Prevalence of all-cause and cardiovascular mortality rates according to different metabolic syndrome definitions
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In order to assess the risk of all-cause mortality and cardiovascular disease (CVD) in subjects with metabolic syndrome using either the recent International Diabetes Federation (IDF) definition or the revised National Cholesterol Educational Program (NCEP-R) definition, but not the original NCEP definition, a total of 84,730 men and women without CVD aged ≥40 years were followed-up for mortality over a mean observation period of 4.7 years. The prevalence of metabolic syndrome was 9.6% by NCEP, 21.6% by IDF, and 16.5% by NCEP-R criteria. Compared with subjects without metabolic syndrome, risks of all-cause mortality associated with metabolic syndrome were 1.63 when using NCEP, 1.25 when using IDF, and 1.32 when using NCEP-R criteria; risks of CVD mortality associated with metabolic syndrome were 2.05, 1.77 and 1.64 when using the respective definitions. In subjects presenting with metabolic syndrome by IDF and NCEP-R definitions, but not by NCEP definition, risks of all-cause mortality were 1.07 and 0.92, respectively, whereas the risks of CVD mortality were 1.42 and 1.07, respectively. Increased risk according to the more recent definitions was largely ascribed to inclusion of subjects already identified with metabolic syndrome using the original NCEP classification. Based on the findings of this very large French population study, the recent definitions of metabolic syndrome almost double its prevalence as compared to the original definition though this was not associated with higher mid-term all-cause mortality and CVD mortality rates.
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