title: Comparison of definitions of metabolic syndrome in relation to the risk of developing stroke and coronary heart disease in Finnish and Swedish cohorts.
abstract: OBJECTIVE
  The purpose of this study was to compare definitions of metabolic syndrome with regard to their prediction of stroke and coronary heart disease incidence.
  
  
  METHODS
  The study comprises 4041 men and 3812 women of 6 Finnish and Swedish cohorts aged 25 to 74 years at baseline. Hazard ratio was estimated applying Cox regression analyses adjusting for cohort, cholesterol, and smoking and using age as a time scale. A paired homogeneity test was performed to compare the differences.
  
  
  RESULTS
  A total of 113 (47) ischemic and 43 (15) hemorrhagic stroke and 235 (50) coronary heart disease events were accumulated in men (women). Hazard ratios (95% CIs) for ischemic stroke in men were 1.59 (1.09 to 2.32), 1.52 (1.01 to 2.28), 1.16 (0.77 to 1.74), and 1.27 (0.87 to 1.86), respectively, for the World Health Organization, National Cholesterol Education Program, National Cholesterol Education Program revised, and the International Diabetes Federation definitions of metabolic syndrome, and in women 2.20 (1.15 to 4.19), 2.68 (1.47 to 4.87), 2.31 (1.27 to 4.20), and 1.91 (1.05 to 3.49), respectively. The corresponding hazard ratios (95% CIs) for coronary heart disease were 1.57 (1.21 to 2.04), 1.51 (1.15 to 1.99), 1.63 (1.25 to 2.13), and 1.46 (1.12 to 1.89) in men and 1.32 (0.69 to 2.51), 1.54 (0.85 to 2.79), 1.81 (1.02 to 3.21), and 2.47 (1.37 to 4.45) in women. None of the definitions of metabolic syndrome predicted hemorrhagic stroke. There was no difference between definitions of metabolic syndrome and between a full definition and its individual components.
  
  
  CONCLUSIONS
  Metabolic syndrome as well as its individual components predicted the incidence of the ischemic stroke and the coronary heart disease equally well and should be treated equally as well.
authors.affiliation: Department of Public Health, University of Helsinki, Helsinki, Finland. qing.qiao@ktl.fi
authors.forename: Qing
authors.initials: Q
authors.lastname: Qiao
authors.forename: Tiina
authors.initials: T
authors.lastname: Laatikainen
authors.forename: Björn
authors.initials: B
authors.lastname: Zethelius
authors.forename: Birgitta
authors.initials: B
authors.lastname: Stegmayr
authors.forename: Mats
authors.initials: M
authors.lastname: Eliasson
authors.forename: Pekka
authors.initials: P
authors.lastname: Jousilahti
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
mesh_terms: D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003327:Coronary Disease / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D018450:Disease Progression; D050171:Dyslipidemias / Q000150:complications / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000097:blood; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D013548:Sweden / Q000453:epidemiology; D009626:Terminology as Topic
chemical_list: D002784:Cholesterol