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. 2023 Jan 17:13:1029736.
doi: 10.3389/fendo.2022.1029736. eCollection 2022.

Incidence and long-term specific mortality trends of metabolic syndrome in the United States

Weiya Li  1 , Xinfan Qiu  1 , Huan Ma  1 , Qingshan Geng  1
Affiliations

Incidence and long-term specific mortality trends of metabolic syndrome in the United States

Weiya Li et al. Front Endocrinol (Lausanne). .

Abstract

Purpose: Metabolic syndrome (MetS) is extremely prevalent and related to severe diseases and death. This study aims to investigate the incidence and mortality trends among MetS over the past few decades. The gender and age differences of MetS are also explored.

Patients and methods: Adults with MetS were screened in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014. The mortality data were also acquired. Then we assessed the incidence and mortality trends of MetS in the United States.

Results: Our study included 14171 participants with a mean age of 46.8 ± 19.3 years, of whom 7354 (51.9%) were women. Among them, 4789 participants were subsequently diagnosed with MetS. From 1999 to 2014, the overall trend of MetS incidence increased (from 27.6 to 32.3%; adjusted odds ratios [aOR], 1.71; 95% confidence interval [CI], 1.42-2.05; P-value <0.001, P for trend <0.001). In more detail, the incidence of MetS rose first but subsequently plateaued and declined. Obvious downward trends were observed from 29.6 to 2.7% for all-cause mortality (aOR, 0.12; 95%CI, 0.07-0.21; P-value <0.001, P for trend <0.001) and 4.8 to 0.8% for cardio-cerebrovascular mortality (aOR, 0.17; 95%CI, 0.05-0.61; P-value =0.007, P for trend <0.001). All-cause mortality decreased yearly, whereas cardio-cerebrovascular death increased briefly before declining and stabilizing. Similarly, the temporal mortality trends in MetS patients of different ages and genders had the same results. Specifically, the incidence of MetS was higher in women than in men (adjusted P =0.003; OR, 1.14; 95%CI, 1.05-1.24), but the mortality was significantly lower after an average of 7.7 years of follow-up (all-cause mortality, adjusted P <0.001; hazard ratio [HR], 0.68; 95%CI, 0.57-0.81; cardio-cerebrovascular mortality, adjusted P =0.004; HR, 0.55; 95%CI, 0.37-0.83).

Conclusion: From 1999 to 2014, the incidence of MetS in U.S. adults significantly increased overall, while the mortality rate of MetS had a considerable downward trend. Both trends showed marked gender differences, being more prevalent and at lower risk in women compared with men. It is important to identify the factors that will curb the incidence of MetS and decrease mortality, especially in male patients.

Keywords: NHANES; incidence; metabolic syndrome; mortality; trend.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The research flow chart.
Figure 2
Figure 2
Trends in the incidence and mortality of MetS patients in the NHANES from 1999 to 2014; (A) The prevalence of MetS increased significantly from 27.6 to 32.3% (adjusted odds ratios [aOR], 1.71; 95%CI, 1.42-2.05; P-value <0.001, P for trend <0.001); trends in all-cause (B) and cardio-cerebrovascular (C) mortality of MetS patients in the NHANES from 1999 to 2014. After an average of 7.7 years of follow-up, the all-cause mortality (from 29.6 to 2.7%; [aOR], 0.12; 95%CI, 0.07-0.21; P-value <0.001, P for trend <0.001) and cardio-cerebrovascular mortality (from 4.8 to 0.8%; [aOR], 0.17; 95%CI, 0.05- 0.61; P-value =0.007, P for trend <0.001) of MetS patients showed obvious downward trends.
Figure 3
Figure 3
Trends in the incidence and mortality of different gender and age subgroups from 1999 to 2014; (A) Trends in the incidence of MetS among men (P for trend <0.001) and women (P for trend <0.001); (B) Trends of 7.7-year all-cause mortality among men (P for trend<0.001) and women (P for trend <0.001); (C) Trends of 7.7-year cardio-cerebrovascular mortality among men (P for trend<0.001) and women (P for trend <0.001); (D) Trends in the incidence of MetS among ≥65 years (P for trend=0.025) and <65 years (P for trend <0.001); (E) Trends of 7.7-year all-cause mortality among ≥65 years (P for trend<0.001) and <65 years (P for trend <0.001); (F) Trends of 7.7-year cardio-cerebrovascular mortality among ≥65 years (P for trend<0.001) and <65 years (P for trend <0.001).
Figure 4
Figure 4
COX regression curves for all-cause (A) and cardio-cerebrovascular (B) mortality rates of MetS patients grouped by gender after multi-factor adjustment and 7.7 years of follow-up; COX regression curves for all-cause (C) and cardio-cerebrovascular (D) mortality rates of MetS in different age groups after multi-factor adjustment and 7.7 years of follow-up.
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