Is there any relationship between different phenotypes of metabolic syndrome and cardiovascular mortality rate?

Document Type : Original Article

Authors
Alireza Khosravi 1
Sareh Ahmadzadeh 2
Mojgan Gharipour 3
Jafar Golshahi 4
Masoumeh Sadeghi 5
Mahnaz Jozan 2
Nizal Sarrafzadegan 6
1 Department of Cardiology, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
2 Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
3 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
4 Department of Cardiology, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
5 Department of Cardiology, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
6 Department of Cardiology, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: This study aimed to focus on different phenotypes of metabolic syndrome (MetS) and their impact on the cardiovascular disease (CVD) events among a sample of the Iranian population.
Materials and Methods: The Isfahan cohort study is a population-based, on-going longitudinal study of adults aged 35 years old or more, living in urban and rural areas of three counties in central Iran namely Isfahan, Najafabad and Arak. Participants were selected by multistage random sampling and were recruited to reflect the age, sex and urban/rural distribution of the community. The sample was restricted to subjects with MetS based on the National Cholesterol Education Program Adult Treatment Panel III criteria and no history of coronary heart disease, stroke, or cancer at the time of the baseline clinical examination.
Results: Among different phenotypes of MetS components, clustering of high triglycerides (TGs), low high-density lipoprotein (HDL) and abdominal obesity (ABO) was the most related to the all-cause mortality among women and followed in order by high TGs, hypertension (HTN) and ABO. In men, the highest rate of all-cause mortality was related to high TGs, low HDL, and HTN. Clustering of four components (high TGs, low HDL and HTN and obesity) is the most related to all-cause mortality in the both sexes (12.1% in men, and 21.5% in women).
Conclusion: This study showed different phenotypes of MetS related with all-cause mortality rate and existing HTN in the phenotype of MetS increased the incidence of CVD mortality.

Keywords

1.
De Simone G, Devereux RB, Chinali M, Best LG, Lee ET, Galloway JM, et al. Prognostic impact of metabolic syndrome by different definitions in a population with high prevalence of obesity and diabetes: The Strong Heart Study. Diabetes Care 2007;30:1851-6.  Back to cited text no. 1
    
2.
Lorenzo C, Williams K, Hunt KJ, Haffner SM. The National Cholesterol Education Program - Adult Treatment Panel III, International Diabetes Federation, and World Health Organization definitions of the metabolic syndrome as predictors of incident cardiovascular disease and diabetes. Diabetes Care 2007;30:8-13.  Back to cited text no. 2
    
3.
Alberti KG, Zimmet P, Shaw J. Metabolic syndrome – A new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med 2006;23:469-80.  Back to cited text no. 3
    
4.
Austin MA, Edwards KL, McNeely MJ, Chandler WL, Leonetti DL, Talmud PJ, et al. Heritability of multivariate factors of the metabolic syndrome in nondiabetic Japanese Americans. Diabetes 2004;53:1166-9.  Back to cited text no. 4
    
5.
Huang P, Kraja AT, Tang W, Hunt SC, North KE, Lewis CE, et al. Factor relationships of metabolic syndrome and echocardiographic phenotypes in the HyperGEN study. J Hypertens 2008;26:1360-6.  Back to cited text no. 5
    
6.
Lin HF, Boden-Albala B, Juo SH, Park N, Rundek T, Sacco RL. Heritabilities of the metabolic syndrome and its components in the Northern Manhattan Family Study. Diabetologia 2005;48:2006-12.  Back to cited text no. 6
    
7.
Franklin BA, Cushman M. Recent advances in preventive cardiology and lifestyle medicine: A themed series. Circulation 2011;123:2274-83.  Back to cited text no. 7
    
8.
Ghaem Maralani H, Tai BC, Wong TY, Tai ES, Li J, Wang JJ, et al. Metabolic syndrome and mortality in the elderly: A time-dependent association. Diabetes Res Clin Pract 2013;99:209-16.  Back to cited text no. 8
    
9.
Saito I, Iso H, Kokubo Y, Inoue M, Tsugane S. Metabolic syndrome and all-cause and cardiovascular disease mortality: Japan Public Health Center-based Prospective (JPHC) Study. Circ J 2009;73:878-84.  Back to cited text no. 9
    
