title: Cardiovascular disease incidence, mortality and case fatality related to diabetes and metabolic syndrome: A community-based prospective study (Ansung-Ansan cohort 2001-12).
abstract: BACKGROUND
  We evaluated the separate and combined effect of metabolic syndrome (MS) and diabetes on incident cardiovascular disease (CVD), CVD mortality and case fatality risk (CFR).
  
  
  METHODS
  8898 subjects were categorized into four groups on the basis of the presence of MS and diabetes (with MS, with diabetes, with both or without either). We compared the development of CVD events, mortality and CFR.
  
  
  RESULTS
  Over a mean follow-up of 8.0 years, 690 subjects developed CVD. There were 434 deaths, of which 101 were from CVD. The presence of diabetes alone, MS alone, or both was associated with an increased risk for incident CVD and CVD mortality. Compared with the MS only group, the adjusted hazard ratio (HR) for CVD events and CVD mortality in the diabetes only group was 1.07 (95% confidence interval [CI] 0.77-1.48) and 2.02 (95% CI 0.99-1.72), respectively. Among individuals with diabetes, the presence of MS did not significantly increase CVD risk and CVD mortality. The adjusted odds ratio for CVD CFR, including adjustment for the presence of MS, in subjects with diabetes versus without diabetes was 2.11 (95% CI 1.34-3.31).
  
  
  CONCLUSIONS
  There was no difference in the risk of incident CVD between individuals with diabetes alone and MS alone, whereas CVD mortality was much higher in individuals with diabetes only. The presence of MS did not exhibit an additive effect on CVD risk and mortality in individuals with diabetes. Individuals with diabetes had a higher CVD case fatality regardless of the presence of MS.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Changwon Hospital, Seoul, Republic of Korea.
authors.forename: Ji Cheol
authors.initials: JC
authors.lastname: Bae
authors.affiliation: Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Nam H
authors.initials: NH
authors.lastname: Cho
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A University Medical Center, Busan, Republic of Korea.
authors.forename: Sunghwan
authors.initials: S
authors.lastname: Suh
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jae Hyeon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Kyu Yeon
authors.initials: KY
authors.lastname: Hur
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Sang-Man
authors.initials: SM
authors.lastname: Jin
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Moon-Kyu
authors.initials: MK
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D002423:Cause of Death; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
keywords: cardiovascular disease; diabetes; metabolic syndrome; 关键词：心血管疾病，糖尿病，代谢综合征