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Metabolic syndrome positively correlates with the risks of atherosclerosis and diabetes in a Chinese population

  • Sung-Sheng Tsai
    Affiliations
    Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
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  • Yu-Sheng Lin
    Affiliations
    Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
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  • Szu-Tah Chen
    Affiliations
    Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
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  • Pao-Hsien Chu
    Correspondence
    Corresponding author at: Department of Cardiology, Chang Gung Memorial Hospital College of Medicine, Chang Gung University, 199 Tun-Hwa North Road, Taipei 105, Taiwan.
    Affiliations
    Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan

    Healthcare Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan

    Heart Failure Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
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Published:April 12, 2018DOI:https://doi.org/10.1016/j.ejim.2018.04.009

      Highlights

      • The prevalence of the ATP III-MetS is lower than that of the Asian-MetS.
      • Both MetS scores are strong risk factors for arterial stiffness and diabetes.
      • The performance of both MetS scores for arterial stiffness is similar.
      • The performance of both MetS scores for risk of diabetes is similar.

      Abstract

      Background

      Published studies seldom tested the weight of different waist circumference (WC) cut-off values for the diagnosis of metabolic syndrome (MetS) in predicting clinical outcomes, including cardiovascular disease and diabetes.

      Methods

      This is a Chinese population-based cross-sectional study screening subjects from a Health Examination Program since 1999 to 2015. The MetS identification and scores were determined either according to the Adult Treatment Panel III/American Heart Association/National Heart, Lung, and Blood Institute (ATP III/AHA/NHLBI)- or Asian-WC cut-off points. The developments of a higher brachial-ankle pulse wave velocity (baPWV), defined as ≥1400 cm/s, and diabetic-level hyperglycemia, defined as a high fasting glucose level ≥6.99 mmol/L or postprandial glucose level ≧11.10 mmol/L, were surveyed by comparing the areas under receiver operating characteristic curves (AUC-ROC) for both MetS scores.

      Results

      According to the ATP III/AHA/NHLBI- vs Asian-MetS criteria, 6633 vs 9133 (24.8% vs 34.2%, p < 0.001) subjects were diagnosed as the MetS among 26,735 study subjects with a mean age of 55 ± 12 years. The stepwise increases in baPWV and prevalence of diabetic-level hyperglycemia were associated with both MetS scores after adjusting for age and sex. Both MetS scores yielded similar results for correlation with a higher baPWV (AUC-ROC = 0.685 for ATP III/AHA/HLBI- vs 0.680 for Asian-MetS, p = 0.271) and diabetic-level hyperglycemia (AUC-ROC = 0.791 for ATP III/AHA/HLBI- vs 0.784 for Asian-MetS, p = 0.546).

      Conclusions

      In a stepwise manner, both ATP III/AHA/NHLBI- or Asian-MetS scores were strong risk factors for arterial stiffness and diabetes. Through a novel and holistic approach, the performance of the ATP III/AHA/NHLBI-MetS score for the risks of arterial stiffness and diabetes was comparable to the Asian-MetS score among a Chinese population.

      Keywords

      Abbreviations:

      ABI (ankle-brachial-index), ASCVD (atherosclerotic cardiovascular disease), ATP III/AHA/NHLBI (Adult Treatment Panel III by the American Heart Association and the National Heart, Lung, and Blood Institute), AUC-ROC (areas under receiver operator characteristic curves), baPWV (brachial-ankle pulse wave velocity), HDL-C (high-density lipoprotein cholesterol), IDF (International Diabetes Federation), MetS (metabolic syndrome), SBP (systolic blood pressure), WC (waist circumferences)
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