Does a diagnosis of the metabolic syndrome provide additional prediction of cardiovascular disease and total mortality in the elderly? The Dubbo Study

Background: The metabolic syndrome is related to an increased risk of cardiovascular disease (CVD), as reported by numerous studies. In this analysis, we investigated the relationship between the metabolic syndrome (MetSyn) and CVD risk in hypercholesterolemic patients and the effect of pravastatin treatment in the MEGA Study population. Methods: The MetSyn was defined according to modified National Cholesterol Education Program (NCEP) criteria, namely, the presence of three or more risk factors: 1)obesity (body mass index ≥25 kg/m 2 ), 2)hypertriglyceridemia (≥150 mg/dL), 3)low HDL cholesterol (<40 mg/dL in men and <50 mg/dL in women), 4)hypertension (SBP≥130 mmHg and/or DBP≥85 mmHg), 5)hyperglycemia (fasting glucose ≥100 mg/dL). The risk of CVD and total mortality was compared in patients with and without MetSyn. The effect of pravastatin plus diet therapy in the patients with MetSyn was compared to those without MetSyn, and moreover these comparisons were conducted in two groups, divided according to their LDL cholesterol levels (cut point: 156.9 mg/dL). Results: A total of 2,636 (33.7%) of the 7,832 hypercholesterolemic patients enrolled in MEGA had MetSyn. A 1.9 times higher incidence of CVD was found in the patients with, compared to those without, MetSyn. The risk of CVD in patients with MetSyn was very similar to that in patients with high LDL cholesterol (≥156.9 mg/dL) and with low LDL cholesterol (<156.9 mg/dL). Notably, a 36% significant risk reduction for CVD and 50% risk reduction for total mortality were observed in the patients with MetSyn treated with pravastatin plus diet treatment compared to diet therapy alone. Moreover, the greatest CVD risk reduction was observed in the high LDL-C group with MetSyn compared to those without MetSyn (Hazard ratio 0.44 vs. 0.56, respectively, interaction p=0.07). Conclusion: Metabolic syndrome increases the risk of CVD regardless of the presence or absence of hypercholesterolemia. Diet plus pravastatin treatment is effective for the prevention of CVD for patients with hypercholesterolemia and MetSyn.

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Cardiovascular Risk Assessement in Osteoporotic Patients Using Osteoprotegerin as a Reliable Predictive Biochemical Marker

Ibn AL- Haitham Journal For Pure and Applied Science ◽

10.30526/2017.ihsciconf.1798 ◽

2018 ◽

pp. 253

Author(s):

Noora Wael Rasheed ◽

Ooroba Jameel Taresh

Keyword(s):

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Cardiovascular Risk ◽

Serum Level ◽

Biochemical Markers ◽

Hdl Cholesterol ◽

Predictive Marker ◽

Serum Levels ◽

Arterial Calcification ◽

The Metabolic Syndrome

Some studies indicated a relationship between increased serum levels of osteoprotegerin with arterial calcification and as a result, it leads to the risk of cardiovascular disease. In our study group we selected patients with osteoporosis, with similar age and body mass index for the assessment of the relationship between cardiovascular disease and osteoprotegerin serum level. We took into account the analysis of correlation and association between the presence of distinct patterns of atherosclerosis and associated diseases like high blood pressure, diabetes mellitus, low HDL cholesterol, increased LDL cholesterol, increased triglycerides and was the case of presence of any type of dyslipidemia, in case of pre-existent treatment. Objective of study was the assessment of osteoprotegerin value as predictive marker for cardiovascular and metabolic risk in osteoporotic patients. Our results showed significant correlations of parathyroid hormone, osteocalcin and biochemical markers of bone with glucose metabolism and lipid were found in our research, maintaining crosstalk between calcium and biochemical markers of bone and cardiovascular risk. The serum level of Osteoprotegerin has been shown to have a large predictive value for the metabolic syndrome as a cardiovascular risk standard in patients with osteoporosis. The osteoprotegerin serum levels were increased in the patients with metabolic syndrome as a protective response facing the atherosclerotic lesions.

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A longitudinal study over 40 years to study the metabolic syndrome as a risk factor for cardiovascular diseases

Scientific Reports ◽

10.1038/s41598-021-82398-8 ◽

2021 ◽

Vol 11 (1) ◽

Cited By ~ 1

Author(s):

Lars Lind ◽

Johan Sundström ◽

Johan Ärnlöv ◽

Ulf Risérus ◽

Erik Lampa

Keyword(s):

