The effects of pre-disease risk factors within metabolic syndrome on all-cause and cardiovascular disease mortality
- 1 October 2008
- journal article
- Published by Elsevier BV in Diabetes Research and Clinical Practice
- Vol. 82 (1), 148-156
- https://doi.org/10.1016/j.diabres.2008.07.016
Abstract
The metabolic syndrome has been criticized for being "polluted with the inclusion of frank "diseases" with "pre-diseases". We assessed the effect of a single and a combination of "pre-disease" risk factors of metabolic syndrome on the overall and cardiovascular disease (CVD) mortality. These pre-disease risk factors included pre-diabetes, pre-hypertension, overweight and borderline hypertriglycerdemia and were defined as: fasting glucose at 110-125 mg/dL, systolic blood pressure at 120-139 mmHg, body mass index at 25-29.9 kg/m(2) and serum triglyceride at 150-199 mg/dL, respectively. The metabolic syndrome in this paper was based on the version defined by the ATP III. The cohort consisted of 35,259 adults (>==40 years) with a medium follow-up of 15 years. Relative risks (RRs) for all-causes, CVD and "CVD plus diabetes" mortality were calculated with the Cox proportional hazards model. Prevalence of the pre-disease risk factors (40.2%) was nearly four times larger than the metabolic syndrome (10.6%). Individual pre-disease risk factor was associated with significant increases of 13% and 67% (pre-diabetes), 22% and 62% (pre-hypertension), 23% and 32% (overweight) and 17% and 46% (borderline hypertriglyceridemia) on all-cause and "CVD plus diabetes" mortality, respectively. Smoking had comparable risks as "pre-diseases", and, as such, should also be considered as the fifth "pre-disease". Like metabolic syndrome, each "Pre-disease" is a major and significant risk factor for all cause and cardiovascular mortality, but unlike metabolic syndrome, the definition or clinical follow up of "Pre-disease" is simple and straightforward. Recognizing each of the four "pre-disease" as a clinical entity, a hitherto sub-clinical status but involving significantly increased mortality, can alert and justify early intervention through changing lifestyle and modifying biologic risk factors.Keywords
This publication has 33 references indexed in Scilit:
- Metabolic syndrome—a new world‐wide definition. A Consensus Statement from the International Diabetes FederationDiabetic Medicine, 2006
- The metabolic syndrome and its components and the long-term risk of death in patients with coronary heart diseaseAmerican Heart Journal, 2006
- The Metabolic Syndrome: Time for a Critical Appraisal: Joint Statement From the American Diabetes Association and the European Association for the Study of DiabetesDiabetes Care, 2006
- Increased Mortality Risks of Pre-Diabetes (Impaired Fasting Glucose) in TaiwanDiabetes Care, 2005
- Diagnosis and Management of the Metabolic SyndromeCirculation, 2005
- Metabolic SyndromeDiabetes Care, 2005
- Excess injury mortality among smokers: a neglected tobacco hazardTobacco Control, 2005
- Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood PressureHypertension, 2003
- Report of the Expert Committee on the Diagnosis and Classification of Diabetes MellitusDiabetes Care, 2003
- Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)JAMA, 2001