title: A gender-stratified comparative analysis of various definitions of metabolic syndrome and cardiovascular risk in a multiethnic U.S. population.
abstract: BACKGROUND
  We sought to evaluate the ability of various metabolic syndrome definitions in predicting primary cardiovascular disease (CVD) outcomes in a vast multiethnic U.S. cohort.
  
  
  METHODS
  This study included 6,814 self-identified men and women aged 45-84 years enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA) study. Gender-stratified analyses were performed to calculate hazard ratios of CVD, stroke, and mortality associated with various metabolic syndrome definitions and their individual constructs.
  
  
  RESULTS
  The hazard ratios [95% confidence interval (CI)] for all-cause CVD in men were 2.90 (2.18-3.85), 2.64 (1.98-3.51), 2.16 (1.62-2.88), 2.56 (1.91-3.44), 1.82 (1.35-2.46), and 2.92 (2.15-3.95) for the National Cholesterol Education Program (NCEP), American Heart Association (AHA), World Health Organization (WHO), International Diabetes Federation (IDF), European Group for the Study of Insulin Resistance (EGIR), and the newly defined consensus criteria. Hazard ratios in women were 2.11 (1.41-3.15), 2.17 (1.45-3.27), 2.04 (1.37-3.06), 1.91 (1.27-2.88), 1.85 (1.23-2.79), and 2.08 (1.37-3.14), respectively. Metabolic syndrome was strongly associated with stroke risk only in males. In men, all constitutive metabolic syndrome components were continuously and strongly associated with CVD. In women, high-density lipoprotein and triglycerides did not appear to be associated with short term CVD risk.
  
  
  CONCLUSIONS
  We found the newly defined consensus criteria for metabolic syndrome to be similarly predictive of cardiovascular events when compared to existing definitions. Significant gender differences exist in the association between metabolic syndrome, its individual components, and CVD.
authors: Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, Michigan, USA.
authors: Pawan
authors: P
authors: Hari
authors: Kamalakar
authors: K
authors: Nerusu
authors: Vikas
authors: V
authors: Veeranna
authors: Rajeev
authors: R
authors: Sudhakar
authors: Sandip
authors: S
authors: Zalawadiya
authors: Krithi
authors: K
authors: Ramesh
authors: Luis
authors: L
authors: Afonso
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000145:classification / Q000175:diagnosis* / Q000208:ethnology*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000145:classification / Q000175:diagnosis* / Q000208:ethnology*; D008875:Middle Aged; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D009626:Terminology as Topic; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data