The Relation of Cardiovascular Risk Factors to Metabolic Syndrome

Park, Sat Byul

Abstract

BACKGROUND
Possible risk factors relating to the development of insulin resistance was analyzed and the clinical availability of metabolic syndrome on insulin resistance was examined to evaluate the relationship between the metabolic syndrome and insulin resistance.
METHODS
A total of 993 clients were selected according to the criteria of clinical identification by NCEP-ATP III. The metabolic syndrome group was 502 subjects and the control group was 491 subjects. Sociodemographic data and lifestyle factors were surveyed by questionnaire. Height, weight, blood pressure, fasting blood cholesterol, triglyceride, HDL cholesterol, glucose, and insulin levels were measured. W/BH ratio, AI, and HOMA-IR were calculated and analyzed in relation to cardiovascular risk factors.
RESULTS
In the metabolic syndrome group, men were significantly greater than women (P<0.05). The mean age and BMI in the metabolic syndrome group were significantly higher than controls (P<0.05). The cut-off point for cardiovascular risk factor using the ROC curve with W/BH ratio was 0.529, AI 4.34, HOMA-IR 1.94, and Insulin 6.35 uIU. The area under the ROC curve for variables was significantly greater than the reference value (P=0.000). Therefore, W/BH ratio was a strong predictor of incident metabolic syndrome. The study subjects were grouped according to insulin resistance and then the relationship of cardiovascular risk factors was evaluated. Odds ratios of hypertension, hypertriglyceridemia, and low HDL-cholesterolemia were significantly increased in the metabolic syndrome group (P<0.05), while the individuals with insulin resistance had a much higher incident diabetes than those without it, regardless of whether NCEP criteria for metabolic syndrome was met. The risk of insulin resistance in relation to metabolic risk factors tended to increase after adjustment of life style factors.
CONCLUSION
The diagnostic criteria for the metabolic syndrome was useful in finding out early stage of insulin resistance as an indirect measurement tool. Incident diabetes related to insulin resistance regardless of the presence of metabolic syndrome. Therefore, clinical treatment and life style modification in metabolic syndrome patients may decrease the development of cardiovascular disease and contribute to health promotion. Further study is needed to follow-up on metabolic syndrome patients.