An Exploratory Analysis of Criteria for the Metabolic Syndrome and Its Prediction of Long-term Cardiovascular Outcomes
Open accessAbstract
Studies have shown an increased risk of cardiovascular outcomes with the metabolic syndrome, but information on predictive properties of the National Cholesterol Education Program Adult Treatment Panel 3 (NCEP) criteria is sparse. The authors used data from the Hoorn population-based study in the Netherlands including 2,484 participants aged 50-75 years examined in 1989 and followed for cardiovascular morbidity and mortality through 2000 to assess NCEP criteria, excluding known diabetes or cardiovascular disease. Cluster analyses explored whether NCEP identifies a mixture of heterogeneous groups. For each gender, participants meeting NCEP criteria seemed to be divided into clusters distinguished primarily by triglycerides or high density lipoprotein cholesterol. Cutpoints for components predicting cardiovascular events using classification and survival tree methodology varied by endpoint and gender, but Cox model hazards ratios were relatively comparable regardless of cutpoints (range: 1.3-2.5). Clear gradation in risk of cardiovascular outcomes was evident with increasing number of components, with statistically elevated risk for >or=3 (NCEP) components in men but for >or=2 components in women. Exploratory analyses of alternative metabolic syndrome criteria suggest cardiovascular risk estimates comparable to those derived by using NCEP, but criteria evaluating risk on more of a continuum would potentially allow consideration of alternative definitions by gender or for patients with other risk factors.
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- Authors
- Girman, C. J., Dekker, J. M., Rhodes, T., Nijpels, G., Stehouwer, C. D. A., Bouter, L. M., & Heine, R. J.
- Affiliations
- Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-09-01
- Volume
- 162
- Issue
- 5
- Pages
- 438-447
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2093974920
- Cited by
- 41
- References
- 55
- Citations by year
- 2023: 1 · 2022: 1 · 2018: 2 · 2017: 2 · 2016: 3 · 2015: 1 · 2014: 2 · 2012: 2
- FWCI
- 3.49
- Type
- journal article
- Language
- en
- Open access
- Licence
- other-oa
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- VU Research Portal (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Vrije Universiteit Amsterdam
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- metabolic syndrome, NCEP ATP III criteria, cardiovascular risk prediction, cardiovascular morbidity and mortality, triglycerides, HDL cholesterol, sex differences, classification and regression trees
- MeSH terms
- Aged, Cardiovascular Diseases, Female, Humans, Male, Middle Aged, Netherlands, Predictive Value of Tests, Registries, Regression Analysis, Risk Factors, Cluster Analysis, Proportional Hazards Models, Statistics, Nonparametric, Metabolic Syndrome
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