Endocrine Abstracts

Background and aims: To compare and contrast the cardiovascular disease (CVD) risk associated with the metabolic syndrome (MetS) and dysglycemia, independent of each other, we evaluated the 6.7-year incidence risk of CVD and coronary heart disease (CHD).

Methods and results: In an Iranian population, 4018 subjects ≥40 years with no history of CVD at baseline, were followed up for new CHD and CVD events. Incidence rates and hazard ratio (HR) were estimated by the presence or absence of MetS, dysglycemia, and by the various traits of MetS. Considering the glycemic status, the ability of MetS in prediction of CVD after adjustment with age, sex,CVD risk factors, and components of MetS, was assessed. The prevalence of MetS, impaired fasting glucose or impaired glucose tolerance (IFG/IGT) and diabetes were 51.4, 27.3, and 18.7%, respectively. The prevalence of MetS in IFG/IGT and diabetes was 67.7 and 85.2%. Among the components of the MetS, only hypertension had a significant HR of 5.2 (95% CI, 1.9–14.0) for incident CVD. After full adjustment, diabetes remained as a significant predictor of incident CVD/CHD, regardless of the presence of MetS. IFG/IGT predicted outcomes only in the presence of MetS for CVD (HR: 1.7 (1.2–2.5)) and CHD (HR: 1.8 (1.3–2.7)); although these associations did not change after risk factor adjustment in the presence of MetS components, IFG/IGT lost its association with incident CVD/CHD.

Conclusion: In Iranian population, MetS in the absence of diabetes does not predict CVD/CHD, and intervention strategies should be focused on the prevention of diabetes.