Metabolic Syndrome ◽

Risk Factor ◽

Longitudinal Study ◽

Clinical Intervention ◽

The Elderly ◽

Adult Men ◽

The Metabolic Syndrome ◽

The Impact ◽

Over 40 Years

AbstractThe impact of most, but not all, cardiovascular risk factors decline by age. We investigated how the metabolic syndrome (MetS) was related to cardiovascular disease (CVD) during 40 years follow-up in the Uppsala Longitudinal Study of Adult Men (ULSAM, 2,123 men all aged 50 at baseline with reinvestigations at age 60, 70, 77 and 82). The strength of MetS as a risk factor of incident combined end-point of three outcomes (CVD) declined with ageing, as well as for myocardial infarction, ischemic stroke and heart failure when analysed separately. For CVD, the risk ratio declined from 2.77 (95% CI 1.90–4.05) at age 50 to 1.30 (95% CI 1.05–1.60) at age 82. In conclusion, the strength of MetS as a risk factor of incident CVD declined with age. Since MetS was significantly related to incident CVD also at old age, our findings suggest that the occurrence of MetS in the elderly should not be regarded as innocent. However, since our data were derived in an observational study, any impact of MetS in the elderly needs to be verified in a randomized clinical intervention trial.

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Association between the Mediterranean lifestyle, metabolic syndrome and mortality: a whole-country cohort in Spain

Cardiovascular Diabetology ◽

10.1186/s12933-020-01195-1 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Mercedes Sotos-Prieto ◽

Rosario Ortolá ◽

Miguel Ruiz-Canela ◽

Esther Garcia-Esquinas ◽

David Martínez-Gómez ◽

...

Keyword(s):

Metabolic Syndrome ◽

Cardiovascular Mortality ◽

Cardiovascular Health ◽

Total Mortality ◽

Hdl Cholesterol ◽

Cardiometabolic Health ◽

The Metabolic Syndrome ◽

Mediterranean Countries ◽

Low Hdl ◽

The Mediterranean

Abstract Background Evidence is limited about the joint health effects of the Mediterranean lifestyle on cardiometabolic health and mortality. The aim of this study was to evaluate the association of the Mediterranean lifestyle with the frequency of the metabolic syndrome (MS) and the risk of all-cause and cardiovascular mortality in Spain. Methods Data were taken from ENRICA study, a prospective cohort of 11,090 individuals aged 18+ years, representative of the population of Spain, who were free of cardiovascular disease (CVD) and diabetes at 2008–2010 and were followed-up to 2017. The Mediterranean lifestyle was assessed at baseline with the 27-item MEDLIFE index (with higher score representing better adherence). Results Compared to participants in the lowest quartile of MEDLIFE, those in the highest quartile had a multivariable-adjusted odds ratio 0.73 (95% confidence interval (CI) 0.5, 0.93) for MS, 0.63. (0.51, 0.80) for abdominal obesity, and 0.76 (0.63, 0.90) for low HDL-cholesterol. Similarly, a higher MELDIFE score was associated with lower HOMA-IR and highly-sensitivity C-reactive protein (P-trend < 0.001). During a mean follow-up of 8.7 years, 330 total deaths (74 CVD deaths) were ascertained. When comparing those in highest vs. lowest quartile of MEDLIFE, the multivariable-adjusted hazard ratio (95% CI) was 0.58 (0.37, 0.90) for total mortality and 0.33 (0.11, 1.02) for cardiovascular mortality. Conclusions The Mediterranean lifestyle was associated with lower frequency of MS and reduced all-cause mortality in Spain. Future studies should determine if this also applies to other Mediterranean countries, and also improve cardiovascular health outside the Mediterranean basin.

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Different definitions of the metabolic syndrome and risk for recurrent cardiovascular disease

Nature Clinical Practice Endocrinology &#38 Metabolism ◽

10.1038/ncpendmet0272 ◽

2006 ◽

Vol 2 (9) ◽

pp. 492-493

Author(s):

W Virgil Brown

Keyword(s):

Cardiovascular Disease ◽

Metabolic Syndrome ◽

The Metabolic Syndrome

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Prostate Cancer, Androgen Deprivation Therapy, Obesity, the Metabolic Syndrome, Type 2 Diabetes, and Cardiovascular Disease

American Journal of Clinical Oncology ◽

10.1097/coc.0b013e318201a406 ◽

2012 ◽

Vol 35 (5) ◽

pp. 504-509 ◽

Cited By ~ 50

Author(s):

Andrew Collier ◽

Sujoy Ghosh ◽

Brian McGlynn ◽

Graham Hollins

Keyword(s):

Prostate Cancer ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Androgen Deprivation Therapy ◽

Androgen Deprivation ◽

Syndrome Type ◽

The Metabolic Syndrome

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Gap analysis of pediatric reference intervals for risk biomarkers of cardiovascular disease and the metabolic syndrome

Clinical Biochemistry ◽

10.1016/j.clinbiochem.2006.02.013 ◽

2006 ◽

Vol 39 (6) ◽

pp. 569-587 ◽

Cited By ~ 45

Author(s):

