Age- and sex-specific prevalence and ten-year risk for CVD of all 16 risk factor combinations of the metabolic syndrome
The results of this study provide overall, as well as age- and sex-based, estimates of the prevalence of various combinations of risk factors that make up metabolic syndrome, as well as identify population groups where targeted surveillance and intervention efforts might be directed...
Age- and sex-specific prevalence and ten-year risk for CVD of all 16 risk factor combinations of the metabolic syndrome
Authors: S Moebus, C Balijepalli, C Losch, L Gores, et al.
Reference: Cardiovascular Diabetology 2010; 9:34 (open access)
http://www.cardiab.com/content/9/1/34/abstract
Reviewer: Robert Goldberg, PhD, Contributing editor, ProCor; Professor of Medicine and Epidemiology, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
Reviewer comments: Metabolic syndrome (METS), and the individual risk factors which make up this metabolic disorder, have been increasingly recognized in the development of coronary heart disease (CHD) in adult men and women from developed countries. While the impact of this syndrome on the development of CHD is certain, what remains unknown about this syndrome, however, is the frequency of various combinations of the different risk factors that make up this disorder and how the combinations of these risk factors differ in both magnitude and in different at risk groups further defined according to age and sex. The results of the present large cross-sectional survey in adult German men and women demonstrate that there is considerable variation in the frequency of the 16 possible different combinations of factors that make up the METS and the combination of an elevated waist circumference, BP findings, and serum glucose levels was the most prevalent. These combinations varied between the sexes being most notably different in older men and women as compared to younger study subjects.
The results of the present study are important in that they provide overall, as well as age- and sex-based, estimates of the prevalence of various combinations of risk factors that make up the METS and identify population groups where targeted surveillance and/or intervention efforts might be directed to reduce the magnitude and impact of combinations of these factors.
Not surprisingly, and consistent with the results of other investigations, persons with the METS were predicted to be at greater risk for both fatal and nonfatal CHD events.
The present findings provide useful information on the prevalence rates of the clustering of various risk factors for the METS in men and women in different age strata. These data can be used to more effectively screen and identify men and women at increased risk for CHD and develop tailored pharmacologic and nonpharmacologic intervention approaches for the enhanced prevention of CHD in at risk groups.
Purpose of study: To examine the magnitude of various combinations of individual risk factors that comprises the METS, and estimated 10 year risk for developing a myocardial infarction in men and in women.
Location of study: Germany
Study design: Cross-sectional
Results: Data from the German Metabolic and Cardiovascular Risk Project (GEMCAS) were utilized for the present investigation. This is a large cross-sectional study that was carried out in the fall of 2005 which included nearly 36,000 men and women between the ages of 18-99 years. This study was undertaken for purposes of determining the prevalence of the METS in Germany. This study was performed at the practice sites of 1511 randomly selected primary care physicians throughout Germany. Data were collected from all adults (older than18 years) visiting these practitioners irrespective of the reason(s) for their visit.
Information was collected about study participant's demographic characteristics, lifestyle practices; and medical history, particularly of diabetes, MI, and stroke.
A standardized assessment was carried out to identify individual risk factors for the METS including an increased waist circumference, elevated blood pressure, and increased serum glucose, triglyceride, and HDL-cholesterol levels. Documentation of the METS was diagnosed according to commonly used AHA and NHLBI criteria at the time this investigation was carried which included the presence of any three of five measured risk factors.
A total of 13,942 men and 21,927 with an average age of 52 years were included in GEMCAS. In this study population, approximately 70% of the men and slightly more than half of the women were overweight or obese, 28% of the men and 24% of the women were current smokers, and one fifth of the men and one tenth of the women had a history of CVD.
In this population, slightly more than one in every five persons had the METS present. Of these, two thirds of the men and women had any three of the five risk factors that comprised the METS, 28% had any four characteristics, whereas 7% had all five characteristics. There were no appreciable sex differences in these prevalence rates between men and women.
In examining differences in the prevalence rates of the different combinations of factors that make up the METS, the combination of an elevated waist circumference/BP/ serum glucose levels was the most frequent combination (28%). The combination of an elevated waist circumference as well as HDL and BP levels was considerably more frequent in women than in men (10% vs. 3%) whereas the combination of elevated triglyceride and glucose levels and BP was more frequently documented in men than in women (10% vs. 3%). Differences in the prevalence rates of these various combinations were noted when age and sex specific differences were examined, with differences in these rates according to age being most notable.
The estimated 10 year risk for MI of different combinations of the individual components of the METS was examined in men between the ages of 35-65 years and for women between the ages of 45-65 years. The estimated risk for MI was considerably higher in men than in women for every combination of clustered risk factors for the METS. Men with the METS had a considerably higher expected 10 year risk for developing MI than men without the METS (7.9% vs. 4.7%). In women, the average 10 year risk for MI in individuals with, as compared to those without, the METS was considerably elevated (2.3% vs. 1.1%); though markedly lower than the risk of MI which was calculated for men. In both sexes, there were several combinations of risk factors that were associated with a particularly elevated risk for MI. In using the ESC score which predicts fatal CVD events, much lower estimates for the association of the METS were observed in both men and in women and, again, persons with the METS as compared to those who did not have this syndrome present were at increased risk for dying from CVD. Similar to the risk for MI, several combinations of risk scores resulted in considerably higher versus lower risk of fatal CVD events and these combinations differed according to age and sex.
