Metabolic Syndrome With and Without C-Reactive Protein as a Predictor of Coronary Heart Disease and Diabetes in the West of Scotland Coronary Prevention Study

Sattar, Naveed; Gaw, Allan; Scherbakova, Olga; Ford, Ian; O’Reilly, Denis St.J.; Haffner, Steven M.; Isles, Chris; Macfarlane, Peter W.; Packard, Chris J.; Cobbe, Stuart M.; Shepherd, James

doi:10.1161/01.cir.0000080897.52664.94

Cited by 1,506Diabetes, Cardiovascular Risks, and LipoproteinsLipoproteins and Cardiovascular HealthAdipokines, Inflammation, and Metabolic Diseases

Metabolic Syndrome With and Without C-Reactive Protein as a Predictor of Coronary Heart Disease and Diabetes in the West of Scotland Coronary Prevention Study

Sattar, Naveed, Gaw, Allan, Scherbakova, Olga, Ford, Ian, O’Reilly, Denis St.J., Haffner, Steven M., Isles, Chris, Macfarlane, Peter W. +3 more·2003·Circulation

DOI 10.1161/01.cir.0000080897.52664.94

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Abstract

Background— The National Cholesterol Education Program (NCEP) recently proposed a simple definition for metabolic syndrome. Information on the prospective association of this definition for coronary heart disease (CHD) and type 2 diabetes is currently limited. Methods and Results— We used a modified NCEP definition with body mass index in place of waist circumference. Baseline assessments in the West of Scotland Coronary Prevention Study were available for 6447 men to predict CHD risk and for 5974 men to predict incident diabetes over 4.9 years of follow-up. Mean LDL cholesterol was similar but C-reactive protein was higher ( P <0.0001) in the 26% of men with the syndrome compared with those without. Metabolic syndrome increased the risk for a CHD event [univariate hazard ratio (HR)=1.76 (95% CI, 1.44 to 2.15)] and for diabetes [univariate HR=3.50 (95% CI 2.51 to 4.90)]. Metabolic syndrome continued to predict CHD events (HR=1.30, 95% CI, 1.00 to 1.67, P =0.045) in a multivariate model incorporating conventional risk factors. Men with 4 or 5 features of the syndrome had a 3.7-fold increase in risk for CHD and a 24.5-fold increase for diabetes compared with men with none (both P <0.0001). C-reactive protein enhanced prognostic information for both outcomes. With pravastatin, men with the syndrome had similar risk reduction for CHD as compared with those without (HR, 0.73 and 0.69; pravastatin versus placebo). Conclusions— A modified NCEP metabolic syndrome definition predicts CHD events, and, more strikingly, new-onset diabetes, and thus helps identify individuals who may receive particular benefit from lifestyle measures to prevent these diseases.

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The MS has been associated with incident CHD and CHD mortality.
“The MS has been associated with incident CHD and CHD mortality, [5][6][7][8][9][10][11]”
From Diabetes, the Metabolic Syndrome, and Angiographic Progression of Coronary Arterial Disease in Postmenopausal Women (2006) · cites this paper as [8]
Many studies evaluating the MS and clinical cardiovascular outcomes included only men or noted a relative paucity of events among women compared with men.
“Many of the studies evaluating the MS and clinical cardiovascular outcomes have included only men 5,6,8,9 or have noted a relative paucity of events among women compared with men.11,39,40”
From Diabetes, the Metabolic Syndrome, and Angiographic Progression of Coronary Arterial Disease in Postmenopausal Women (2006) · cites this paper as [8]
CVD event reductions were similar across categories of baseline triglycerides in LIPID, the Heart Protection Study, and WOSCOPS.
“However, CVD event reductions were similar across categories of baseline triglycerides in the Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID), 488 the Heart Protection Study, 489 and WOSCOPS, 490”
From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [490]

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Authors: Sattar, N., Gaw, A., Scherbakova, O., Ford, I., O’Reilly, D. S. J., Haffner, S. M., Isles, C., Macfarlane, P. W., Packard, C. J., Cobbe, S. M., & Shepherd, J.
Affiliations: The University of Texas at San Antonio Health Science Center (US)
ORCID: Sattar, Naveed
Ford, Ian
Isles, Chris
Macfarlane, Peter W.
Packard, Chris J.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2003-07-29
Volume: 108
Issue: 4
Pages: 414-419
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.0000080897.52664.94
OpenAlex: W2169121622
Cited by: 1,506
References: 30
Citations by year: 2026: 8 · 2025: 11 · 2024: 18 · 2023: 39 · 2022: 17 · 2021: 25 · 2020: 29 · 2019: 27 · 2018: 32 · 2017: 39 · 2016: 48 · 2015: 46 · 2014: 54 · 2013: 58 · 2012: 81
FWCI: 82.61
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Keywords: metabolic syndrome, C-reactive protein, coronary artery disease, type 2 diabetes, NCEP criteria, pravastatin, cardiovascular risk prediction, body mass index, WOSCOPS, men
MeSH terms: C-Reactive Protein, Coronary Disease, Diabetes Mellitus, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Predictive Value of Tests, Scotland, Triglycerides, Cohort Studies, Comorbidity, Body Mass Index, Incidence, Multivariate Analysis, Pravastatin, Risk Assessment, Metabolic Syndrome

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Metabolic Syndrome With and Without C-Reactive Protein as a Predictor of Coronary Heart Disease and Diabetes in the West of Scotland Coronary Prevention Study

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