Metabolic syndrome and its individual components with mortality among patients with coronary heart disease.
BACKGROUND
The metabolic syndrome (MetS) and its metabolic risk factors appear to promote the development of atherosclerotic cardiovascular disease. The aim of this study was to examine the association of MetS and its individual components with all-cause and cardiovascular mortality among patients with coronary heart disease (CHD).


METHODS
We performed a prospective, hospital-based cohort among 3599 CHD patients in China. Cox proportional hazards regression models were used to estimate the association of MetS and its components at baseline with risk of mortality.


RESULTS
During a mean follow-up period of 4.9years, 308 deaths were identified, 200 of which were due to cardiovascular disease. Compared with patients without MetS, patients with MetS according to the AHA/NHLBI statement had a 1.26-fold higher risk (95% CI, 1.01-1.59) of all-cause mortality and a 1.41-fold higher risk (1.06-1.87) of cardiovascular mortality. Patients with increasing numbers of components of MetS had a gradually increased risk for all-cause and cardiovascular mortality (P<0.05). When each component of MetS was considered as a dichotomized variable separately, only low high-density lipoprotein cholesterol (HDL-C) and elevated fasting blood glucose (FBG) were associated with all-cause and cardiovascular mortality. After using restricted cubic splines, we found a U-shaped association of HDL-C, body mass index and blood pressure, a positive association of FBG, and no association of triglycerides with the risks of all-cause and cardiovascular mortality.


CONCLUSIONS
MetS is a risk factor for all-cause and cardiovascular mortality among CHD patients. It is very important to control metabolic components in a reasonable control range.
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, Guangdong 510080, China; Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA.
Qian
Q
Chen
Department of Cardiology, General Hospital of Guangzhou Military Command of People's Liberation Army, Guangdong 510010, China.
Yuan
Y
Zhang
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, Guangdong 510080, China.
Ding
D
Ding
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, Guangdong 510080, China.
Dan
D
Li
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, Guangdong 510080, China.
Min
M
Xia
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, Guangdong 510080, China.
Xinrui
X
Li
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, Guangdong 510080, China.
Yunou
Y
Yang
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, Guangdong 510080, China.
Qing
Q
Li
Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA. Electronic address: gang.hu@pbrc.edu.
Gang
G
Hu
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, Guangdong 510080, China. Electronic address: lingwh@mail.sysu.edu.cn.
Wenhua
W
Ling
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002681:China / Q000453:epidemiology; D008076:Cholesterol, HDL / Q000097:blood; D003327:Coronary Disease / Q000097:blood* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000401:mortality*; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011446:Prospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D008076:Cholesterol, HDL; D008075:Lipoproteins, HDL; D014280:Triglycerides
All-cause mortality; Cardiovascular mortality; Cohort study; Coronary heart disease; Metabolic syndrome