Metabolic Syndrome and Risk of Cardiovascular Disease: A Meta-Analysis

Department of Medicine, Tulane University, New Orleans, Louisiana, United States
The American journal of medicine (Impact Factor: 5). 11/2006; 119(10):812-9. DOI: 10.1016/j.amjmed.2006.02.031
Source: PubMed


The use of different definitions of the metabolic syndrome has led to inconsistent results on the association between the metabolic syndrome and risk of cardiovascular disease. We examined the association between the metabolic syndrome and risk of cardiovascular disease.
A MEDLINE search (1966-April 2005) was conducted to identify prospective studies that examined the association between the metabolic syndrome and risk of cardiovascular disease. Information on sample size, participant characteristics, metabolic syndrome definition, follow-up duration, and endpoint assessment was abstracted.
Data from 21 studies met the inclusion criteria and were included. Individuals with the metabolic syndrome, compared to those without, had an increased mortality from all causes (relative risk [RR] 1.35; 95% confidence interval [CI], 1.17-1.56) and cardiovascular disease (RR 1.74; 95% CI, 1.29-2.35); as well as an increased incidence of cardiovascular disease (RR 1.53; 95% CI, 1.26-1.87), coronary heart disease (RR 1.52; 95% CI, 1.37-1.69) and stroke (RR 1.76; 95% CI, 1.37-2.25). The relative risk of cardiovascular disease associated with the metabolic syndrome was higher in women compared with men and higher in studies that used the World Health Organization definition compared with studies that used the Adult Treatment Panel III definition.
This analysis strongly suggests that the metabolic syndrome is an important risk factor for cardiovascular disease incidence and mortality, as well as all-cause mortality. The detection, prevention, and treatment of the underlying risk factors of the metabolic syndrome should become an important approach for the reduction of the cardiovascular disease burden in the general population.

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    • "Cardiovascular disease (CVD) is the leading cause of global mortality . Several prospective and retrospective studies have shown that hypertension, diabetes, obesity and dyslipidaemia are important risk factors for CVD [1] [2]. As the prevalence of these risk factors (especially obesity and diabetes) is increasing in adult populations in most countries [3], the necessity to identify potential modifiable risk factors increases, in order to reduce adverse CVD outcomes. "

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    • "Metabolic syndrome is an important risk factor for cardiovascular disease (CVD) and type 2 diabetes (Galassi et al., 2006; Mottillo et al., 2010). One of the symptoms of metabolic syndrome is dyslipidemia characterized by increased plasma levels of triglycerides (TG), total cholesterol (CH), low-density lipoproteins (LDL) and low concentrations of high-density lipoproteins (HDL). "
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    ABSTRACT: 1. To compare the effectiveness of different drug forms of silymarin: standardized extract of silymarin (SS), micronized silymarin (MS) and silymarin in the form of phytosome (PS) on dyslipidemia and liver fat accumulation in a model of metabolic syndrome, in non-obese hereditary hypertriglyceridemic rats. The second aim of this study was to slightly uncover the silymarin action on enzymes and proteins involved in cholesterol metabolism and excretion. 2. Silymarin administered to hereditary hypertriglyceridemic rats as dietary supplements (1%) for 4 weeks significantly lowered the plasma levels of triglycerides, total cholesterol and markedly increased HDL cholesterol level. Western blot analyses showed significant increase in the protein expression of CYP7A1 and CYP4A and increase in protein expression of selected ABC transporters. Silymarin in the form of phytosome and micronized silymarin were more effective forms of silymarin. 3. These findings suggest that silymarin may favorably affect the metabolism of cholesterol and triglycerides in rats with metabolic syndrome. Raising HDL levels suggests potentially important anti-atherogenic effect of silymarin. The changes in expression of cytochromes P450 and ABC transporters involved in cholesterol metabolism and excretion could be partially responsible for the hypolipidemic effect of silymarin.
    Xenobiotica 06/2015; 45(9):1-6. DOI:10.3109/00498254.2015.1010633 · 2.20 Impact Factor
    • "round physical health problems among people who suffer from severe mental illnesses ( Bartoli et al . , 2013a , b ; De Hert et al . , 2011 ; Mitchell et al . , 2013 ) . Individuals with SD have a much higher chance , relative to general population but also to SCZ / ONAP , of suffering from comorbid MetS , that represents an important risk factor ( Galassi et al . , 2006 ; Gami et al . , 2007 ; Mottillo et al . , 2010 ; Wu et al . , 2010 ) at least partially explaining the excess mortality among SD patients ( Capasso et al . , 2008 ; Laursen et al . , 2007 ) . The assessment of relevant clinical parameters should be part of regular screening for people with SD , with long - term monitoring of lifestyle "
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    ABSTRACT: People with psychotic disorders, including schizophrenia (SCZ), schizoaffective disorder (SD), or other non-affective psychoses (ONAP), have a higher risk of metabolic syndrome (MetS) than general population. However, previous meta-analyses failed to explore if people with SD are more likely to suffer from MetS than SCZ and ONAP. We carried out a systematic review and meta-analysis comparing rates of MetS in SD with those in SCZ or ONAP. We searched main electronic databases for relevant articles published up to January 2015, and for unpublished data, contacting corresponding authors, to minimize selective reporting bias. Odds ratios (ORs) based on random effects models, with 95% confidence intervals (CIs), and heterogeneity (I2), were estimated. We performed leave-one-out, quality-based, and subgroups analyses to check findings validity. Testing for publication bias, Egger's test estimates were reported. We included 7,616 individuals (1,632 with SD and 5,984 with SCZ/ONAP) from 30 independent samples. SD, as compared with SCZ/ONAP, had a random-effect pooled OR (95%CI) for MetS of 1.41 (1.23-1.61; p<0.001; I2 = 5%). No risk of publication bias was found (p=0.85). Leave-one-out, sensitivity, and subgroups analyses confirmed the association. To our knowledge, this is the first meta-analysis comparing MetS comorbidity between individuals with SD and those with SCZ or ONAP. SD subjects are more likely to suffer from MetS, with consistent findings across the studies included. However, the role of explanatory factors of this association, and the relative contribution of MetS subcomponents, deserve further research.
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