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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“Metabolic syndrome is very common, affecting about 44% of the United States population over the age of 50 years (13).”
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“Consistent with the observations of the NHANES Study[2], obesity is also a positive and independent risk factor for pro-atherosclerotic conditions traditionally attributed to diabetes, such as rates of restenosis after stenting [15, 27].”
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BackgroundHbA1c, fasting and 2 h plasma glucose in current, ex- and never-smokers: a meta-analysis
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“Background: Increased plasma plasminogen activator inhibitor-1 (PAI-1) activity and decreased tissue plasminogen activator (tPA) activity could be considered a true component of the metabolic syndrome (MetS) associated with an increased risk of developing cardiovascular diseases (CVD) and fibrinolytic abnormalities.”
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“Although recent studies indicate positive associations between the metabolic syndrome and risk of cardiovascular events in the elderly [11,15,16], these relationships are weaker than those reported in middle-age individuals, probably because age itself is an independent predictor of cardiovascular risk.”
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Diabetes and Coronary Risk Equivalency
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Variation in the Lamin A/C Gene
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Comparisons of Metabolic Syndrome Definitions in Four Populations of the Asia-Pacific Region
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“The low prevalence with EGIR-defined MetS is because this definition does not include people with known diabetes in whom MetS is more prevalent 15,16 and because of the higher cut-point for triglycerides and blood pressure.”
Retinol-binding protein-4 in experimental and clinical metabolic disease
von Eynatten, M., & Humpert, P. M. (2008) · Expert Review of Molecular Diagnostics · doi:10.1586/14737159.8.3.289 · Cited by 49
Daly, C., Hildebrandt, P. R., Bertrand, M. E., Ferrari, R., Remme, W. J., Simoons, M. L., & Fox, K. M. (2007) · Heart · doi:10.1136/hrt.2006.113084 · Cited by 50
Blackburn, P., Lemieux, I., Lamarche, B., Bergeron, J., Perron, P., Tremblay, G., Gaudet, D., & Després, J. (2007) · Diabetes Care · doi:10.2337/dc07-0272 · Cited by 50
Management of Diabetic Dyslipidemia
Solano, M. D. P., & Goldberg, R. B. (2005) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2005.01.001 · Cited by 47
The Maracaibo City Metabolic Syndrome Prevalence Study: Design and Scope
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Kalk, W. J., & Joffe, B. I. (2008) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2008.0003 · Cited by 48
Inflammation, Atherosclerosis, and Aspects of Insulin Action
Bloomgarden, Z. T. (2005) · Diabetes Care · doi:10.2337/diacare.28.9.2312 · Cited by 48
“The National Cholesterol Education Program criteria (48) have been used to show the high prevalence of metabolic syndrome in the population, with evidence that metabolic syndrome rather than hyperglycemia per se is associated with CVD (13).”
BackgroundMethodHollander, P. A. (2007) · The American Journal of Medicine · doi:10.1016/j.amjmed.2006.11.014 · Cited by 49
Metabolic syndrome: epidemiology and consequences.
Sacks, F. M. (2004) · PubMed · Cited by 47
Pourfarzam, M., Zadhoush, F., & Sadeghi, M. (2016) · Advanced Biomedical Research · doi:10.4103/2277-9175.188489 · Cited by 49
Gunning, M. N., Meun, C., van Rijn, B. B., Daan, N. M. P., van Lennep, J. E. R., Appelman, Y., Boersma, E. H., Hofstra, L., Fauser, C. G. K. M., Rueda-Ochoa, O. L., et al. (2020) · PLoS ONE · doi:10.1371/journal.pone.0229576 · Cited by 49
“%) versus 21 (17%), p < 0.01) and MetS (19 (16”
MethodInfluentialEvaluation of metabolic syndrome in adults of Talca city, Chile
Mujica, V., Elba Leiva, M., Icaza, G., Díaz, N. S., Arredondo, M., Moore‐Carrasco, R., Orrego, R., Vásquez, M., & Palomo, I. F. (2008) · Nutrition Journal · doi:10.1186/1475-2891-7-14 · Cited by 48
Cardiovascular Disease in Diabetes
Bloomgarden, Z. T. (2010) · Diabetes Care · doi:10.2337/dc10-zb04 · Cited by 49
Grandi, A., Maresca, A. M., GIUDICI, E., Laurita, E., Marchesi, C., Solbiati, F., Nicolini, E., Guasti, L., & Venco, A. (2006) · American Journal of Hypertension · doi:10.1016/j.amjhyper.2005.07.024 · Cited by 48
Role of the Metabolic Syndrome in Risk Assessment for Coronary Heart Disease
Kohli, P. (2006) · JAMA · doi:10.1001/jama.295.7.819 · Cited by 48
Kasai, T., Miyauchi, K., Kurata, T., Ohta, H., Okazaki, S., Miyazaki, T., Kajimoto, K., Kubota, N., & Daida, H. (2006) · Circulation Journal · doi:10.1253/circj.70.1531 · Cited by 48
Chan, D. C., Barrett, P. H. R., & Watts, G. F. (2004) · Clinical Science · doi:10.1042/cs20040108 · Cited by 50
The Metabolic Syndrome and Cardiovascular Disease: Part 2
Jiamsripong, P., Mookadam, M., Alharthi, M. S., Khandheria, B. K., & Mookadam, F. (2008) · Preventive Cardiology · doi:10.1111/j.1751-7141.2008.00002.x · Cited by 47
Lipid control in patients with diabetes mellitus
Betteridge, D. J. (2011) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2011.23 · Cited by 48
“Those with the metabolic syndrome—a group which includes the great majority of patients with type 2 diabetes—are also at high risk, whereas the presence of type 2 diabetes in the absence of the metabolic syndrome does not appear to confer increased risk”
BackgroundHajat, C., & Shather, Z. (2012) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2012.09.037 · Cited by 47
Li, X., Cao, C., Tang, X., Yan, X., Zhou, H., Liu, J., Ji, L., Yang, X., & Zhou, Z. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00661 · Cited by 46
“Previous studies found that older age (28) and higher HOMA-IR (7) were associated with higher risks of MetS in diabetes, while residence in the South (29) and a relatively high education level (15) were associated with lower risks of MetS, in support of our findings.”
BackgroundResultGenes for left ventricular hypertrophy
Arnett, D. K., Fuentes, L. D. L., & Broeckel, U. (2004) · Current Hypertension Reports · doi:10.1007/s11906-004-0009-5 · Cited by 46
Metabolic syndrome and its association with morbidity and mortality
Ardern, C. I., & Janssen, I. (2007) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/h06-099 · Cited by 46
“Contrary to these initial findings based on insulin resistance, the results from a nationally representative cross-sectional study of US adults found that the MetS, as defined according to NCEP, was no longer significantly associated with prevalent CVD after adjusting for the components of the MetS (Alexander et al. 2…”
ResultDepressive Symptom Clusters as Predictors of 6-Year Increases in Insulin Resistance
Khambaty, T., Stewart, J. C., Muldoon, M. F., & Kamarck, T. W. (2014) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000063 · Cited by 49
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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