Metabolic syndrome and diabetes, alone and in combination, as predictors of cardiovascular disease mortality among men - PubMed (original) (raw)
. 2009 Jul;32(7):1289-94.
doi: 10.2337/dc08-1871. Epub 2009 Apr 14.
Affiliations
- PMID: 19366967
- PMCID: PMC2699717
- DOI: 10.2337/dc08-1871
Metabolic syndrome and diabetes, alone and in combination, as predictors of cardiovascular disease mortality among men
Timothy S Church et al. Diabetes Care. 2009 Jul.
Abstract
Objective: To examine cardiovascular disease (CVD) mortality risk in men with diabetes only, metabolic syndrome only, and concurrent metabolic syndrome and diabetes.
Research design and methods: We examined CVD mortality risk by metabolic syndrome and diabetes status in men from the Aerobics Center Longitudinal Study (ACLS) (mean +/- SD age 45.1 +/- 10.2 years). Participants were categorized as having neither diabetes nor metabolic syndrome (n = 23,770), metabolic syndrome only (n = 8,780), diabetes only (n = 532), or both (n = 1,097). The duration of follow-up was 14.6 +/- 7.0 years with a total of 483,079 person-years of exposure and 1,085 CVD deaths.
Results: Age-, examination year-, and smoking-adjusted CVD death rates (per 1,000 man-years) in men with neither metabolic syndrome nor diabetes, metabolic syndrome only, diabetes only, and both were 1.9, 3.3, 5.5, and 6.5, respectively. CVD mortality was higher in men with metabolic syndrome only (hazard ratio 1.8 [95% CI 1.5-2.0]), diabetes only (2.9 [2.1-4.0]), and both (3.4 [2.8-4.2]) compared with men with neither. The presence of metabolic syndrome was not associated (1.2 [0.8-1.7]) with higher CVD mortality risk in individuals with diabetes. In contrast, the presence of diabetes substantially increased (2.1 [1.7-2.6]) CVD mortality risk in individuals with metabolic syndrome.
Conclusions: The presence of diabetes was associated with a threefold higher CVD mortality risk, and metabolic syndrome status did not modify this risk. Our findings support the fact that physicians should be aggressive in using CVD risk-reducing therapies in all diabetic patients regardless of metabolic syndrome status.
Figures
Figure 1
Data from the combined cohort of 34,179 men with 1,085 CVD deaths. Curves represent age- and smoking-adjusted survival rates with individuals categorized by diabetes (DM) and metabolic syndrome (MS) status: neither, MS only, DM only, or MS & DM.
Figure 2
The risk of CVD mortality associated with having metabolic syndrome only, diabetes only, or both with the reference group being individuals free of metabolic syndrome or diabetes (neither) is depicted. Cox proportional hazards models were used to estimate age, examination year, and smoking-adjusted hazard ratios (bottom panel) and CVD mortality rates as deaths/1,000 man-years of follow-up (top panel). The error bars represent the 95% CIs.
Similar articles
- Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial.
Stamler J, Vaccaro O, Neaton JD, Wentworth D. Stamler J, et al. Diabetes Care. 1993 Feb;16(2):434-44. doi: 10.2337/diacare.16.2.434. Diabetes Care. 1993. PMID: 8432214 - The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men.
Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT. Lakka HM, et al. JAMA. 2002 Dec 4;288(21):2709-16. doi: 10.1001/jama.288.21.2709. JAMA. 2002. PMID: 12460094 - Metabolic syndrome as a predictor of all-cause and cardiovascular mortality in type 2 diabetes: the Casale Monferrato Study.
Bruno G, Merletti F, Biggeri A, Bargero G, Ferrero S, Runzo C, Prina Cerai S, Pagano G, Cavallo-Perin P; Casale Monferrato Study. Bruno G, et al. Diabetes Care. 2004 Nov;27(11):2689-94. doi: 10.2337/diacare.27.11.2689. Diabetes Care. 2004. PMID: 15505006 - Proteinuria and metabolic syndrome as predictors of cardiovascular death in non-diabetic and type 2 diabetic men and women.
