title: Using structural equation model to illustrate the relationship between metabolic risk factors and cardiovascular complications in Taiwan.
abstract: BACKGROUND
  The objective of this study was to perform a population-based screening programme to determine the prevalence of the metabolic syndrome (MetS) and the relationship between metabolic risk factors and prevalent cardiovascular complications in Taiwan.
  
  
  METHODS
  A screening programme recruited residents aged 40 years and older in Sanchih, Taipei County, Taiwan, and collected demographic data, blood and urine samples. Fasting plasma glucose level, serum total cholesterol, high-density lipoprotein cholesterol, and triglyceride were measured. Atherosclerotic complications, including myocardial infarction, stress-positive angina, ischaemic stroke, and proteinuria were confirmed.
  
  
  METHODS
  A structural equation model (SEM) was constructed to identify the association between metabolic abnormality and atherosclerosis.
  
  
  RESULTS
  A total of 1494 subjects, 776 male and 718 female, were recruited in this study. The crude prevalence of the MetS was 19.3% for men [95% confidence interval (CI) 16.3-22.2%] and 18.7% for women (95% CI 15.6-22.0%). The presence of the MetS posed a substantial risk to microvascular complications in both sexes [odds ratio (OR) 3.29, P<0.001] and to macrovascular complications in men (OR 1.95, P=0.04) and also a trend in women (OR 2.24, P=0.089). There was a positive association between metabolic abnormality and atherosclerosis (B=0.55, P<0.001).
  
  
  CONCLUSIONS
  This study has found the prevalence of the MetS and the association with atherosclerotic complications in Taiwan. The SEM approach has demonstrated a positive correlation between metabolic abnormality and atherosclerosis and can be used to explore new risk factors for cardiovascular diseases.
authors.affiliation: National Taiwan University Hospital Yun-Lin Branch, Yun-Lin bNational Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jou-Wei
authors.initials: JW
authors.lastname: Lin
authors.forename: Juey-Jen
authors.initials: JJ
authors.lastname: Hwang
authors.forename: Dao-Fu
authors.initials: DF
authors.lastname: Dai
authors.forename: Yung-Zu
authors.initials: YZ
authors.lastname: Tseng
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000453:epidemiology; D015233:Models, Statistical; D017202:Myocardial Ischemia / Q000453:epidemiology* / Q000209:etiology; D016017:Odds Ratio; D011159:Population Surveillance; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population; D017678:Sex Distribution; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D013624:Taiwan / Q000453:epidemiology