Highly prevalent metabolic syndrome (MS) is a major public health problem worldwide. Insulin resistance and central obesity are postulated to be the key components of this metabolic syndrome, and inflammation also plays a role in cardiovascular events. In previous years, many definitions of metabolic syndrome have emerged.
Design and methods
The value of MS as a predictor of cardiovascular events in median 18-year follow-up was studied in a prospective study cohort that included 1004 Finnish males and females. Cardiovascular disease included major coronary heart disease and stroke (excluding subarachnoid hemorrhage)—whichever of these happened first.
Results
Subjects with metabolic syndrome had a 2.01-fold (95% CI 1.46–2.77) higher probability for any cardiovascular event compared with subjects with no MS. hsCRP seemed to increase the risk prediction, whereas adiponectin was not helpful. Those having five components of MS had hazard ratios of 7.89 (2.26–27.60) for any cardiovascular event in the follow-up when compared with those having no components and adjusting by traditional risk factors (p < 0.01).
Conclusions
MS is an important predictor of cardiovascular events and is most harmful in combination with high plasma hsCRP. The clustering of components is especially harmful.
GrundySM. Pre-diabetes, metabolic syndrome, and cardiovascular risk. J Am Coll Cardiol2012; 59(7): 635–643.
2.
MatsuzawaYFunahashiTNakamuraT. The concept of metabolic syndrome: Contribution of visceral fat accumulation and its molecular mechanism. J Atheroscler Thromb2011; 18(8): 629–639.
3.
AlbertiKGEckelRHGrundySM. International Diabetes Federation Task Force on Epidemiology and Prevention, National Heart, Lung, and Blood Institute, American Heart Association, World Heart Federation, International Atherosclerosis Society and International Association for the Study of Obesity. Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation2009; 120(16): 1640–1645.
4.
SantaniemiMKesäniemiYAUkkolaO. Low plasma adiponectin concentration is an indicator of the metabolic syndrome. Eur J Endocrinol2006; 155(5): 745–750.
RidkerPMWilsonPWGrundySM. Should C-reactive protein be added to metabolic syndrome and to assessment of global cardiovascular risk?Circulation2004; 109(23): 2818–2825.
7.
RantalaAOKaumaHLiljaM. Prevalence of the metabolic syndrome in drug-treated hypertensive patients and control subjects. J Intern Med1999; 245(2): 163–174.
8.
PajunenPJousilahtiPBorodulinK. Body fat measured by a near-infrared interactance device as a predictor of cardiovascular events: The FINRISK'92 cohort. Obesity2011; 19(4): 848–852.
9.
MottilloSFilionKBGenestJ. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol2010; 56(14): 1113–1132.
10.
OdaE. The metabolic syndrome as a concept of adipose tissue disease. Hypertens Res2008; 31(7): 1283–1291.
11.
FordES. The metabolic syndrome and C-reactive protein, fibrinogen, and leukocyte count: Findings from the Third National Health and Nutrition Examination Survey. Atherosclerosis2003; 168(2): 351–8.
12.
FordESAjaniUAMokdadAH. National Health and Nutrition Examination. The metabolic syndrome and concentrations of C-reactive protein among U.S. youth. Diabetes Care2005; 28(4): 878–81.
13.
LaugsandLEAsvoldBOVattenLJ. Metabolic factors and high-sensitivity C-reactive protein: The HUNT study. Eur J Prev Cardiol2012; 19(5): 1101–10.
14.
RidkerPMBuringJECookNRRifaiN. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: An 8-year follow-up of 14 719 initially healthy American women. Circulation2003; 107(3): 391–397.
15.
RidkerPMDanielsonEFonsecaFA. JUPITER Trial Study Group. Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: A prospective study of the JUPITER trial. Lancet2009; 373(9670): 1175–1182.
16.
EmbersonJBennettDLinkE. Heart Protection Study Collaborative Group. C-reactive protein concentration and the vascular benefits of statin therapy: An analysis of 20,536 patients in the Heart Protection Study. Lancet2011; 377(9764): 469–476.
17.
PilzSMaerzWWeihrauchG. LUdwigshafen RIsk and Cardiovascular Health (LURIC) Group. Adiponectin serum concentrations in men with coronary artery disease: The LUdwigshafen RIsk and Cardiovascular Health (LURIC) study. Clin Chim Acta2006; 364(1–2): 251–255.
18.
WannametheeSGWhincupPHLennonLSattarN. Circulating adiponectin levels and mortality in elderly men with and without cardiovascular disease and heart failure. Arch Intern Med2007; 167(14): 1510–1517.
19.
WannametheeSGWhincupPHRumleyALoweGD. Inter-relationships of interleukin-6, cardiovascular risk factors and the metabolic syndrome among older men. J Thromb Haemost2007; 5(8): 1637–1643.
20.
LaughlinGABarrett-ConnorEMaySLangenbergC. Association of adiponectin with coronary heart disease and mortality: The Rancho Bernardo study. Am J Epidemiol2007; 165(2): 164–174.
21.
PischonTHuFBGirmanCJ. Plasma total and high molecular weight adiponectin levels and risk of coronary heart disease in women. Atherosclerosis2011; 219(1): 322–329.
22.
SattarNWannametheeGSarwarN. Adiponectin and coronary heart disease: A prospective study and meta-analysis. Circulation2006; 114(7): 623–629.
23.
OgorodnikovaADWassertheil-SmollerSMancusoP. High-molecular-weight adiponectin and incident ischemic stroke in postmenopausal women: A Women's Health Initiative Study. Stroke2010; 41(7): 1376–1381.
24.
LawlorDADavey SmithGEbrahimS. Plasma adiponectin levels are associated with insulin resistance, but do not predict future risk of coronary heart disease in women. J Clin Endocrinol Metab2005; 90(10): 5677–5683.
25.
KizerJRBarzilayJIKullerLHGottdienerJS. Adiponectin and risk of coronary heart disease in older men and women. J Clin Endocrinol Metab2008; 93(9): 3357–3364.
26.
SattarNWattPCherryL. High molecular weight adiponectin is not associated with incident coronary heart disease in older women: A nested prospective case-control study. J Clin Endocrinol Metab2008; 93(5): 1846–1849.
27.
WannametheeSGWelshPWhincupPH. High adiponectin and increased risk of cardiovascular disease and mortality in asymptomatic older men: Does NT-proBNP help to explain this association?Eur J Cardiovasc Prev Rehabil2011; 18(1): 65–71.
