title: Risk of coronary heart disease associated with metabolic syndrome and its individual components in Iranian subjects: a matched cohort study.
abstract: OBJECTIVE
  To evaluate the risk of coronary heart disease (CHD) associated with metabolic syndrome (MetS) and its individual components in a representative sample of diabetic and nondiabetic Iranians. Moreover, we aimed to define the most hazardous MetS components.
  
  
  METHODS
  Two cohorts consisting of 1737 nondiabetic and 2385 diabetic participants were followed for the first CHD event during 8.5 years (until December 2013).
  
  
  RESULTS
  MetS is defined as having 3 individual components associated with increased risk of CHD (hazard ratio [HR] for MetS: in the unadjusted were 2.85 [2.27-3.57] and in the fully adjusted model 1.80 [1.42-2.28]). MetS was associated with lower hazard of CHD in subjects older than 65 (HR: 1.50 vs. 3.47; P for interaction < .05) and in men (HR: 1.68 vs. 4.87; P for interaction < .05). Presence of 4 of 5 individual MetS components increased the risk of CHD associated with MetS as a constellation. The value of MetS is augmented in the presence of low high-density lipoprotein-cholesterol (HR: 5.74 [2.52-13.08]) versus its absence (HR 1.91 [1.33-2.75]), high triglycerides (HR: 3.39 [1.38-8.34] vs. 1.99 [1.40-2.82] in its absence) and elevated blood pressure (HR: 2.61 [1.43-4.76] vs. 1.80 [1.26-2.58] in its absence).
  
  
  CONCLUSIONS
  We address the value of MetS components in the prediction of CHD and in the absence of traditional risk factors. This study provides evidence for the synergistic effect of MetS components on the incidence of CHD.
authors.affiliation: Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, PO Box 13145-784, Tehran, Iran. Electronic address: esteghamati@tums.ac.ir.
authors.forename: Alireza
authors.initials: A
authors.lastname: Esteghamati
authors.affiliation: Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, PO Box 13145-784, Tehran, Iran.
authors.forename: Nima
authors.initials: N
authors.lastname: Hafezi-Nejad
authors.affiliation: Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, PO Box 13145-784, Tehran, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Sheikhbahaei
authors.affiliation: Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, PO Box 13145-784, Tehran, Iran.
authors.forename: Behnam
authors.initials: B
authors.lastname: Heidari
authors.affiliation: Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, PO Box 13145-784, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Zandieh
authors.affiliation: Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, PO Box 13145-784, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Ebadi
authors.affiliation: Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, PO Box 13145-784, Tehran, Iran.
authors.forename: Manouchehr
authors.initials: M
authors.lastname: Nakhjavani
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002784:Cholesterol / Q000378:metabolism; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology*; D048909:Diabetes Complications / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension; D015994:Incidence; D007492:Iran; D008075:Lipoproteins, HDL / Q000378:metabolism; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D014280:Triglycerides / Q000378:metabolism
chemical_list: D008075:Lipoproteins, HDL; D014280:Triglycerides; D002784:Cholesterol
keywords: Cohort; Coronary heart disease; Epidemiology; Hypertriglyceridemia; Low HDL-C; Metabolic syndrome