The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.
NCEP-Defined Metabolic Syndrome, Diabetes, and Prevalence of Coronary Heart Disease Among NHANES III Participants Age 50 Years and Older
Abstract
Although the individual components of the metabolic syndrome are clearly associated with increased risk for coronary heart disease (CHD), we wanted to quantify the increased prevalence of CHD among people with metabolic syndrome. The Third National Health and Nutrition Examination Survey (NHANES III) was used to categorize adults over 50 years of age by presence of metabolic syndrome (National Cholesterol Education Program [NCEP] definition) with or without diabetes. Demographic and risk factor information was determined for each group, as well as the proportion of each group meeting specific criteria for metabolic syndrome. The prevalence of CHD for each group was then determined. Metabolic syndrome is very common, with ∼44% of the U.S. population over 50 years of age meeting the NCEP criteria. In contrast, diabetes without metabolic syndrome is uncommon (13% of those with diabetes). Older Americans over 50 years of age without metabolic syndrome regardless of diabetes status had the lowest CHD prevalence (8.7% without diabetes, 7.5% with diabetes). Compared with those with metabolic syndrome, people with diabetes without metabolic syndrome did not have an increase in CHD prevalence. Those with metabolic syndrome without diabetes had higher CHD prevalence (13.9%), and those with both metabolic syndrome and diabetes had the highest prevalence of CHD (19.2%) compared with those with neither. Metabolic syndrome was a significant univariate predictor of prevalent CHD (OR 2.07, 95% CI 1.66–2.59). However, blood pressure, HDL cholesterol, and diabetes, but not presence of metabolic syndrome, were significant multivariate predictors of prevalent CHD. The prevalence of CHD markedly increased with the presence of metabolic syndrome. Among people with diabetes, the prevalence of metabolic syndrome was very high, and those with diabetes and metabolic syndrome had the highest prevalence of CHD. Among all individuals with diabetes, prevalence of CHD was increased compared with those with metabolic syndrome without diabetes. However, individuals with diabetes without metabolic syndrome had no greater prevalence of CHD compared with those with neither.
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“In individuals with diabetes, the coexistence of other metabolic syndrome factors denotes a higher risk for future development of ASCVD.69”
From Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement (2005) · cites this paper as [69]
In the citing paper
“the combination of MS and hypertension has been reported to result in an even higher morbidity and mortality.11”
From Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension (2004) · cites this paper as [11]
In the citing paper
“It is already known that MS or EHT patients have a high cardiovascular risk”
From Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension (2004) · cites this paper as [11]
In the citing paper
“ASCVD risk is higher with MetS in the absence of T2D compared with T2D without MetS (13.9% vs. 7.5%, respectively) (13).”
From The CardioMetabolic Health Alliance (2015) · cites this paper as [13]
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“Abbreviations: AACE, American Association of Clinical Endocrinologists; ATP, Adult Treatment Panel; CHD, coronary heart disease; CVD, cardiovascular disease; EGIR, European Group for the Study of Insulin Resistance; IGFBP, IGF binding protein; IMT, intima-media thickness; IRS, insulin resistance syndrome; NHS, Nurses’…”
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Hypertensive target organ damage predicts incident diabetes mellitus
Izzo, R., SIMONE, G. D., Trimarco, V., Gerdts, E., Giudice, R., Vaccaro, O., LUCA, N. D., & Trimarco, B. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht281 · Cited by 75
“This scenario is also consistent with the evidence that most vascular damage associated with diabetes seems to be related to the coexisting MetS, more than to diabetes itself.(29,30) Taken together with our findings, this evidence also suggests that the potent atherogeniceffect of insulin resistance might be part of t…”
ResultInsulin-like growth factor binding protein: a possible marker for the metabolic syndrome?
Ruan, W., & Lai, M. (2010) · Acta Diabetologica · doi:10.1007/s00592-009-0142-3 · Cited by 96
“The increasing prevalence of the metabolic syndrome and the growing recognition of the adverse complications, including cardiovascular disease (CVD) and nonalcoholic fatty liver disease (NAFLD) [4, 5], have focused attention on this important metabolic abnormality, emphasizing the importance of understanding the compl…”
BackgroundPrevalence of metabolic syndrome in a rural area of Brazil
Velásquez-Meléndez, G., Gazzinelli, A., Corrêa‐Oliveira, R., Pimenta, A. M., & Kac, G. (2007) · Sao Paulo Medical Journal · doi:10.1590/s1516-31802007000300006 · Cited by 69
Won, K. B., Chang, H., Kim, H. C., Jeon, K., Lee, H., Shin, S., Cho, I., Park, S., Lee, S., & Jang, Y. (2013) · Cardiovascular Diabetology · doi:10.1186/1475-2840-12-41 · Cited by 77
“[21] reported that the prevalence of CHD is substantially higher in subjects with both diabetes and MS than in those with only diabetes.”
