Endocrinol Metab.  2014 Dec;29(4):522-529. 10.3803/EnM.2014.29.4.522.

Sex Factors in the Metabolic Syndrome as a Predictor of Cardiovascular Disease

Affiliations
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Korea.
  • 2Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. leemk@skku.edu
  • 3Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • 4Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea. chnaha@ajou.ac.kr

Abstract

BACKGROUND
Metabolic syndrome (MetS) is a condition characterized by a cluster of metabolic disorders and is associated with increased risk of cardiovascular disease (CVD). This study analyzed data from the Korean Health and Genome Study to examine the impact of MetS on CVD.
METHODS
A total of 8,898 subjects (4,241 males and 4,657 females), 40 to 69 years of age, were enrolled and evaluated for the development of new onset CVD from 2001 to 2012 (median 8.1 years of follow-up).
RESULTS
The prevalence of MetS at baseline was 22.0% (932/4,241) and 29.7% (1,383/4,657) in males and females, respectively. MetS was associated with increased risk of coronary heart disease (CHD; hazard ratio [HR], 1.818; 95% confidence interval [CI], 1.312 to 2.520 in males; HR, 1.789; 95% CI, 1.332 to 2.404 in females) and CVD (HR, 1.689; 95% CI, 1.295 to 2.204 in males; HR, 1.686; 95% CI, 1.007 to 2.192 in females). Specifically, MetS was associated with risk of future stroke in females only (HR, 1.486; 95% CI, 1.007 to 2.192). Among MetS components, abdominal obesity and hypertension were independent predictors of both CHD and CVD. In addition, a higher number of MetS components correlated with higher CVD risk.
CONCLUSION
MetS is a significant risk factor for the development of CVD although its impact varies between sexes.

Keyword

Cardiovascular diseases; Metabolic syndrome; Coronary disease; Stroke; Sex

MeSH Terms

Cardiovascular Diseases*
Coronary Disease
Female
Genome
Humans
Hypertension
Male
Obesity, Abdominal
Prevalence
Risk Factors
Sex Factors*
Stroke

