Metabolic syndrome increases all-cause and vascular mortality: the Hong Kong Cardiovascular Risk Factor Study.
OBJECTIVE
The metabolic syndrome has been associated with increased mortality in some Caucasian populations, but data in Asian populations are not available. We present data describing the association of the metabolic syndrome with mortality.


METHODS
The impact of the US National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) metabolic syndrome guidelines definition (using Asian central obesity criteria) on mortality was examined using Cox regression analyses in a population-based cohort (n = 2863) of Chinese subjects.


RESULTS
The cohort was followed up for a mean duration of 8.45 years, a total of 24 101 person-years, with 89 deaths (33.7% of vascular origin). Compared to those without any component of the metabolic syndrome, following adjustment for age, socioeconomic status and a range of lifestyle habits, those with the metabolic syndrome had increased risk of both all-cause [hazard ratio (HR) 2.02, 95% confidence interval (CI) 1.02-4.00, P for trend = 0.037] and vascular disease (HR 6.39, 95% CI 1.40-29.2, P < 0.05, P for trend = 0.002) mortality. When those with 0-2 components were compared to those with the metabolic syndrome, the HRs were 1.49 (95% CI 0.95-2.33, P = 0.084) and 3.36 (95% CI 1.57-7.19, P = 0.002), respectively.


CONCLUSIONS
This study shows that the metabolic syndrome is associated with increased mortality risk in an Asian population. The high prevalence of the metabolic syndrome, particularly in the elderly, forewarns of a rapidly increasing problem in mainland China, and other Asian populations, which could have overwhelming public health ramifications.
Thomas
G Neil
GN
Department of Community Medicine, The University of Hong Kong, Hong Kong, China.
Schooling
C Mary
CM
McGhee
Sarah M
SM
Ho
Sai-Yin
SY
Cheung
Bernard M Y
BM
Wat
Nelson M S
NM
Janus
Edward D
ED
Lam
Karen S L
KS
Lam
Tai Hing
TH
D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking; D002784:Cholesterol / Q000097:blood; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D008875:Middle Aged; D010353:Patient Education as Topic; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012044:Regression Analysis; D012306:Risk; D012907:Smoking; D012923:Social Class; D014652:Vascular Diseases / Q000209:etiology / Q000401:mortality*
D002784:Cholesterol