10.
Sarrafzadegan N, Talaei M, Sadeghi M, Kelishadi R, Oveisgharan S, Mohammadifard N, et al. The Isfahan cohort study: Rationale, methods and main findings. J Hum Hypertens 2011;25:545-53.  Back to cited text no. 10
    
11.
Sarrafzadegan N, Talaei M, Kelishadi R, Toghianifar N, Sadeghi M, Oveisgharan S, et al. The influence of gender and place of residence on cardiovascular diseases and their risk factors. The Isfahan cohort study. Saudi Med J 2012;33:533-40.  Back to cited text no. 11
    
12.
O'Donnell CJ, Ridker PM, Glynn RJ, Berger K, Ajani U, Manson JE, et al. Hypertension and borderline isolated systolic hypertension increase risks of cardiovascular disease and mortality in male physicians. Circulation 1997;95:1132-7.  Back to cited text no. 12
    
13.
Gharipour M, Sarrafzadegan N, Sadeghi M, Andalib E, Talaie M, Shafie D, et al. Predictors of metabolic syndrome in the Iranian population: Waist circumference, body mass index, or waist to hip ratio? Cholesterol 2013;2013:198384.  Back to cited text no. 13
    
14.
Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol 2010;56:1113-32.  Back to cited text no. 14
    
15.
Malik S, Wong ND, Franklin SS, Kamath TV, L'Italien GJ, Pio JR, et al. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all-causes in United States adults. Circulation 2004;110:1245-50.  Back to cited text no. 15
    
16.
Suzuki T, Hirata K, Elkind MS, Jin Z, Rundek T, Miyake Y, et al. Metabolic syndrome, endothelial dysfunction, and risk of cardiovascular events: The Northern Manhattan Study (NOMAS). Am Heart J 2008;156:405-10.  Back to cited text no. 16
    
17.
Donato GB, Fuchs SC, Oppermann K, Bastos C, Spritzer PM. Association between menopause status and central adiposity measured at different cutoffs of waist circumference and waist-to-hip ratio. Menopause 2006;13:280-5.  Back to cited text no. 17
    
18.
Blake GJ, Otvos JD, Rifai N, Ridker PM. Low-density lipoprotein particle concentration and size as determined by nuclear magnetic resonance spectroscopy as predictors of cardiovascular disease in women. Circulation 2002;106:1930-7.  Back to cited text no. 18
    
19.
Hokanson JE, Austin MA. Plasma triglyceride level is a risk factor for cardiovascular disease independent of high-density lipoprotein cholesterol level: A meta-analysis of population-based prospective studies. J Cardiovasc Risk 1996;3:213-9.  Back to cited text no. 19
    
20.
Williams K, Tchernof A, Hunt KJ, Wagenknecht LE, Haffner SM, Sniderman AD. Diabetes, abdominal adiposity, and atherogenic dyslipoproteinemia in women compared with men. Diabetes 2008;57:3289-96.  Back to cited text no. 20
    
21.
Legro RS. Polycystic ovary syndrome and cardiovascular disease: A premature association? Endocr Rev 2003;24:302-12.  Back to cited text no. 21
    
22.
Anderson GL, Limacher M, Assaf AR, Bassford T, Beresford SA, Black H, et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: The women's health initiative randomized controlled trial. JAMA 2004;291:1701-12.  Back to cited text no. 22
    
23.
Hsia J, Langer RD, Manson JE, Kuller L, Johnson KC, Hendrix SL, et al. Conjugated equine estrogens and coronary heart disease: The women's health initiative. Arch Intern Med 2006;166:357-65.  Back to cited text no. 23
    
24.
Manson JE, Hsia J, Johnson KC, Rossouw JE, Assaf AR, Lasser NL, et al. Estrogen plus progestin and the risk of coronary heart disease. N Engl J Med 2003;349:523-34.  Back to cited text no. 24
    
25.
Carr DB, Utzschneider KM, Hull RL, Tong J, Wallace TM, Kodama K, et al. Gestational diabetes mellitus increases the risk of cardiovascular disease in women with a family history of type 2 diabetes. Diabetes Care 2006;29:2078-83.  Back to cited text no. 25
Advanced Biomedical Research
Volume 2016, November
November 2016
Pages 1-5