Abstract 860: Metabolic Syndrome and Long-term Outcomes in United States Adults -Cohort Analysis From the Third National Health and Nutrition Survey (NHANES III)
Background: The objective of this study was to validate the long-term outcomes associated with metabolic syndrome (MetSyn) from the newly released vital statistics of the Third National Health and Nutrition Examination Survey (NHANES III).
Methods: We selected the subjects aged ≥40 years in NHANES III (1988~1994) who completed the interviews and had fasted at least 8 h prior to the blood collection so that MetSyn could be ascertained. MetSyn was defined according to the criteria by the National Cholesterol Education Program Adult Treatment Panel (NCEP ATP) III 2001 and the modified glucose criterion in 2005. All-cause mortality, cardiovascular mortality, cardiac mortality, and non-cardiovascular mortality were obtained from the NHANES III-linked mortality follow-up file through December 31, 2000. Univariate and multivariate Cox regression model was used to find the association between MetSyn and various types of outcomes in men and women respectively.
Results: A total of 1,355 men and 1,308 women, including the white, the black, and the Hispanic, was included in the analysis. The prevalence of MetSyn aged 40 and above was 32% and 28% respectively for male and female. In the male subjects, there was no association between MetSyn and all-cause mortality, cardiovascular mortality, cardiac mortality, and non-cardiovascular mortality in the univariate analysis and in the multivariate analysis adjusted for age, race, renal function, low-density lipoprotein cholesterol level, and smoking status. In the female, MetSyn was an independent risk factor for all-cause mortality (hazard ratio: 1.84, 95% CI: 1.29~2.64, p=0.001), cardiovascular mortality (HR: 1.96, 95% CI: 1.21~3.17, p=0.007), cardiac mortality (HR: 1.88, 95% CI: 1.15~3.09, p=0.01), and even non-cardiovascular mortality (HR: 1.80, 95% CI: 1.13~2.87, p=0.01) after consideration of weighting, clustering, and stratification variables and after adjustment for covariates.
Conclusion: The results of the national cohort have demonstrated the detrimental effects of MetSyn on all-cause, cardiovascular, cardiac, and non-cardiovascular mortality through an observation period as long as 12 years in women, but not in men. Gender was a strong modifier of the NCEP-MetSyn on long-term outcomes.