title: All-cause and cardiovascular disease mortality increased with metabolic syndrome in Taiwanese.
abstract: OBJECTIVE
  This study aimed to investigate the relationship between mortality and metabolic syndrome using the America Heart Association/National Heart Lung Blood Institute (AHA/NHLBI) and International Diabetes Federation (IDF) definitions in a Taiwanese cohort.
  
  
  METHODS
  A total of 124,513 participants, aged 20-94 years, from four nationwide health centers in Taiwan were recruited from 1998 to 1999. Cox proportional hazard regression analyses were used to estimate the relative risks (RRs) for all-cause and cardiovascular disease (CVD) mortality for those with metabolic syndrome compared to those without metabolic syndrome over 8 years of follow-up.
  
  
  RESULTS
  The baseline prevalence of metabolic syndrome was 22.4% by the AHA/NHLBI and 13.9% by the IDF definition. A total of 2,762 deaths (527 CVD) occurred. Using the AHA/NHLBI definition, the RRs (95% confidence intervals) of all-cause and CVD mortality were 1.21 (1.09-1.34) and 1.77 (1.40-2.24), respectively, in men and 1.30 (1.12-1.49) and 1.69 (1.19-2.42), respectively, in women. The association between metabolic syndrome and mortality was attenuated when using the IDF definition. Excluding subjects with diabetes or CVD at baseline, the RRs for CVD mortality still remained significant using the two definitions.
  
  
  CONCLUSIONS
  Metabolic syndrome, using either the AHA/NHLBI or IDF definitions, is a common disorder in Taiwanese adults and is similarly associated with an increase in all-cause and CVD mortality as found in Western populations. Our study suggests that Asians with metabolic syndrome are also at higher risk for death.
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan. chin3@ha.mc.ntu.edu.tw
authors.forename: Kuo-Chin
authors.initials: KC
authors.lastname: Huang
authors.forename: Long-Teng
authors.initials: LT
authors.lastname: Lee
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Chen
authors.forename: Pei-Kun
authors.initials: PK
authors.lastname: Sung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000209:etiology / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000208:ethnology / Q000401:mortality*; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D018570:Risk Assessment; D013624:Taiwan / Q000453:epidemiology; D009626:Terminology as Topic; D013997:Time Factors