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, N. et al. (2003) 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. Circulation, 108(4), pp. 414-419. (doi:10.1161/01.CIR.0000080897.52664.94) (PMID:12860911)

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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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Macfarlane, Professor Peter and Isles, Dr Christopher and O'Reilly, Dr Denis and Ford, Professor Ian and Shepherd, Prof James and Gaw, Dr Allan and Cobbe, Professor Stuart and Packard, Professor Chris and Sattar, Professor Naveed
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., and Shepherd, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > School of Life Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Circulation
Publisher:American Heart Association
ISSN:0009-7322
ISSN (Online):1524-4539
Published Online:28 July 2003

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