Metabolic syndrome doubles risk for MI, stroke: NHANES data

OB/GYN News,  Oct 15, 2003  by Miriam E. Tucker

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NEW YORK -- The metabolic syndrome doubles one's risk for myocardial infarction and stroke, irrespective of traditional cardiovascular risk factors, based on an analysis of data from the third National Health and Nutrition Examination Survey.

In the study sample of 10,768 adults who had blood samples taken after 7 or more hours of fasting, the prevalence of self-reported prior myocardial infarction among the 22% with metabolic syndrome was twice (odds ratio 2.01) that of those who did not meet the criteria for the syndrome. The risk for stroke was slightly higher (odds ratio 2.16). Metabolic syndrome increased the risk of having either MI or stroke similarly among men (1.9) and women (2.2), after adjustment for age, race, and smoking.

The findings, reported by Dr. Michael H. Criqui at a symposium sponsored by the Giovanni Lorenzini Medical Foundation, is perhaps the first to align metabolic disorder as an independent risk factor for acute cardiac and cerebrovascular events in nondiabetic subjects.

The fasting cut point of 7 hours was chosen because it was determined to be the point after which both triglyceride and glucose levels stabilize. In the 4,236 subjects who had fasted less than 7 hours, an even stronger association with MI (2.64), stroke (2.95), and the combination (2.84) was found. This finding correlates with several previous studies in which postprandial lipid and glucose values were found to be better predictors of outcome than were fasting glucose levels, noted Dr. Criqui, professor of medicine at the University of California, San Diego.

Exclusion of the 845 diabetic subjects, who comprised nearly 8% of the total population studied, reduced the risk only slightly, to 1.90 for MI and/or stroke, 1.89 for MI, and 2.02 for stroke. "'So, metabolic syndrome poses a risk independent of clinical diabetes," he noted.

"The data suggest the importance of managing the metabolic syndrome overall, and the individual component conditions, given the strong relationship with cardiovascular morbidity," he said at the meeting.

BY MIRIAM E. TUCKER Senior Writer

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