The predictive value of metabolic syndrome for cardiovascular and all-cause mortality: Tehran Lipid and Glucose Study

Introduction The association of total and cardiovascular disease (CVD) mortality with metabolic syndrome (Mets) is controversial. We estimated the predictive value of MetS and its components for total and CVD mortality. Materials and methods A total of 7932 subjects aged >= 30 years; participants of the Tehran Lipid and Glucose Study were enrolled and followed for 9.0 +/- 2.3 years. MetS was defined according to three different definitions: World Health Organization (WHO), International Diabetes Federation (IDF) and Joint Interim Statement (JIS). Results WHO-MetS remained a significant predictor of total and CVD mortality in men (HR 1.66, 95% CI 1.23-2.24, p<0.001; 1.93 HR 1.93, 95% CI 1.26-2.94, p=0.002) and women (HR 2.01, 95% CI 1.39-2.88, p<0.001; HR 2.71, 95% CI 1.44-5.09, p=0.002), respectively. IDF-MetS was associated with increased risk of total mortality only in women (HR 1.51, 95% CI 1.07-2.12, p=0.01), but after controlling for diabetes, IDF and WHO-MetS lost their associations. The incidence of CVD mortality was highest in WHO group (13.4) compared with IDF (8.5), JIS (8.14) and control (5.5) groups. The incidence of total mortality for WHO (27.1) was highest compared with IDF (17.7), JIS (16.5) and control (12.9) groups. In men, hypertension, impaired fasting glucose (IFG) and abdominal obesity and in women, IFG (WHO criteria) and high triglycerides levels increased the risk of CVD mortality. In men, hypertension and IFG directly and high triglycerides inversely were associated with total mortality. In women, IFG and obesity increased the risk of all-cause mortality. Conclusion Diagnosis of MetS seems no more informative than its individual components in predicting mortality. Copyright (C) 2016 John Wiley & Sons, Ltd.