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Reference

1. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988; 37:1595–1607.
2. Mozumdar A, Liguori G. Persistent increase of prevalence of metabolic syndrome among U.S. adults: NHANES III to NHANES 1999-2006. Diabetes Care. 2011; 34:216–219.
3. Pan WH, Yeh WT, Weng LC. Epidemiology of metabolic syndrome in Asia. Asia Pac J Clin Nutr. 2008; 17:Suppl 1. 37–42.
4. Lim S, Shin H, Song JH, Kwak SH, Kang SM, Won Yoon J, Choi SH, Cho SI, Park KS, Lee HK, Jang HC, Koh KK. Increasing prevalence of metabolic syndrome in Korea: the Korean National Health and Nutrition Examination Survey for 1998-2007. Diabetes Care. 2011; 34:1323–1328.
5. Haffner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stern MP. Prospective analysis of the insulin-resistance syndrome (syndrome X). Diabetes. 1992; 41:715–722.
6. Oh SW. Obesity and metabolic syndrome in Korea. Diabetes Metab J. 2011; 35:561–566.
7. Kim DJ. The epidemiology of diabetes in Korea. Diabetes Metab J. 2011; 35:303–308.
8. Galassi A, Reynolds K, He J. Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med. 2006; 119:812–819.
9. Alexander CM, Landsman PB, Teutsch SM, Haffner SM. Third National Health and Nutrition Examination Survey (NHANES III). National Cholesterol Education Program (NCEP). NCEP-defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes. 2003; 52:1210–1214.
10. Chien KL, Hsu HC, Sung FC, Su TC, Chen MF, Lee YT. Metabolic syndrome as a risk factor for coronary heart disease and stroke: an 11-year prospective cohort in Taiwan community. Atherosclerosis. 2007; 194:214–221.
11. Hwang YC, Jee JH, Oh EY, Choi YH, Lee MS, Kim KW, Lee MK. Metabolic syndrome as a predictor of cardiovascular diseases and type 2 diabetes in Koreans. Int J Cardiol. 2009; 134:313–321.
12. Kim MH, Kim MK, Choi BY, Shin YJ. Prevalence of the metabolic syndrome and its association with cardiovascular diseases in Korea. J Korean Med Sci. 2004; 19:195–201.
13. Khang YH, Cho SI, Kim HR. Risks for cardiovascular disease, stroke, ischaemic heart disease, and diabetes mellitus associated with the metabolic syndrome using the new harmonised definition: findings from nationally representative longitudinal data from an Asian population. Atherosclerosis. 2010; 213:579–585.
14. Kim BG, Park JT, Ahn Y, Kimm K, Shin C. Geographical difference in the prevalence of isolated systolic hypertension in middle-aged men and women in Korea: the Korean Health and Genome Study. J Hum Hypertens. 2005; 19:877–883.
15. Choi SH, Kim TH, Lim S, Park KS, Jang HC, Cho NH. Hemoglobin A1c as a diagnostic tool for diabetes screening and new-onset diabetes prediction: a 6-year community-based prospective study. Diabetes Care. 2011; 34:944–949.
16. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F. American Heart Association. National Heart, Lung, and Blood Institute. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005; 112:2735–2752.
17. Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ, Kim DY, Kwon HS, Kim SR, Lee CB, Oh SJ, Park CY, Yoo HJ. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract. 2007; 75:72–80.
18. Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, Montori VM. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007; 49:403–414.
19. Asia Pacific Cohort Studies Collaboration. Patel A, Barzi F, Woodard M, Ni Mhurchu C, Ohkubo T, Lam TH, Welborn T. An evaluation of metabolic risks for coronary death in the Asia Pacific region. Diabetes Res Clin Pract. 2006; 74:274–281.
20. Ninomiya T, Kubo M, Doi Y, Yonemoto K, Tanizaki Y, Rahman M, Arima H, Tsuryuya K, Iida M, Kiyohara Y. Impact of metabolic syndrome on the development of cardiovascular disease in a general Japanese population: the Hisayama study. Stroke. 2007; 38:2063–2069.
21. Boden-Albala B, Sacco RL, Lee HS, Grahame-Clarke C, Rundek T, Elkind MV, Wright C, Giardina EG, DiTullio MR, Homma S, Paik MC. Metabolic syndrome and ischemic stroke risk: Northern Manhattan Study. Stroke. 2008; 39:30–35.
22. McNeill AM, Rosamond WD, Girman CJ, Golden SH, Schmidt MI, East HE, Ballantyne CM, Heiss G. The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study. Diabetes Care. 2005; 28:385–390.
23. Lorenzano S, Ahmed N, Falcou A, Mikulik R, Tatlisumak T, Roffe C, Wahlgren N, Toni D. SITS Investigators. Does sex influence the response to intravenous thrombolysis in ischemic stroke?: answers from safe implementation of treatments in Stroke-International Stroke Thrombolysis Register. Stroke. 2013; 44:3401–3406.
24. Peters SA, Huxley RR, Woodward M. Diabetes as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 64 cohorts, including 775,385 individuals and 12,539 strokes. Lancet. 2014; 383:1973–1980.
25. Walsh T, Donnelly T, Lyons D. Why a sex difference in age-adjusted relationship between height and stroke mortality? Stroke. 2007; 38:e92.
26. Kannel WB. Elevated systolic blood pressure as a cardiovascular risk factor. Am J Cardiol. 2000; 85:251–255.
27. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Magid D, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, Moy CS, Mussolino ME, Nichol G, Paynter NP, Schreiner PJ, Sorlie PD, Stein J, Turan TN, Virani SS, Wong ND, Woo D, Turner MB. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics: 2013 update: a report from the American Heart Association. Circulation. 2013; 127:e6–e245.
28. Shin CY, Yun KE, Park HS. Blood pressure has a greater impact on cardiovascular mortality than other components of metabolic syndrome in Koreans. Atherosclerosis. 2009; 205:614–619.
29. Felix-Redondo FJ, Grau M, Baena-Diez JM, Degano IR, de Leon AC, Guembe MJ, Alzamora MT, Vega-Alonso T, Robles NR, Ortiz H, Rigo F, Mayoral-Sanchez E, Tormo MJ, Segura-Fragoso A, Fernandez-Berges D. Prevalence of obesity and associated cardiovascular risk: the DARIOS study. BMC Public Health. 2013; 13:542.
30. Gong HP, Tan HW, Fang NN, Song T, Li SH, Zhong M, Zhang W, Zhang Y. Impaired left ventricular systolic and diastolic function in patients with metabolic syndrome as assessed by strain and strain rate imaging. Diabetes Res Clin Pract. 2009; 83:300–307.
31. Aijaz B, Ammar KA, Lopez-Jimenez F, Redfield MM, Jacobsen SJ, Rodeheffer RJ. Abnormal cardiac structure and function in the metabolic syndrome: a population-based study. Mayo Clin Proc. 2008; 83:1350–1357.
32. Sundstrom J, Arnlov J, Stolare K, Lind L. Blood pressure-independent relations of left ventricular geometry to the metabolic syndrome and insulin resistance: a population-based study. Heart. 2008; 94:874–878.
33. Hutcheson R, Rocic P. The metabolic syndrome, oxidative stress, environment, and cardiovascular disease: the great exploration. Exp Diabetes Res. 2012; 2012:271028.
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