scholarly journals Comparison of coronary heart disease risk assessments among individuals with metabolic syndrome using three diagnostic definitions: a cross-sectional study from China

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022974
Author(s):  
Juan Zhou ◽  
Qin Gao ◽  
Jun Wang ◽  
Min Zhang ◽  
Jianping Ma ◽  
...  

ObjectiveMetabolic syndrome (MetS) is a notable risk factor of coronary heart disease (CHD). However, there are differences in the methods used to define MetS. The purpose of this study was to determine which MetS definition most fully reflects the 10-year probability of CHD based on the Framingham risk algorithm.DesignCross-sectional study.SettingData were obtained from the China Health and Nutrition Survey and the Influencing Factors of Chronic Diseases Survey conducted among residents of Nanshan District in Shenzhen, China.ParticipantsIn total, 1721 participants aged 20–80 years were included in this study.MethodsMetS was diagnosed according to the criteria of the National Cholesterol Education Program’s Adult Treatment Panel (revised NCEP-ATP III), the International Diabetes Federation (IDF) and the Chinese Diabetes Society (CDS). The NCEP-ATP III algorithm was used to calculate the Framingham risk score, and the Framingham risk score was used to define the probability of developing CHD within 10 years either as low (<6%), moderate (6%–10%), moderately high (10%–20%) or high (>20%). Chi-square tests with or without the Bonferroni correction were used to compare the differences in the distribution of the 10-year estimated risk of developing CHD among the three definitions.ResultsCompared with the other definitions, the revised NCEP-ATP III criteria identified more participants (30.96%, 95% CI 28.8% to 33.2%) as having MetS, while the CDS criteria showed the highest 10-year probability of developing CHD. The 10-year probability of developing CHD in the participants with MetS was significantly higher than that in the participants without MetS (CDS: χ2=157.65, revised ATP III: χ2=45.17, IDF: χ2=306.15, all p<0.001), and all definitions more fully reflect the CHD risk in men than in women (revised NCEP-ATP III: χ2=72.83; IDF: χ2=63.60; CDS: χ2=23.84; all p<0.001).ConclusionsThis study demonstrates the differences in the prevalence and distribution of the 10-year estimated risk of developing CHD based on the definition of MetS. A significant finding of this study is that the MetS definitions have better performance for men than for women. Further studies in China, especially longitudinal studies, are needed to determine which definition of MetS is best suited for predicting CHD risk.

2017 ◽  
Vol 7 (1) ◽  
pp. 79-88 ◽  
Author(s):  
Chadia Haddad ◽  
Souheil Hallit ◽  
Pascale Salameh ◽  
Tarek Bou-Assi ◽  
Marouan Zoghbi

Background: Coronary heart disease (CHD) is a leading cause of premature death in patients with schizophrenia. CHD risk in Lebanese patients with schizophrenia remains unknown. Objectives: To (i) evaluate CHD risk of patients with schizophrenia in Lebanon; and (ii) detect the modifiable and non-modifiable factors affecting this risk. Methods: Cross-sectional study of 329 patients with schizophrenia aged 20–75 years. Ten-year hard CHD risk was calculated using the Framingham risk score. A logistic regression was conducted taking the dichotomous hard CHD (<10% and ≥10%) as the dependent variable. Results: Ten-year hard CHD risk was low (<10%) in 60.8% of patients, intermediate (10–20%) in 31.6%, and high (>20%) in 7.6%. Multivariate analysis showed that the mean 10-year hard CHD risk was 8.76±6.92 (10.82±6.83 in men and 3.18±2.90 in women). Ten-year hard CHD risk was higher in patients with the metabolic syndrome (odds ratio [OR] 2.67, confidence interval [CI] 1.54–4.64), a longer duration of schizophrenia (OR 1.03, CI 1.01–1.05), a history of other medical illnesses (OR 2.02, CI 1.18–3.47), and in those participating in art therapy (OR 2.13, CI 1.25–3.64) or therapeutic education (OR 1.93, CI 0.93–4.01). Ten-year hard CHD risk was lower in patients receiving risperidone (OR 0.23, CI 0.08–0.68), any anti-epileptic (OR 0.41, CI 0.24–0.73), or any benzodiazepine (OR 0.33, CI 0.17–0.66) medication. Conclusion: CHD is prevalent in patients with schizophrenia in Lebanon. Physicians are recommended to monitor the components of the metabolic syndrome to identify patients with increased risk of cardiovascular diseases.


