -