Abstract
The aim of this study was to investigate the prevalence of premetabolic syndrome (pre-MetSyn) and its components and to longitudinally examine their association with new-onset type 2 diabetes (T2D) or hypertension. A total of 4037 men and 4400 women aged 40 to 69 years were selected from the Korean Genome and Epidemiology Study, observed from 2001 to 2014. Pre-MetSyn was defined as the presence of one or two components of MetSyn (B, elevated blood pressure; G, elevated glucose; H, low HDL-cholesterol; T, elevated triglycerides; W, increased waist circumference). The prevalence of pre-MetSyn was higher than that of non-MetSyn and MetSyn in both men and women. In multivariate Cox regression analyses, G, T, G+T, W+G, B+G, B+T, W+T, B+H, and H+T in men and G, T, G+H, B+T, and H+T in women were significantly associated with new-onset T2D. B, W, B+H, B+T, W+H, and W+T in men and B, B+T, B+H, B+W, and W+H in women were significantly associated with new-onset hypertension. The prevalence of pre-MetSyn components and their associations with new-onset T2D or hypertension differed according to sex and disease. Our results suggest that specific phenotypes of pre-MetSyn may be important factors for predicting and preventing the development of T2D and hypertension.
Highlights
Metabolic syndrome (MetSyn) was first described by Reaven in 1988 [1] under the name of “Syndrome X”, which included glucose intolerance, hyperinsulinemia, increased very-low-density lipoprotein (VLDL) and triglyceride levels (TG), decreased high-density lipoprotein (HDL) cholesterol level, and hypertension
Since MetSyn is a constellation of different physiologic conditions, many researchers have extended the simple association between the overall syndrome and chronic diseases to more heterogeneous relationships between the number of MetSyn components or specific combinations of these components and the outcomes of type 2 diabetes (T2D), cardiovascular disease (CVD), and all-cause mortality [7,9,10,11,12,13]
We examined whether different combinations of MetSyn components in patients with pre-MetSyn are differentially associated with new-onset T2D or hypertension in this cohort when observed over a 12-year period
Summary
Metabolic syndrome (MetSyn) was first described by Reaven in 1988 [1] under the name of “Syndrome X”, which included glucose intolerance, hyperinsulinemia, increased very-low-density lipoprotein (VLDL) and triglyceride levels (TG), decreased high-density lipoprotein (HDL) cholesterol level, and hypertension. In 2009, expert groups agreed that three of five abnormal findings (increased waist circumference, blood pressure elevation, low HDL-cholesterol, high triglycerides, and hyperglycemia) were sufficient to diagnose MetSyn [5]. MetSyn is associated with an increased risk of type 2 diabetes (T2D), hypertension, cardiovascular disease (CVD), and all-cause mortality [6,7,8,9]. Since MetSyn is a constellation of different physiologic conditions, many researchers have extended the simple association between the overall syndrome (i.e., absence or presence of MetSyn) and chronic diseases to more heterogeneous relationships between the number of MetSyn components or specific combinations of these components and the outcomes of T2D, CVD, and all-cause mortality [7,9,10,11,12,13]. Most researchers have agreed that pre-MetSyn represents a stage at which the existing
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