title: Gender- and race-specific metabolic score and cardiovascular disease mortality in adults: A structural equation modeling approach--United States, 1988-2006.
abstract: OBJECTIVE
  Consider all metabolic syndrome (MetS) components [systolic (SBP) and diastolic (DBP) blood pressures, waist circumference, HDL cholesterol, triglycerides (TG), and fasting glucose] and gender/race differential risk when assessing cardiovascular disease (CVD) risk.
  
  
  METHODS
  We estimated a gender- and race-specific continuous MetS score using structural equation modeling and tested its association with CVD mortality using data from National Health and Nutrition Examination Survey III linked with the National Death Index. Cox proportional hazard regression tested the association adjusted for sociodemographic and behavior characteristics.
  
  
  RESULTS
  For men, continuous MetS components associated with CVD mortality were SBP (hazard ratio = 1.50, 95% confidence interval = 1.14-1.96), DBP (1.48, 1.16-1.90), and TG (1.15, 1.12-1.16). In women, SBP (1.44, 1.27-1.63) and DBP (1.24, 1.02-1.51) were associated with CVD mortality. MetS score was not significantly associated with CVD mortality in men; but significant associations were found for all women (1.34, 1.06-1.68), non-Hispanic white women (1.29, 1.01-1.64), non-Hispanic black women (2.03, 1.12-3.69), and Mexican-American women (3.57, 2.21-5.76). Goodness-of-fit and concordance were overall better for models with the MetS score than MetS (yes/no).
  
  
  CONCLUSIONS
  When assessing CVD mortality risk, MetS score provided additional information than MetS (yes/no).
authors: Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors: Carla I
authors: CI
authors: Mercado
authors: Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors: Quanhe
authors: Q
authors: Yang
authors: Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors: Earl S
authors: ES
authors: Ford
authors: Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors: Edward
authors: E
authors: Gregg
authors: Division of Strategic National Stockpile, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors: Amy L
authors: AL
authors: Valderrama
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D005783:Gender Identity; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000401:mortality*; D008875:Middle Aged; D009749:Nutrition Surveys; D044469:Racial Groups; D012307:Risk Factors; D014481:United States; D055815:Young Adult