Wilson PWF, Agostino RBD, Parise H, Sullivan L, Meigs JB. Metabolic Syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation 112, 3066-3072

Division of Mathematics, Boston University, Boston, Massachusetts, United States
Circulation (Impact Factor: 14.43). 12/2005; 112(20):3066-72. DOI: 10.1161/CIRCULATIONAHA.105.539528
Source: PubMed


The incidence of cardiovascular disease (CVD), coronary heart disease (CHD), and type 2 diabetes mellitus (T2DM) has not been well defined in persons with the metabolic syndrome (at least 3 of the following: abdominal adiposity, low HDL cholesterol, high triglycerides, hypertension, and impaired fasting glucose). The objective was to investigate risk for CVD, CHD, and T2DM according to metabolic syndrome traits.
The study followed a cohort of 3323 middle-aged adults for the development of new CVD, CHD, and T2DM over an 8-year period. In persons without CVD or T2DM at baseline, the prevalence of the metabolic syndrome (> or =3 of 5 traits) was 26.8% in men and 16.6% in women. There were 174 incident cases of CVD, 107 of CHD, and 178 of T2DM. In men, the metabolic syndrome age-adjusted relative risk (RR) and 95% CIs were RR=2.88 (95% CI 1.99 to 4.16) for CVD, RR=2.54 (95% CI 1.62 to 3.98) for CHD, and RR=6.92 (95% CI 4.47 to 10.81) for T2DM. Event rates and RRs were lower in women for CVD (RR=2.25, 95% CI 1.31 to 3.88) and CHD (RR=1.54, 95% CI 0.68 to 3.53), but they were similar for T2DM (RR=6.90, 95% CI 4.34 to 10.94). Population-attributable risk estimates associated with metabolic syndrome for CVD, CHD, and T2DM were 34%, 29%, and 62% in men and 16%, 8%, 47% in women.
Metabolic syndrome is common and is associated with an increased risk for CVD and T2DM in both sexes. The metabolic syndrome accounts for up to one third of CVD in men and approximately half of new T2DM over 8 years of follow-up.

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    • "), and is a primary pathological process in the aetiology of Alzheimer's Disease (Kalaria, 1999; Selley, 2003; Dickstein et al. 2010). Peripheral insulin resistance related to increases in adiposity with ageing can lead to pancreatic β-cell dysregulation and increases risk of type 2 diabetes mellitus (Chang & Halter, 2003; Wilson et al. 2005; Neeland et al. 2012). Reductions in glomerular filtration rate with ageing increase the risk of developing chronic kidney disease, end-stage renal disease and CVD (Anderson et al. 2009). "
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    ABSTRACT: Most nations of the world are undergoing rapid and dramatic population aging, which presents great socio-economic challenges, as well as opportunities, for individuals, families, governments and societies. The prevailing biomedical strategy for reducing the healthcare impact of population aging has been “compression of morbidity” and, more recently, to increase healthspan, both of which seek to extend the healthy period of life and delay the development of chronic diseases and disability until a brief period at the end of life. Indeed, a recently established field within biological aging research, “Geroscience”, is focused on healthspan extension. Superimposed on this background are new attitudes and demand for “optimal longevity”—living long, but with good health and quality of life. A key obstacle to achieving optimal longevity is the progressive decline in physiological function that occurs with aging, which causes functional limitations (e.g., reduced mobility) and increases the risk of chronic diseases, disability and mortality. Current efforts to increase healthspan center on slowing the fundamental biological processes of aging such as inflammation/oxidative stress, increased senescence, mitochondrial dysfunction, impaired proteostasis and reduced stress resistance. We propose that optimization of physiological function throughout the lifespan should be a major emphasis of any contemporary biomedical policy addressing global aging. Effective strategies should delay, reduce or abolish reductions in function with aging (primary prevention) and/or improve function or slow further declines in older adults with already impaired function (secondary prevention). Healthy lifestyle practices featuring regular physical activity and ideal energy intake/diet composition represent first-line function-preserving strategies, with pharmacological agents, including existing and new pharmaceuticals and novel “nutraceutical” compounds, serving as potential complementary approaches. Future research efforts should focus on defining the temporal patterns of functional declines with aging, identifying the underlying mechanisms and modulatory factors involved, and establishing the most effective lifestyle practices and pharmacological options for maintaining function. Continuing development of effective behavioral approaches for enhancing adherence to healthy aging practices in diverse populations, and ongoing analysis of the socio-economic costs and benefits of healthspan extension will be important supporting goals. To meet the demands created by rapid population aging, a new emphasis in physiological geroscience is needed, which will require the collaborative, interdisciplinary efforts of investigators working throughout the translational research continuum from basic science to public health.This article is protected by copyright. All rights reserved
    The Journal of Physiology 01/2015; DOI:10.1113/jphysiol.2014.282665 · 5.04 Impact Factor
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    • "Robust evidence showed that individuals diagnosed with MetS using these definitions have a greater risk of significant clinical consequences, the two most prominent of which are the development of T2DM and CVD [12] [13] [14] [15]. Individuals with MetS have a fivefold greater risk of developing T2DM [12], while a systematic review of 37 studies involving more than 170,000 patients has shown that MetS doubles the risk of cardiovascular events [15]. "

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    • "Metabolic syndrome (MetS) is a clustering of metabolic risk factors including central obesity, elevated blood pressure, increased fasting plasma glucose, high serum triglycerides, and low high-density cholesterol levels [1]. People with metabolic syndrome are at increased risk for atherosclerosis, peripheral vascular disease, coronary heart disease, myocardial infarction, stroke, and type 2 diabetes [2-5], which are the leading causes of death and disability worldwide [6]. However, metabolic syndrome and its deadly consequences can be preventable and treated by maintaining a healthy weight, eating a healthy diet, getting adequate physical activity, and following healthcare providers’ instructions [7,8]. "
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    ABSTRACT: Background Metabolic syndrome (MetS) is a clustering of metabolic risk factors for cardiovascular diseases and type 2 diabetes. The study aimed to estimate the prevalence of MetS, its components, and their associations among rural middle-aged population in Vietnam. Methods A cross-sectional study with a representative sample (n = 2443) was conducted to collect data on demographic, socioeconomic, anthropometric, lifestyles, plasma glucose, and lipid profile. The age- and sex-adjusted prevalences of MetS and its components were calculated using the direct standardization. Associations of risk factors with MetS were evaluated using logistic regression, taken into account the confounding factors. Results The total age- and sex-adjusted prevalence (95% CI) of MetS was 16.3% (14.0 - 18.6). The most frequent component of MetS was high triglycerides (43.2%), followed by low HDL-C (42.0%), elevated blood pressure (29.2%), high plasma glucose (14.3%), and central obesity (12.3%). Of the total population, only 17.6% did not have any component of MetS and more than 40% had at least two MetS components. The association of MetS with residence, age, body mass index, marital status, and siesta time per day was statistically significant in univariate analysis and replicated in multivariate analysis. Conclusion The MetS prevalence and its components are common and major public health burden in the middle-aged adults in Vietnam. Habitants living in urban, being never-married, having an increase in age, BMI, and siesta time per day are significantly associated with MetS, and they should be paid much more attention for screening and implementing preventive activities.
    BMC Endocrine Disorders 09/2014; 14(1):77. DOI:10.1186/1472-6823-14-77 · 1.71 Impact Factor
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