Author(s):  
Nuria Matilla-Santander ◽  
Marina Espinola ◽  
Àurea Cartanyà-Hueso ◽  
Cristina Lidón-Moyano ◽  
Adrián González-Marrón ◽  
...  

Abstract Objective To describe the prevalence of Spanish workers with Metabolic Syndrome (MetS) and those at risk of developing MetS in 2015. Methods Cross-sectional study of workers (n = 15 614). We used a modified definition of the NCEP:ATPIII criteria for MetS (we used body mass index (BMI) above 28.8 kg/m2 instead of the waist circumference criterion). We calculated the prevalence of MetS (having at least three components) and of being at risk of MetS (having one or two components). We calculated adjusted odds ratios (aOR) of MetS according to socio-economic and workplace characteristics. Results The proportions of workers with and at risk of MetS were 7.1 and 31.9%, respectively. The most prevalent criterion was having a BMI > 28.8 kg/m2 (24.1%) in men and cHDL < 40 mg/dl in women (12.9%). There were significant associations between MetS and men (aOR compared to women = 3.73, CI 95%: 3.19; 4.36); age (higher among oldest, aOR = 5.75, CI 95%: 4.37;7.56); and social class (higher among lower social class, aOR = 2.03, CI 95%: 1.65;2.48). Conclusion Reducing any of the five MetS components, while taking into account the differences found by socio-economic and workplace characteristics, should be one priority for reducing MetS prevalence.


BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e028351
Author(s):  
Mingsheng Xie ◽  
Dongxing Xie ◽  
Ye Yang ◽  
Yi Zhang ◽  
Kun Li ◽  
...  

ObjectivesPatients with hyperuricaemia are at relatively high risk of developing coronary heart disease (CHD). The purpose of this study was to examine the relationship between high-sensitivity C-reactive protein (hs-CRP) and CHD risk in a middle-aged and elderly population with hyperuricaemia.DesignA cross-sectional study.Setting and participantsThis study was conducted in a health examination centre of China. Participants were diagnosed with hyperuricaemia based on uric acid concentrations. Specifically, males with a uric acid concentration ≥416 μmol/L were included, as well as females with a concentration ≥360 μmol/L.Main outcome measures10-year CHD risk for each individual was evaluated using Framingham risk score based on the Adult Treatment Panel III charts.ResultsA total of 517 patients with hyperuricaemia (438 males and 79 females) aged from 40 to 85 years old were included in the present study. 193 (37.3%) patients were defined with relatively high 10-year CHD risk. Compared with the lowest quintile, the crude ORs of relatively high 10-year CHD risks were 1.43 (95% CI 0.78 to 2.63, p=0.245), 2.05 (95% CI 1.14 to 3.67, p=0.016), 2.77 (95% CI 1.54 to 4.98, p=0.001), 2.12 (95% CI 1.18 to 3.80, p=0.012) in the second, third, fourth and fifth quintiles of serum hs-CRP level, respectively (p for trend=0.057). The multivariable-adjusted ORs of relatively high 10-year CHD risk were 1.40 (95% CI 0.75 to 2.61, p=0.291) in the second, 2.05 (95% CI 1.13 to 3.72, p=0.019) in the third, 2.69 (95% CI 1.47 to 4.89, p=0.001) in the fourth and 2.10 (95% CI 1.15 to 3.84, p=0.016) in the fifth quintile of serum hs-CRP level when compared with the lowest quintile (p for trend=0.068).ConclusionThis study showed that ORs of relatively high 10-year CHD risk were raised in patients with hyperuricaemia with higher serum hs-CRP level; however, there was a not significant but borderline trend association and that more research is needed.


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