title: Cardiovascular morbidity and mortality associated with the metabolic syndrome.
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
  
  
  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 diferent studies.
authors.affiliation: Department of Internal Medicine, Jakobstad Hospital, Finland. bo.isomaa@fimnet.fi
authors.forename: B
authors.initials: B
authors.lastname: Isomaa
authors.forename: P
authors.initials: P
authors.lastname: Almgren
authors.forename: T
authors.initials: T
authors.lastname: Tuomi
authors.forename: B
authors.initials: B
authors.lastname: Forsén
authors.forename: K
authors.initials: K
authors.lastname: Lahti
authors.forename: M
authors.initials: M
authors.lastname: Nissén
authors.forename: M R
authors.initials: MR
authors.lastname: Taskinen
authors.forename: L
authors.initials: L
authors.lastname: Groop
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000419:Albuminuria / Q000453:epidemiology; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D005190:Family; D005260:Female; D005387:Finland / Q000453:epidemiology; D018149:Glucose Intolerance / Q000097:blood / Q000150:complications / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood; D006973:Hypertension / Q000453:epidemiology; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin; D014280:Triglycerides