BARCELONA — Some metabolic syndrome types are substantially deadlier than others, according to an analysis of 3,000 people followed in the Framingham Offspring Study.
People who first developed metabolic syndrome because of abdominal obesity, hypertension, and hyperglycemia had a greater than twofold increased risk for a later cardiovascular disease event, and a threefold increased risk of death, compared with people with metabolic syndrome first diagnosed because of other risk-factor combinations, Dr. Oscar H. Franco said at the annual congress of the European Society of Cardiology.
The data came from 5,124 Framingham, Mass., residents who entered the Offspring Study in 1971–1975 and were children of the first Framingham Heart Study cohort. Dr. Franco and his associates focused on 3,078 who underwent their fourth, fifth, and sixth serial examinations, in 1987–1991, 1991–1995, and 1995–1998. Data from these visits established whether each participant had metabolic syndrome. Follow-up tracked the incidence of new cardiovascular disease events and deaths during the 10 years following 1998, said Dr. Franco, a public health researcher at the University of Warwick in Coventry, England.
Metabolic syndrome was defined in 2004 as the concurrence of at least three of these five cardiovascular disease risk factors: abdominal obesity, defined by waist circumference; low serum HDL cholesterol level; elevated triglyceride level; cholesterol level;. [pavated triglyceride level; systolic or diastolic hypertension or on an antihypertensive drug; and elevated fasting blood glucose level (Circulation 2004;109:433–8).
The prevalence of metabolic syndrome among the people studied jumped during the decade of the three exams, from a 23% rate during the first exam to a 41% rate at the third exam. The biggest jumps in risk factors came for abdominal obesity, which rose from a 25% prevalence to 51% from the first exam to the third, and hyperglycemia, which spiked from 18% in exam one to 43% in exam three. By the third exam, the most common risk factor was hypertension, in 77%.
The most common triad of risk factors for metabolic syndrome was obesity, hypertension, and hyperglycemia, in 29% of the people included. The least common triad was low HDL, hyperglycemia, and high triglycerides, in 15%.
During 10 years of follow-up after the last examination, events were 2.3-fold more common in people who had the obesity, hypertension, and hyperglycemia triad, compared with all other people with a metabolic syndrome triad. People with low HDL, hypertension, and high triglycerides had a 90% higher risk for a cardiovascular event, compared with those with other triads. All the other triads had event rates that were close to the reference rate of one, and some triads had relative risks of less than one.
Deaths were slightly more than threefold more common among those with the obesity, hypertension, hyperglycemia triad, and 70% more common in those with low HDL, hypertension, and high triglycerides, Dr. Franco said.
Deaths were threefold more common in those with the obesity, hypertension, hyperglycemia triad.
Source DR. FRANCO