Cited by 4,760Diabetes, Cardiovascular Risks, and LipoproteinsCardiovascular Function and Risk FactorsCardiovascular Health and Risk Factors

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Cardiovascular Morbidity and Mortality Associated With the Metabolic Syndrome

Isomaa, Bo, Almgren, Peter, Tuomi, Tiinamaija, Forsén, Björn, Lahti, Kaj, Nissén, Michael, Taskinen, Marja-Riitta, Groop, Leif·2001·Diabetes Care

DOI 10.2337/diacare.24.4.683

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Abstract

OBJECTIVE—To estimate the prevalence of and the cardiovascular risk associated with the metabolic syndrome using the new definition proposed by the World Health Organization (WHO). RESEARCH DESIGN AND METHODS—A total of 4,483 subjects aged 35–70 years participating in a large family study of type 2 diabetes in Finland and Sweden (the Botnia study) were included in the analysis of cardiovascular risk associated with the metabolic syndrome. In subjects who had type 2 diabetes (n = 1,697), impaired fasting glucose (IFG)/impaired glucose tolerance (IGT) (n = 798), or insulin-resistance with normal glucose tolerance (NGT) (n = 1,988), the metabolic syndrome was defined as presence of at least two of the following risk factors: obesity, hypertension, dyslipidemia, or microalbuminuria. Cardiovascular mortality was assessed in 3,606 subjects with a median follow-up of 6.9 years. RESULTS—In women and men, respectively, the metabolic syndrome was seen in 10 and 15% of subjects with NGT, 42 and 64% of those with IFG/IGT, and 78 and 84% of those with type 2 diabetes. The risk for coronary heart disease and stroke was increased threefold in subjects with the syndrome (P < 0.001). Cardiovascular mortality was markedly increased in subjects with the metabolic syndrome (12.0 vs. 2.2%, P < 0.001). Of the individual components of the metabolic syndrome, microalbuminuria conferred the strongest risk of cardiovascular death (RR 2.80; P = 0.002). CONCLUSIONS—The WHO definition of the metabolic syndrome identifies subjects with increased cardiovascular morbidity and mortality and offers a tool for comparison of results from different studies.

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Authors: Isomaa, B., Almgren, P., Tuomi, T., Forsén, B., Lahti, K., Nissén, M., Taskinen, M.-R., & Groop, L.
Affiliations: Department of Internal Medicine, Jakobstad Hospital, Jakobstad, Finland
Lund University (SE)
Helsinki University Hospital (FI)
Närpes Health Center, Närpes
Vasa Health Center
Vaasa Central Hospital (FI)
ORCID: Almgren, Peter
Taskinen, Marja-Riitta
Groop, Leif
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2001-04-01
Volume: 24
Issue: 4
Pages: 683-689
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/diacare.24.4.683
OpenAlex: W1986349550
Cited by: 4,760
References: 36
Citations by year: 2026: 27 · 2025: 70 · 2024: 93 · 2023: 88 · 2022: 123 · 2021: 132 · 2020: 128 · 2019: 137 · 2018: 139 · 2017: 153 · 2016: 185 · 2015: 198 · 2014: 218 · 2013: 211 · 2012: 222
FWCI: 100.87
Type: journal article
Language: en
Open access: closed
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
Lund University Publications (Lund University) (submittedVersion)
Funders: Svenska Läkaresällskapet
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Keywords: metabolic syndrome, cardiovascular mortality, cardiovascular morbidity, type 2 diabetes, impaired fasting glucose, impaired glucose tolerance, insulin resistance, microalbuminuria, coronary artery disease, stroke, obesity, hypertension, dyslipidemia, WHO definition
MeSH terms: Adult, Age Factors, Aged, Albuminuria, Blood Glucose, Cardiovascular Diseases, Cholesterol, Diabetes Mellitus, Type 2, Family, Female, Finland, Glycated Hemoglobin, Humans, Hyperlipidemias, Hypertension, Insulin Resistance, Cholesterol, HDL, Male, Middle Aged, Morbidity, Obesity, Risk Factors, Sex Factors, Sweden, Triglycerides, Prevalence, Glucose Intolerance

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Cardiovascular Morbidity and Mortality Associated With the Metabolic Syndrome

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