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Independent metabolic syndrome variants predict new-onset coronary artery disease.

Vaidya D, Mathias RA, Kral BG, Yanek LR, Becker LC, Becker DM - Diabetes Care (2010)

Bottom Line: RESEARCH DESIGN AND METHODS" Healthy adult siblings (n = 987) of premature CAD (<60 years) case subjects were followed for 9.8 +/- 3.8 years.Traditionally defined MetS had a hazard ratio of 1.32 (P = 0.18).Independent MetS variants identified by PC analysis may explain metabolic mechanisms that increase CAD risk better than the presence of traditional MetS.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Division of General Internal Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA. dvaidya1@jhmi.edu

ABSTRACT

Objective: Any combination of metabolic abnormalities may constitute the metabolic syndrome (MetS), conferring coronary artery disease (CAD) risk, but the independent effect of different combinations on CAD onset remains unknown. RESEARCH DESIGN AND METHODS" Healthy adult siblings (n = 987) of premature CAD (<60 years) case subjects were followed for 9.8 +/- 3.8 years. Baseline MetS variables (insulin sensitivity index, waist circumference, systolic blood pressure, HDL cholesterol, and triglycerides) were recombined into five principal components (PC1-5), and risk factor-adjusted proportional hazards for CAD onset of median-dichotomized PCs were estimated.

Results: The significant hazard ratios were as follows: for PC1 (all abnormalities except blood pressure) 1.66 (P = 0.036), PC2 (high blood pressure levels, high HDL cholesterol) 1.71 (P = 0.016), and PC4 (low HDL cholesterol, high insulin sensitivity, low triglycerides) 2.0 (P = 0.001). Traditionally defined MetS had a hazard ratio of 1.32 (P = 0.18).

Conclusions: Independent MetS variants identified by PC analysis may explain metabolic mechanisms that increase CAD risk better than the presence of traditional MetS.

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Related in: MedlinePlus

Hazard ratios for CAD and 95% CIs for baseline metabolic status for the NCEP-defined metabolic syndrome (MetS present vs. MetS absent) in one model and all five PCA scores dichotomized at the median (score > median vs. ≤ median) in the other model. Models adjusted for age, sex, race, smoking, total cholesterol, and blood pressure medication use.
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Figure 1: Hazard ratios for CAD and 95% CIs for baseline metabolic status for the NCEP-defined metabolic syndrome (MetS present vs. MetS absent) in one model and all five PCA scores dichotomized at the median (score > median vs. ≤ median) in the other model. Models adjusted for age, sex, race, smoking, total cholesterol, and blood pressure medication use.

Mentions: Unadjusted incidence curves by PC score are shown in Fig. A1 in the online appendix. The age, sex, race, and risk factor–adjusted relative hazards of the PCs (dichotomized at the median) and NCEP–ATP-III MetS are shown in Fig. 1. PC1, PC2, and PC4 are independently associated with a significant hazard ratio of new-onset CAD. The hazard ratio associated with the higher level of PC1 is greater than that associated with the NCEP-defined MetS (estimated in a separate model), which is not statistically significant in this sample.


Independent metabolic syndrome variants predict new-onset coronary artery disease.

Vaidya D, Mathias RA, Kral BG, Yanek LR, Becker LC, Becker DM - Diabetes Care (2010)

Hazard ratios for CAD and 95% CIs for baseline metabolic status for the NCEP-defined metabolic syndrome (MetS present vs. MetS absent) in one model and all five PCA scores dichotomized at the median (score > median vs. ≤ median) in the other model. Models adjusted for age, sex, race, smoking, total cholesterol, and blood pressure medication use.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2875458&req=5

Figure 1: Hazard ratios for CAD and 95% CIs for baseline metabolic status for the NCEP-defined metabolic syndrome (MetS present vs. MetS absent) in one model and all five PCA scores dichotomized at the median (score > median vs. ≤ median) in the other model. Models adjusted for age, sex, race, smoking, total cholesterol, and blood pressure medication use.
Mentions: Unadjusted incidence curves by PC score are shown in Fig. A1 in the online appendix. The age, sex, race, and risk factor–adjusted relative hazards of the PCs (dichotomized at the median) and NCEP–ATP-III MetS are shown in Fig. 1. PC1, PC2, and PC4 are independently associated with a significant hazard ratio of new-onset CAD. The hazard ratio associated with the higher level of PC1 is greater than that associated with the NCEP-defined MetS (estimated in a separate model), which is not statistically significant in this sample.

Bottom Line: RESEARCH DESIGN AND METHODS" Healthy adult siblings (n = 987) of premature CAD (<60 years) case subjects were followed for 9.8 +/- 3.8 years.Traditionally defined MetS had a hazard ratio of 1.32 (P = 0.18).Independent MetS variants identified by PC analysis may explain metabolic mechanisms that increase CAD risk better than the presence of traditional MetS.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Division of General Internal Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA. dvaidya1@jhmi.edu

ABSTRACT

Objective: Any combination of metabolic abnormalities may constitute the metabolic syndrome (MetS), conferring coronary artery disease (CAD) risk, but the independent effect of different combinations on CAD onset remains unknown. RESEARCH DESIGN AND METHODS" Healthy adult siblings (n = 987) of premature CAD (<60 years) case subjects were followed for 9.8 +/- 3.8 years. Baseline MetS variables (insulin sensitivity index, waist circumference, systolic blood pressure, HDL cholesterol, and triglycerides) were recombined into five principal components (PC1-5), and risk factor-adjusted proportional hazards for CAD onset of median-dichotomized PCs were estimated.

Results: The significant hazard ratios were as follows: for PC1 (all abnormalities except blood pressure) 1.66 (P = 0.036), PC2 (high blood pressure levels, high HDL cholesterol) 1.71 (P = 0.016), and PC4 (low HDL cholesterol, high insulin sensitivity, low triglycerides) 2.0 (P = 0.001). Traditionally defined MetS had a hazard ratio of 1.32 (P = 0.18).

Conclusions: Independent MetS variants identified by PC analysis may explain metabolic mechanisms that increase CAD risk better than the presence of traditional MetS.

Show MeSH
Related in: MedlinePlus