title: Does the constellation of risk factors with and without abdominal adiposity associate with different cardiovascular mortality risk?
abstract: OBJECTIVE
  To evaluate whether the metabolic syndrome (MetS) defined by the International Diabetes Federation (IDF) criteria, which has abdominal adiposity as a mandatory element, predicts cardiovascular disease (CVD) mortality better than the cluster of other IDF-defined abnormalities not including abdominal adiposity.
  
  
  METHODS
  Data from nine European population-based studies, including 7782 men and 7739 women (aged 30-89 years), with a median follow-up of 8.55 years, were jointly analyzed. Hazard ratios for CVD mortality were calculated with Cox regression models.
  
  
  RESULTS
  In total, 41% of the men and 38% of the women had the IDF MetS. Individuals with the IDF MetS were by definition more obese and had a higher prevalence of diabetes than non-obese subjects with > or = 2 IDF abnormalities; whereas non-obese men with > or = 3 factors had more atherogenic lipid profiles. Multivariate adjusted hazard ratio for CVD death in men and women with the IDF MetS was 2.44 (1.69-2.98) and 2.32 (1.27-4.23); in non-obese men with 2 and > or = 3 factors the hazard ratio was 1.60 (1.12-2.30) and 2.44 (1.62-3.66), respectively, and in non-obese women with 2 factors the hazard ratio was 2.41 (1.09-5.33).
  
  
  CONCLUSIONS
  The cluster of the CVD risk factors predicted CVD mortality regardless of the presence or absence of the abdominal adiposity. Inclusion of abdominal adiposity as a prerequisite will miss those non-obese individuals who have increased CVD mortality.
authors.affiliation: Department of Public Health, University of Helsinki, Mannerheimintie 172, 6th floor, KTTL, 6krs, PL 41, Helsinki FIN-00014, Finland. gao.weiguo@ktl.fi
authors.forename: W
authors.initials: W
authors.lastname: Gao
mesh_terms: D050153:Abdominal Fat / Q000502:physiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000401:mortality; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D016016:Proportional Hazards Models; D012307:Risk Factors; D049629:Waist-Hip Ratio
chemical_list: D008055:Lipids