The metabolic syndrome as a predictor of incident diabetes and cardiovascular events in the Health 2000 Study

Abstract

Aim The study aimed to examine the role of the metabolic syndrome (MetS) as a predictor of incident cardiovascular disease (CVD) events and incident diabetes, and to compare the various definitions of MetS. Methods The population-based Health 2000 Study included 6105 individuals, aged 30–79 years, followed-up for 7 years. CVD during follow-up was defined as coronary death, acute myocardial infarction, coronary revascularization or stroke. MetS was defined according to the International Diabetes Federation (IDF), the 2005 National Cholesterol Education Program–Adult Treatment Panel III (ATP III), the World Health Organization (WHO) and the new Harmonization definitions. The Bayesian information criterion (BIC) was used to compare different Cox proportional-hazards regression models. Results The highest prevalence estimates of MetS at baseline were observed with the Harmonization definition: 47.8% in men and 40.7% in women. During the follow-up, 238 cases of incident CVD and 172 cases of incident diabetes were observed. All definitions of MetS were significant predictors for incident CVD and diabetes. BIC suggested that the new Harmonization definition of MetS as one entity was a better predictor of the CVD endpoint than the sum of its components, but not for diabetes. Also, the Harmonization definition of MetS was a better predictor of CVD than the Framingham equation in women, but not in men. Conclusion Irrespective of definition, MetS is a significant predictor of incident CVD events and incident diabetes. Also, the new Harmonization definition may be a better predictor of incident CVD than the sum of its components.