Sepideh Mansoub ◽

Man Khun Chan ◽

Khosrow Adeli

Keyword(s):

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Gap Analysis ◽

Reference Intervals ◽

The Metabolic Syndrome ◽

Risk Biomarkers

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Prevalence and factors associated with Metabolic Syndrome in elderly users of the Unified Health System

Revista Brasileira de Epidemiologia ◽

10.1590/1809-4503201400040001 ◽

2014 ◽

Vol 17 (4) ◽

pp. 805-817 ◽

Cited By ~ 10

Author(s):

Edna Cunha Vieira ◽

Maria do Rosário Gondim Peixoto ◽

Erika Aparecida da Silveira

Keyword(s):

Metabolic Syndrome ◽

Health System ◽

Health Workers ◽

The Elderly ◽

World Health ◽

Fat Percentage ◽

Cross Sectional ◽

Factors Associated ◽

Unified Health System ◽

The Metabolic Syndrome

OBJECTIVE: To evaluate the prevalence and factors associated with metabolic syndrome in the elderly. METHODS: Cross-sectional study, with 133 individuals randomly selected in the Unified Health System in Goiania, Goiás. The following variables were researched: anthropometric (BMI, waist circumference, fat percentage by Dual X-ray absorptiometry), sociodemographic (gender, age, color, income, marital status and years of schooling), lifestyle (physical activity, smoking and risk alcohol consumption) and food intake (risk and protective foods). The metabolic syndrome was assessed according to harmonized criteria proposed by the World Health Organization (WHO). The combinations were tested by Poisson regression for confounding factors. RESULTS: The prevalence of metabolic syndrome was 58.65% (95%CI 49.8 - 67.1), with 60.5% (95%CI 49.01 - 71.18) for females and 55.7% (95%CI 41.33 - 69.53) for males. Hypertension was the most prevalent component of the syndrome in both men, with 80.8% (95%CI 64.5 - 90.4), and women, with 85.2% (95%CI 75.5 - 92.1). After the multivariate analysis, only the excess of weight measured by body mass index (prevalence ratio = 1.66; p < 0.01) remained associated with the metabolic syndrome. CONCLUSIONS: The prevalence of metabolic syndrome in this sample was high, indicating the need for systematic actions by health workers in the control of risk factors through prevention strategies and comprehensive care to the elderly.

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Abstract P189: Associations between Lactation and Maternal Measures of Total and Regional Adiposity 15 Years Postpartum: Results from the Study of Women’s Health Across the Nation

Circulation ◽

10.1161/circ.127.suppl_12.ap189 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Candace K McClure ◽

Christina M Shay ◽

Ping G Tepper ◽

Molly B Conroy ◽

Barbara Sternfeld ◽

...

Keyword(s):

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Women’S Health ◽

Women's Health ◽

Menopausal Status ◽

Lower Leg ◽

Cross Sectional ◽

The Metabolic Syndrome ◽

Increased Risk ◽

Regional Adiposity

Objective: It has been reported that mothers who do not breastfeed are at an increased risk of T2DM, metabolic syndrome, and CVD. We hypothesize that lactation may influence cardio-metabolic risk by altering maternal body composition. We examined the extent to which lactation was associated with regional and total adiposity in a sample of US women 15 years after their last birth. Study Design : Cross-sectional analysis of data provided by 1,268 women aged 45-58 who enrolled in the Study of Women’s Health Across the Nation (1996 -1997). Adiposity was assessed using dual-energy X-ray absorptiometry. History of lactation was self-reported and categorized into three groups: mothers who breastfed for ≥3 months after every birth, those who discontinued lactation within 3 months of some births, and those who never breastfed. Results: Compared with mothers who breastfed after every birth for at least 3 months, mothers who never breastfed had 0.87 kg greater trunk fat mass (FM), 1.3% greater % trunk FM, 1.3% lower % leg FM, and 0.075 greater trunk to leg FM ratio after adjustment for age, parity, height, years since last birth, race/ethnicity, socioeconomic, lifestyle, psychological, and family history variables, maximum gestational weight gain, and menopausal status. After additional adjustment for current BMI, women who never breastfed had 0.40 kg greater trunk FM and 0.053 greater trunk to leg FM ratio than mothers who breastfed every child for ≥3 months. Similarly, mothers who discontinued lactation within 3 months of some births had 0.28 kg greater trunk FM and 0.87% lower % leg FM than mothers who consistently breastfed. Conclusion : Women who did not breastfeed for at least 3 months after every birth exhibit less favorable body fat distributions 15 years postpartum. These results provide a potential physiologic basis for prior findings that women who do not breastfeed their children face increased risk of diabetes, the metabolic syndrome, and cardiovascular disease. Given existing disparities in rates of lactation, obesity and CVD, these findings have great clinical relevance and suggest the need for targeted lactation support for women at risk of cardiovascular disease.

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