Juutilainen A, Lehto S, Rönnemaa T, Pyörälä K, Laakso M. Juutilainen A, et al. Diabetologia. 2006 Jan;49(1):56-65. doi: 10.1007/s00125-005-0050-1. Epub 2005 Dec 20. Diabetologia. 2006. PMID: 16365726 - Mortality in diabetes compared with previous cardiovascular disease: a gender-specific meta-analysis.
Lee C, Joseph L, Colosimo A, Dasgupta K. Lee C, et al. Diabetes Metab. 2012 Nov;38(5):420-7. doi: 10.1016/j.diabet.2012.04.002. Epub 2012 Jun 7. Diabetes Metab. 2012. PMID: 22682738 Review.
Cited by
- The impact of technology on promoting physical activities and mental health: a gender-based study.
Liu Y, Zhang H, Xu R. Liu Y, et al. BMC Psychol. 2023 Sep 29;11(1):298. doi: 10.1186/s40359-023-01348-3. BMC Psychol. 2023. PMID: 37775753 Free PMC article. Clinical Trial. - A three-month physical training program improves cardiovascular autonomic function in patients with metabolic syndrome with and without diabetes - a pilot study.
Vágvölgyi A, Ábrahám JE, Máthéné Köteles É, Korom A, Barnai M, Szűcs M, Orosz A, Kempler P, Menyhárt A, Nemes A, Várkonyi T, Baczkó I, Kósa I, Lengyel C. Vágvölgyi A, et al. Front Endocrinol (Lausanne). 2023 Aug 17;14:1224353. doi: 10.3389/fendo.2023.1224353. eCollection 2023. Front Endocrinol (Lausanne). 2023. PMID: 37664832 Free PMC article. - Physiological and psychological effects of a 12-week home-based telemonitored training in metabolic syndrome.
Máthéné Köteles É, Rafael B, Korom A, Vágvölgyi A, Ábrahám JE, Domján A, Szűcs M, Nemes A, Barnai M, Lengyel C, Kósa I. Máthéné Köteles É, et al. Front Cardiovasc Med. 2023 Jan 10;9:1075361. doi: 10.3389/fcvm.2022.1075361. eCollection 2022. Front Cardiovasc Med. 2023. PMID: 36704473 Free PMC article. - Metabolic syndrome in patients with first-ever ischemic stroke: prevalence and association with coronary heart disease.
Liang Y, Yan Z, Hao Y, Wang Q, Zhang Z, She R, Wang P, Du Y, Lau JT, Dekker J, Bai B, Qiu C. Liang Y, et al. Sci Rep. 2022 Jul 29;12(1):13042. doi: 10.1038/s41598-022-17369-8. Sci Rep. 2022. PMID: 35906390 Free PMC article. - Are Clinicians Aggressive Enough in Treating Diabetes-Related Hyperlipidemia in Youth?
Jackson S, Creo A, Kumar S. Jackson S, et al. Curr Atheroscler Rep. 2022 Jun;24(6):471-481. doi: 10.1007/s11883-022-01020-y. Epub 2022 Apr 11. Curr Atheroscler Rep. 2022. PMID: 35404039 Review.
References
- Centers for Disease Control and Prevention. National Diabetes Fact Sheet: General Information and National Estimates on Diabetes in the United States, 2007. Atlanta, GA, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2008
- King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care 1998; 21: 1414– 1431 - PubMed
- Narayan KMV, Boyle JP, Geiss LS, Saaddine JB, Thompson TJ. Impact of recent increase in incidence on future diabetes burden; U.S., 2005–2050. Diabetes Care 2006; 29: 2114– 2116 - PubMed
- 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; 285: 2486– 2497 - PubMed
- Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998; 15: 539– 553 - PubMed