Metabolic syndrome, diabetes, and cardiovascular disease in an elderly Caucasian cohort: The Italian longitudinal study on aging

Background. The metabolic syndrome (MetS) is represented by a cluster of risk factors for cardiovascular diseases (CVDs). In spite of its high frequency and strong association with morbidity and mortality in the adult population, little is known about its magnitude in elderly persons. Methods. We assessed the prevalence of MetS by diabetic status and sex in the participants in the Italian Longitudinal Study on Aging (ILSA), a population-based study on a sample of 5632 individuals 65-84 years old at baseline (1992). We measured the association of MetS with stroke, coronary heart disease, and diabetes at baseline and with CVD mortality at 4-year follow-up. Results. The prevalence of MetS was 25.9% in nondiabetic men and 55.2% in nondiabetic women; in diabetic individuals it was 64.9% and 87.1% in men and women, respectively. At baseline, in both men and women there was a significant association with stroke (odds ratio [OR] 1.67, 95% confidence interval [CI], 1.02-2.75 in men and OR 1.72, CL 1.01-2.93 in women) and diabetes (OR= 4.58, CL 3.12-6.74 in men and OR= 5.15, CI, 3.23-8.20 in women). A significant association with chronic heart disease was found in men only (OR = 1.40; CL 1.02-1.97). During the approximately 4-year follow-up, nondiabetic men with MetS had a risk of CVD mortality 12% higher compared to those without MetS, whereas no significant differences were found in women. Conclusions. MetS is very common in aged Italians, and it is associated with stroke and diabetes in both sexes, and with chronic heart disease in men. In men, it increases significantly the risk of CVD mortality.