title: Does diagnosis of the metabolic syndrome detect further men at high risk of cardiovascular death beyond those identified by a conventional cardiovascular risk score? The DECODE Study.
abstract: BACKGROUND
  It is not known whether the metabolic syndrome detects further individuals at high risk of death from cardiovascular disease (CVD), beyond those identified by a conventional cardiovascular risk score.
  
  
  METHODS
  A prospective study.
  
  
  METHODS
  A total of 2790 men without diabetes, aged 50-69 years from seven population-based European cohorts participating in the DECODE Study, were followed for CVD mortality over 10 years.
  
  
  RESULTS
  Some 51% of the men had an estimated 10-year risk of fatal CVD under 5%, using the European SCORE project equation, and 22% of them had the metabolic syndrome, as defined by the National Cholesterol Education Program Adult Treatment Panel III. In the low-risk men, the hazards ratio for fatal CVD, after adjusting for age and study centre, was 2.71 (1.33-5.51) for men with the syndrome (P<0.01) compared with men without the syndrome. A large waist circumference (>102 cm) carried an odds ratio of 2.24 (1.05-4.76) in the low CVD risk men.
  
  
  CONCLUSIONS
  Men with a low cardiovascular risk score and the metabolic syndrome had a significantly higher risk of fatal CVD than those without the syndrome. The use of the metabolic syndrome in clinical practice is thus justified in men, but waist circumference provided a simpler diagnostic tool with similar fatal CVD risk in these low-risk men. A large waist circumference could be used for prescreening, and could be included in CVD risk scores.
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D005060:Europe / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015228:Hypertriglyceridemia / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D011159:Population Surveillance; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012107:Research Design; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D049629:Waist-Hip Ratio
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides