Metabolic syndrome and incident end-stage peripheral vascular disease: a 14-year follow-up study in elderly Finns.
OBJECTIVE
We investigated the relationship of the metabolic syndrome and its single components, defined by four different criteria, with peripheral vascular disease (PVD) in a prospective population-based study.


METHODS
The metabolic syndrome was defined according to the World Health Organization (WHO), the National Cholesterol Education Program (NCEP), the International Diabetes Federation (IDF), and the American Heart Association (updated NCEP) criteria. We investigated the relationship of the metabolic syndrome defined by the aforementioned four criteria with PVD (revacularization and amputation) by Cox regression analyses in a Finnish population of 1,212 subjects, aged 65-74 years, with and without diabetes during a 14-year follow-up.


RESULTS
The metabolic syndrome defined by the WHO, NCEP, and updated NCEP criteria was associated with a statistically significant risk for incident PVD (n = 57) with adjustment for all confounding variables except for prevalent diabetes (hazard ratios [HRs] from 1.91 to 2.62). After adjustment for prevalent diabetes or after the exclusion of subjects with prevalent diabetes, there was no association between the metabolic syndrome by any criteria and incident PVD. Of the single components of the metabolic syndrome, elevated fasting glucose by the WHO and NCEP criteria (HR 2.35) and microalbuminuria by the WHO definition (2.56) predicted PVD in multivariable models (prevalent diabetes included).


CONCLUSIONS
The metabolic syndrome defined by the WHO, NCEP, and updated NCEP criteria predicted incident end-stage PVD in elderly Finns but only when not adjusted for diabetes status. Two of the single components of the metabolic syndrome, elevated fasting plasma glucose and microalbuminuria, predicted PVD. We conclude that the metabolic syndrome predicts PVD but not above and beyond the risk associated with diabetes and microalbuminuria.
Wang
Jianjun
J
Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
Ruotsalainen
Sanna
S
Moilanen
Leena
L
Lepistö
Päivi
P
Laakso
Markku
M
Kuusisto
Johanna
J
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D049628:Body Size; D001835:Body Weight; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007328:Insulin / Q000097:blood; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000453:epidemiology*; D011446:Prospective Studies; D013997:Time Factors
D001786:Blood Glucose; D007328:Insulin