Korean Circ J.  2012 Jun;42(6):371-378. 10.4070/kcj.2012.42.6.371.

Linkage of Epidemiologic Evidence With the Clinical Aspects of Metabolic Syndrome

• Jee SH
• Jo J

• KMID: 1433855
• DOI: http://doi.org/10.4070/kcj.2012.42.6.371

Abstract

Metabolic syndrome (MetS) is characterized by a cluster of cardiovascular risk factors, such as hypertension, glucose intolerance, high triglycerides, and a low high density lipoprotein-cholesterol level. MetS is known to be associated with cardiovascular diseases. In order to diagnose MetS, definitions such as National Cholesterol Education Program Adult Treatment Panel III, American Heart Association/National Heart Lung and Blood Institute, International Diabetes Federation, World Health Organization, European Group for the Study of Insulin Resistance and American College of Endocrinology are widely used. However, using different criteria may lead to confusion regarding the diagnosis and treatment of patients with MetS in the primary care setting. Our objected was to review 3 aspects concerning MetS using the Metabolic Syndrome Research Initiatives study of 123892 healthy Koreans (1994-2001) that had a maximum follow-up of 12 years. The 3 aspects were reviewed by determination of the association of MetS with the development of atherosclerotic cardiovascular disease (ASCVD) and ischemic heart disease (IHD). Based on our findings, each metabolic factor associated with MetS was not weighted equally. The hazard ratio (HR) was higher in individuals with higher glucose compared with the HR in individuals with higher body mass index. Individuals with pre-MetS (having 1 or 2 metabolic factors) had 1.5-2.3 fold higher risk of developing ASCVD and IHD in both genders. In the presence of MetS, both singly and in combination, precede the development of ASCVD and IHD and individuals with pre-MetS must not be ignored as there is no apparent threshold in defining MetS. Furthermore, MetS may complement the Framingham Risk Score and can be used as the first line approach to treat the ASCVD or IHD.

Keyword

Metabolic cardiovascular syndrome; Atherosclerosis; Ischemic heart disease

MeSH Terms

Adult
Atherosclerosis
Body Mass Index
Cardiovascular Diseases
Cholesterol
Complement System Proteins
Endocrinology
Follow-Up Studies
Glucose
Glucose Intolerance
Heart
Humans
Hypertension
Insulin Resistance
Lung
Metabolic Syndrome X
Myocardial Ischemia
Primary Health Care
Risk Factors
Triglycerides
World Health Organization
Cholesterol
Complement System Proteins
Glucose
Triglycerides

Figure

• 

  Fig. 1 HR for IHD and stroke according to the metabolic syndrome component in Korean men in the MSRI after adjusting for age, smoking, alcohol consumption, and exercise (all p<0.0001). HR: hazard ratio, IHD: ischemic heart disease, BMI: body mass index, TG: triglyceride, HDL-C: high density lipoprotein-cholesterol, BP: blood pressure, MSRI: Metabolic Syndrome Research Initiatives.

• 

  Fig. 2 HRs for development of ASCVD and IHD according to MetS in Korean men and women in the MRSI after adjusting for age, smoking, alcohol consumption, and exercise. A: HRs for development of ASCVD according to MetS using NCEP definition. B: HRs for development of IHD according to MetS using NCEP and AHA definition. HR: hazard ratio, ASCVD: atherosclerotic cardiovascular disease, IHD: ischemic heart disease, Mets: Metabolic syndrome, NCEP: National Cholesterol Education Program, MSRI: Metabolic Syndrome Research Initiatives, AHA: American Heart Association.

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