Age- and sex-specific prevalence and ten-year risk for CVD of all 16 risk factor combinations of the metabolic syndrome
Authors: S Moebus, C Balijepalli, C Losch, L Gores, et al.
Reference: Cardiovascular Diabetology 2010; 9:34 (open access)
http://www.cardiab.com/content/9/1/34/abstract
Reviewer: Robert Goldberg, PhD, Contributing editor, ProCor; Professor of Medicine and Epidemiology, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
Reviewer comments: Metabolic syndrome (METS), and the individual risk factors which make up this metabolic disorder, have been increasingly recognized in the development of coronary heart disease (CHD) in adult men and women from developed countries. While the impact of this syndrome on the development of CHD is certain, what remains unknown about this syndrome, however, is the frequency of various combinations of the different risk factors that make up this disorder and how the combinations of these risk factors differ in both magnitude and in different at risk groups further defined according to age and sex. The results of the present large cross-sectional survey in adult German men and women demonstrate that there is considerable variation in the frequency of the 16 possible different combinations of factors that make up the METS and the combination of an elevated waist circumference, BP findings, and serum glucose levels was the most prevalent. These combinations varied between the sexes being most notably different in older men and women as compared to younger study subjects.
The results of the present study are important in that they provide overall, as well as age- and sex-based, estimates of the prevalence of various combinations of risk factors that make up the METS and identify population groups where targeted surveillance and/or intervention efforts might be directed to reduce the magnitude and impact of combinations of these factors.
Not surprisingly, and consistent with the results of other investigations, persons with the METS were predicted to be at greater risk for both fatal and nonfatal CHD events.
The present findings provide useful information on the prevalence rates of the clustering of various risk factors for the METS in men and women in different age strata. These data can be used to more effectively screen and identify men and women at increased risk for CHD and develop tailored pharmacologic and nonpharmacologic intervention approaches for the enhanced prevention of CHD in at risk groups.
Purpose of study: To examine the magnitude of various combinations of individual risk factors that comprises the METS, and estimated 10 year risk for developing a myocardial infarction in men and in women.
Location of study: Germany
Study design: Cross-sectional
Results: Data from the German Metabolic and Cardiovascular Risk Project (GEMCAS) were utilized for the present investigation. This is a large cross-sectional study that was carried out in the fall of 2005 which included nearly 36,000 men and women between the ages of 18-99 years. This study was undertaken for purposes of determining the prevalence of the METS in Germany. This study was performed at the practice sites of 1511 randomly selected primary care physicians throughout Germany. Data were collected from all adults (older than18 years) visiting these practitioners irrespective of the reason(s) for their visit.
Information was collected about study participant's demographic characteristics, lifestyle practices; and medical history, particularly of diabetes, MI, and stroke.
A standardized assessment was carried out to identify individual risk factors for the METS including an increased waist circumference, elevated blood pressure, and increased serum glucose, triglyceride, and HDL-cholesterol levels. Documentation of the METS was diagnosed according to commonly used AHA and NHLBI criteria at the time this investigation was carried which included the presence of any three of five measured risk factors.
A total of 13,942 men and 21,927 with an average age of 52 years were included in GEMCAS. In this study population, approximately 70% of the men and slightly more than half of the women were overweight or obese, 28% of the men and 24% of the women were current smokers, and one fifth of the men and one tenth of the women had a history of CVD.
In this population, slightly more than one in every five persons had the METS present. Of these, two thirds of the men and women had any three of the five risk factors that comprised the METS, 28% had any four characteristics, whereas 7% had all five characteristics. There were no appreciable sex differences in these prevalence rates between men and women.
In examining differences in the prevalence rates of the different combinations of factors that make up the METS, the combination of an elevated waist circumference/BP/ serum glucose levels was the most frequent combination (28%). The combination of an elevated waist circumference as well as HDL and BP levels was considerably more frequent in women than in men (10% vs. 3%) whereas the combination of elevated triglyceride and glucose levels and BP was more frequently documented in men than in women (10% vs. 3%). Differences in the prevalence rates of these various combinations were noted when age and sex specific differences were examined, with differences in these rates according to age being most notable.
The estimated 10 year risk for MI of different combinations of the individual components of the METS was examined in men between the ages of 35-65 years and for women between the ages of 45-65 years. The estimated risk for MI was considerably higher in men than in women for every combination of clustered risk factors for the METS. Men with the METS had a considerably higher expected 10 year risk for developing MI than men without the METS (7.9% vs. 4.7%). In women, the average 10 year risk for MI in individuals with, as compared to those without, the METS was considerably elevated (2.3% vs. 1.1%); though markedly lower than the risk of MI which was calculated for men. In both sexes, there were several combinations of risk factors that were associated with a particularly elevated risk for MI. In using the ESC score which predicts fatal CVD events, much lower estimates for the association of the METS were observed in both men and in women and, again, persons with the METS as compared to those who did not have this syndrome present were at increased risk for dying from CVD. Similar to the risk for MI, several combinations of risk scores resulted in considerably higher versus lower risk of fatal CVD events and these combinations differed according to age and sex.
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