Evaluating CMR

Metabolic Syndrome and Type 2 Diabetes/CVD Risk

IDF

IDF Clinical Tools for Diagnosing the Metabolic Syndrome and Type 2 Diabetes/CVD Risk

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One of the most important studies to tie the metabolic syndrome (as diagnosed by the IDF) to CVD mortality is the Diabetes Epidemiology: Collaborative analysis Of Diagnostic criteria in Europe (DECODE) Study. A total of 4,715 men and 5,554 women 30 to 89 years of age were drawn from nine European population-based cohorts (19). The maximum follow-up periods ranged from 7 to 16 years. Metabolic syndrome prevalence was 35.9% in men and 34.1% in women. Hazard ratios (HR) were estimated using Cox regression analysis. A total of 105 men with the metabolic syndrome died from CVD, and the unadjusted HR was 1.79 (95% CI, 1.36-2.36). A total of 47 women with the metabolic syndrome died from CVD (the unadjusted HR for women was 2.38; 95% CI, 1.55-3.65). The DECODE study also looked at the relationship between World Health Organization (WHO) clinical criteria, NCEP-ATP III guidelines, and revised NCEP-ATP III guidelines. Study findings are summarized in section Comparison of Screening Tools.

Interestingly, a cohort study of 4,350 Chinese patients with type 2 diabetes failed to find a positive association between the metabolic syndrome as defined by the IDF and CHD (myocardial infarction, ischemic heart disease, coronary revascularization, heart failure, and CHD-related death) (20). Median study follow-up was 7.1 years. Compared to subjects without the metabolic syndrome, the HR for individuals with the metabolic syndrome (as identified by the IDF) was 1.13 (95% CI, 0.86-1.48). However, the authors reached different conclusions with NCEP-ATP III clinical criteria, as discussed in section Comparison of Screening Tools.


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19. Qiao Q. Comparison of different definitions of the metabolic syndrome in relation to cardiovascular mortality in European men and women. Diabetologia 2006; 49: 2837-46.
20. Tong PC, Kong AP, So WY, et al. The usefulness of the International Diabetes Federation and the National Cholesterol Education Program's Adult Treatment Panel III definitions of the metabolic syndrome in predicting coronary heart disease in subjects with type 2 diabetes. Diabetes Care 2007; 30: 1206-11.