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. 2016 Apr 27:15:69.
doi: 10.1186/s12933-016-0387-4.

The clinical value of metabolic syndrome and risks of cardiometabolic events and mortality in the elderly: the Rotterdam study

Thijs T W van Herpt  1   2 , Abbas Dehghan  3 , Mandy van Hoek  2 , M Arfan Ikram  1   4   5 , Albert Hofman  1 , Eric J G Sijbrands  2 , Oscar H Franco  1
Affiliations

The clinical value of metabolic syndrome and risks of cardiometabolic events and mortality in the elderly: the Rotterdam study

Thijs T W van Herpt et al. Cardiovasc Diabetol. .

Abstract

Background: To evaluate the clinical value of metabolic syndrome based on different definitions [American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI), International Diabetes Federation (IDF) and European Group for the Study of Insulin Resistance (EGIR)] in middle-aged and elderly populations.

Methods: We studied 8643 participants from the Rotterdam study (1990-2012; mean age 62.7; 57.6 % female), a large prospective population-based study with predominantly elderly participants. We performed cox-proportional hazards models for different definitions, triads within definitions and each separate component for the risk of incident type 2 diabetes mellitus, coronary heart disease, stroke, cardiovascular- and all-cause mortality.

Results: In our population of 8643 subjects, metabolic syndrome was highly prevalent (prevalence between 19.4 and 42.4 %). Metabolic syndrome in general was associated with incident type 2 diabetes mellitus (median follow-up of 6.8 years, hazard ratios 3.13-3.78). The associations with coronary heart disease (median follow-up of 7.2 years, hazard ratios 1.08-1.32), stroke (median follow-up of 7.7 years, hazard ratios 0.98-1.32), cardiovascular mortality (median follow-up of 8.2 years, ratios 0.95-1.29) and all-cause mortality (median follow-up of 8.7 years, hazard ratios 1.05-1.10) were weaker. AHA/NHLBI- and IDF-definitions showed similar associations with clinical endpoints compared to the EGIR, which was only significantly associated with incident type 2 diabetes mellitus. All significant associations disappeared after correcting metabolic syndrome for its individual components.

Conclusions: Large variability exists between and within definitions of the metabolic syndrome with respect to risk of clinical events and mortality. In a relatively old population the metabolic syndrome did not show an additional predictive value on top of its individual components. So, besides as a manner of easy identification of high risk patients, the metabolic syndrome does not seem to add any predictive value for clinical practice.

Keywords: All-cause mortality; Cardiovascular disease; Cardiovascular mortality; Diabetes mellitus; Metabolic syndrome; Preventive medicine; Rotterdam study; Stroke.

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Figures

Fig. 1
Fig. 1
Concordance and disparity in diagnosis of metabolic syndrome according to different definitions
See this image and copyright information in PMC

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