NDLI: Impact of reference category and number of traits in the cluster on risk of coronary heart disease in metabolic syndrome: prospective data from the Bruneck study.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Bonora, Enzo Kiechl, Stefan Zoppini, Giacomo Targher, Giovanni Meigs, James B. Willeit, Johann Oberhollenzer, Friedrich Bonadonna, Riccardo C. Muggeo, Michele
Spatial Coverage	Italy
Description	Country affiliation: Italy Author Affiliation: Bonora E ( Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Italy. enzo.bonora@univr.it)
Abstract	BACKGROUND: We assessed the risk of coronary heart disease (CHD) in subjects with metabolic syndrome using different reference categories and focusing on the number of traits in the cluster. METHODS: For 15 years, we followed 840 subjects from the general population living in Bruneck, northeastern Italy, aged 40-79 years, without CHD at baseline. Metabolic syndrome was diagnosed at baseline using American Heart Association/National Heart, Lung, and Blood Institute criteria. Subjects with the syndrome were compared to subjects without, as well as to subjects without any metabolic abnormality, using Cox models adjusted for sex, age, smoking, and low-density lipoprotein-cholesterol. There were 89 incident CHD cases. RESULTS: In subjects with the metabolic syndrome, the risk of CHD was1.5-fold higher when subjects without the syndrome were the reference category. CHD risk, however, was 12.5-fold higher (95% confidence interval [CI], 1.7-92.7, P=0.014) when subjects without any metabolic abnormality composed the reference category. As compared to subjects with no abnormalities (who had a trivial number of CHD events), the risk increased from subjects with one (hazard ratio 7.6, 95% CI 1.0-56.5, P=0.047) to those with 2, 3, and 4/5 abnormalities (11.6, 1.6-84.9, P=0.016; 12.9, 1.7-96.0, P=0.013; and 10.1, 1.3-79.2, P=0.028), respectively. CONCLUSIONS: When compared to the reference category of people without any metabolic abnormality, those with the metabolic syndrome had high cardiovascular risk. However, in the Bruneck population, the risk of CHD seems to be similar in subjects having two or three to five clinical features of metabolic syndrome. Therefore, the clinical utility of identifying subjects with the syndrome using current diagnostic criteria remains uncertain and might be the focus of further specific studies.
File Format	HTM / HTML
ISSN	15404196
Issue Number	4
Volume Number	9
e-ISSN	15578518
Journal	Metabolic Syndrome and Related Disorders
Language	English
Publisher	Mary Ann Liebert
Publisher Date	2011-08-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Discipline Metabolism Coronary Disease Etiology Metabolic Syndrome X Complications Adult Age Factors Aged Cholesterol, Ldl Blood Female Humans Italy Male Middle Aged Proportional Hazards Models Prospective Studies Risk Factors Sex Factors Smoking Adverse Effects Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Endocrinology, Diabetes and Metabolism Internal Medicine

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