BackgroundThe association between frailty, the metabolic syndrome, and mortality over the lifespan
Kane, A. E., Gregson, E., Theou, O., Rockwood, K. J., & Howlett, S. E. (2017) · GeroScience · doi:10.1007/s11357-017-9967-9 · Cited by 78
“High BP has been associated with both increased (Alexander et al. 2003) and decreased (Blom et al.”
Lewis, G. F., Murdoch, S. J., Uffelman, K. D., Naples, M., Szeto, L., Albers, A., Adeli, K., & Brunzell, J. D. (2004) · Diabetes · doi:10.2337/diabetes.53.11.2893 · Cited by 73
“The insulin resistance (or metabolic) syndrome is estimated to affect approximately one-quarter of the North American population (1) and is associated with a high risk for the development of both type 2 diabetes as well as atherosclerotic cardiovascular disease (2,3).”
BackgroundEthnic Disparities in the Association of Body Mass Index with the Risk of Hypertension and Diabetes
Wong, R. J., Chou, C., Sinha, S. R., Kamal, A., & Ahmed, A. (2013) · Journal of Community Health · doi:10.1007/s10900-013-9792-8 · Cited by 72
Szalat, A., & Itamar, R. (2008) · Diabetes Obesity and Metabolism · doi:10.1111/j.1463-1326.2008.00896.x · Cited by 75
Cavallari, C., Ranghino, A., Tapparo, M., Cedrino, M., Figliolini, F., Grange, C., Giannachi, V., Garneri, P., Deregibus, M. C., Collino, F., et al. (2017) · Scientific Reports · doi:10.1038/s41598-017-08250-0 · Cited by 74
Aso, Y., Wakabayashi, S., Yamamoto, R., Matsutomo, R., Takebayashi, K., & Inukai, T. (2005) · Diabetes Care · doi:10.2337/diacare.28.9.2211 · Cited by 72
Point: The Metabolic Syndrome Still Lives
Grundy, S. M. (2005) · Clinical Chemistry · doi:10.1373/clinchem.2005.050989 · Cited by 71
Subclinical Hypothyroidism Is Associated with Early Insulin Resistance in Kuwaiti Women
SAYED, A. A., Ali, N. A., ABBAS, Y. B., & ALFADHLI, E. (2006) · Endocrine Journal · doi:10.1507/endocrj.k06-018 · Cited by 71
Rahimi, G. R. M., Bijeh, N., & Rashidlamir, A. (2019) · Experimental Physiology · doi:10.1113/ep088036 · Cited by 69
“MetS and obesity are accompanied by an increased risk for type 2 diabetes, cardiovascular disease and some metabolic bone disorders (Alexander et al., 2003).”
BackgroundHaffner, S. M. (2006) · The American Journal of Medicine · doi:10.1016/j.amjmed.2006.01.008 · Cited by 70
Self-citationCardiovascular risks of atypical antipsychotic drug treatment
Drici, M., & Priori, S. G. (2007) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.1424 · Cited by 70
“Several studies have associated the MS with an increased risk for cardiovascular morbi-mortality.(41,42) Weight gain and obesity are becoming increasingly prevalent among the general population of Westernised countries.”
Chan, D. C., & Watts, G. F. (2011) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2010.502529 · Cited by 69
“However, by whichever definition, most subjects with MetS have normal or IGT and are not formally diabetic [4].”
