Risk from Metabolic Syndrome Does Not Exceed the Sum of Its Component Factors
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Does the metabolic syndrome—the common clustering of metabolic abnormalities including abdominal obesity, elevated blood glucose, abnormal lipids, and elevated blood pressure—confer a cardiovascular risk that is greater than the sum of its parts?
Apparently not, according to a recent analysis of data from the large-scale, international, multi-ethnic INTERHEART study.
INTERHEART is a standardized case-control study of incident acute myocardial infarction in 52 countries. In the current analysis, the nearly 27,000 INTERHEART participants (12,297 cases and 14,606 controls) were classified using both World Health Organization (WHO) and International Diabetes Federation (IDF) criteria for metabolic syndrome. The effect of metabolic syndrome on acute myocardial infarction was compared with the effect of its component risk factors considered singly and in combination.
No matter which definition of metabolic syndrome was used, the presence of metabolic syndrome was associated with a more than 2.5-fold increase in the risk of acute myocardial infarction. However, the effect of metabolic syndrome on myocardial infarction was similar to that of diabetes mellitus (OR, 2.72; 95% CI, 2.53 to 2.92) and hypertension (OR, 2.60; 95% CI, 2.46 to 2.76). Additionally, the population attributable risk (PAR) of metabolic syndrome on myocardial infarction was substantially lower than the PAR of several component factors considered separately (depending on the definition used), suggesting that metabolic syndrome accounts for a smaller number of cases of myocardial infarction in a population compared with several of its constituent components.
J Am Coll Cardiol. 2010;55:2390-8.