title: The Natural History of Patients With Isolated Metabolic Syndrome.
abstract: To define the natural history of patients with isolated metabolic syndrome (MS).
  
  
  
  Metabolic syndrome is associated with increased risk of cardiovascular mortality. Patients with isolated MS are a subset of patients with MS who do not meet the diagnostic criteria of hypertension (HTN) and diabetes mellitus (DM). Data were collected prospectively on a population-based random sample of 1042 Olmsted County, Minnesota, residents aged 45 years or older who underwent clinical evaluation, medical record abstraction, and echocardiography (visit 1: January 1,1997, to December 31, 2000). The cohort was subdivided into healthy controls, those with isolated MS, and those with MS with HTN and/or DM groups. After 4 years, patients returned for visit 2 (September 1, 2001, to December 30, 2004). After visit 2, we have a median of 8.3 years of follow-up.
  
  
  
  There was a higher incidence of HTN, DM, and obesity in the isolated MS group at visit 2 (P<.001) than in healthy controls. Patients with isolated MS did not have significantly higher rates of cardiovascular mortality (hazard ratio [HR], 0.85; 95% CI, 0.23-3.13; P=.80) or development of heart failure (HR, 1.29; 95% CI, 0.58-2.73; P=.53) compared with healthy controls over 8 years of follow-up after visit 2. However, patients with MS with HTN and/or DM had higher rates of cardiovascular mortality (HR, 2.40; 95% CI, 1.00-5.83; P=.02) and heart failure (HR, 2.24; 95% CI, 1.16-4.32; P=.02) compared with healthy controls over 8 years of follow-up after visit 2.
  
  
  
  Isolated MS was associated with increased risk for the development of HTN, DM, and obesity, but not increased mortality or heart failure over an 8-year period compared with healthy controls. Future studies should determine whether aggressive management of risk factors in isolated MS will prevent progression to MS.
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Pratik A
authors.initials: PA
authors.lastname: Patel
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Scott
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Rodeheffer
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN. Electronic address: chen.horng@mayo.edu.
authors.forename: Horng H
authors.initials: HH
authors.lastname: Chen
mesh_terms: D017677:Age Distribution; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000401:mortality*; D016022:Case-Control Studies; D002423:Cause of Death; D008076:Cholesterol, HDL / Q000032:analysis; D015897:Comorbidity; D057225:Data Mining; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D024821:Metabolic Syndrome / Q000145:classification / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D056128:Obesity, Abdominal; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D014280:Triglycerides / Q000097:blood
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D014280:Triglycerides