BackgroundRole of C-Reactive Protein in Contributing to Increased Cardiovascular Risk in Metabolic Syndrome
Devaraj, S., Valleggi, S., Siegel, D., & Jialal, I. (2010) · Current Atherosclerosis Reports · doi:10.1007/s11883-010-0098-3 · Cited by 70
Ribe, A. R., Laursen, T. M., Sandbæk, A., Charles, M., Nordentoft, M., & Vestergaard, M. (2014) · Psychological Medicine · doi:10.1017/s0033291714000634 · Cited by 70
“The metabolic syndrome is strongly associated with the risk of cardiovascular disease (Alexander et al. 2003), which may explain at least (a)”
BackgroundChen, K., Lindsey, J. B., Khera, A., de Lemos, J. A., Ayers, C. R., Goyal, A., Vega, G. L., Murphy, S. A., Grundy, S. M., & McGuire, D. K. (2008) · Diabetes and Vascular Disease Research · doi:10.3132/dvdr.2008.016 · Cited by 69
“An interesting observation from the present study that was also evident in the study from NHANES is that the subset with DM but no MetS had a notably low-risk CVD risk profile.(9) Despite the fact that the subgroup with only DM in the present study was older, with a greater proportion of men and smokers, the remainder…”
ResultMetabolic Syndrome and Cardiometabolic Risk Factors
Papakonstantinou, E., Lambadiari, V., Dimitriadis, G., & Zampelas, A. (2014) · Current Vascular Pharmacology · doi:10.2174/15701611113116660176 · Cited by 67
Association of Posttraumatic Stress Disorder With Increased Prevalence of Metabolic Syndrome
Jin, H., Lanouette, N. M., Mudaliar, S. R. D., Henry, R. R., Folsom, D. P., Khandrika, S., Glorioso, D., & Jeste, D. V. (2009) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3181a45ed0 · Cited by 67
“Metabolic syndrome is a significant risk factor for cardiovascular disease and diabetes.(1,2) The prevalence of metabolic syndrome is higher in people older than 40 years than in those younger than 40 years, with the highest rates being among women older than 60 years.”
BackgroundSubclinical Cushing's syndrome
Terzolo, M., Bovio, S., Pia, A. R., Osella, G., Borretta, G., Angeli, A., & Reimondo, G. (2007) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/s0004-27302007000800013 · Cited by 67
“Even if it is held that the metabolic syndrome is associated with enhanced all-cause and cardiovascular mortality [ 38 ,39], evidence of increased morbidity and mortality in patients with clinically inapparent adrenal adenoma, with or without subclinical Cushing’s syndrome, is presently lacking [32].”
BackgroundTargeting the Consequences of the Metabolic Syndrome in the Diabetes Prevention Program
Goldberg, R. B., & Mather, K. J. (2012) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.111.241893 · Cited by 67
Cardiovascular Risks Associated With Obesity in Children and Adolescents
Ho, T. F. (2009) · Annals of the Academy of Medicine Singapore · doi:10.47102/annals-acadmedsg.v38n1p48 · Cited by 65
Longitudinal and age trends of metabolic syndrome and its risk factors: The Family Heart Study
Kraja, A. T., Borecki, I. B., North, K. E., Tang, W., Myers, R. H., Hopkins, P. N., Arnett, D. K., Corbett, J., Adelman, A., & Province, M. A. (2006) · Nutrition & Metabolism · doi:10.1186/1743-7075-3-41 · Cited by 66
“Alexander et al. reported that participants who had MetS but not diabetes had a 13.9% prevalence of CHD, whereas those with MetS and diabetes had a 19.2% prevalence of CHD [ 4 ].”
InfluentialOnat, A., Hergenç, G., Keleş, İ., Doğan, Y., Türkmen, S., & Sansoy, V. (2005) · Metabolism · doi:10.1016/j.metabol.2005.01.025 · Cited by 66
Metadata
- Authors
- Alexander, C. M., Landsman, P. B., Teutsch, S. M., & Haffner, S. M.
- Affiliations
- Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
- The University of Texas at San Antonio Health Science Center (US)
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2003-05-01
- Volume
- 52
- Issue
- 5
- Pages
- 1210-1214
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2151152924
- Cited by
- 1,475
- References
- 30
- Citations by year
- 2026: 9 · 2025: 14 · 2024: 18 · 2023: 20 · 2022: 30 · 2021: 37 · 2020: 32 · 2019: 30 · 2018: 42 · 2017: 39 · 2016: 51 · 2015: 43 · 2014: 61 · 2013: 65 · 2012: 73
- FWCI
- 77.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- metabolic syndrome, coronary artery disease, prevalence, older adults, NCEP criteria, NHANES III, cardiovascular risk factors, blood pressure, HDL cholesterol
- MeSH terms
- Age Factors, Blood Pressure, Body Constitution, Coronary Disease, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Humans, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Patient Education as Topic, Physical Examination, Surveys and Questionnaires, Risk Factors, Smoking, United States, Prevalence, Metabolic Syndrome
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