The Metabolic Syndrome and Coronary Heart Disease in Older Women: Findings From the British Women's Heart and Health Study
Posted on: Sunday, 8 May 2005, 03:00 CDT
Lawlor DA, Ebrahim S, Davey Smith G: The metabolic syndrome and coronary heart disease in older women: findings from the British Women's Heart and Health Study. Diabet Med 21:906-913, 2004
Findings. This was a cross-sectional study of 3,770 women aged 60- 79 years randomly selected from 23 British towns. The prevalence of the metabolic syndrome was high in this population and similar with both definitions: 28.2% (95% CI 26.8-29.7) of the women had metabolic syndrome according to the World Health Organization (WHO) definition, and 29.2% (27.7-30.7) had the Adult Treatment Panel III (ATP III)-defined syndrome. There was reasonable agreement between the two definitions, with 79% of the participants being similarly classified by both definitions. The syndrome was associated with prevalent coronary heart disease (CHD), with the magnitude of the association with CHD being similar for both definitions. The odds ratio for the age-, smoking-, physical activity-, adult social class- , and childhood social class-adjusted association was 1.45 (95% CI 1.19-1.75) for the WHO-defined syndrome with prevalent CHD and 1.53 (1.27-1.85) for the ATP III-defined syndrome. Insulin resistance alone, hypertension alone, and dyslipidemia alone were all associated with CHD, with the magnitudes of these associations being similar to those for the WHO- and ATP III-defined syndrome with CHD.
Significance. There is controversy over the relevance of the various definitions of the metabolic syndrome. The predictive value of the syndrome also needs to be evaluated in different subgroups. This study shows that the prevalence of the metabolic syndrome is high in older British women and is associated with CHD. There is reasonable agreement between the WHO definition and the ATP III definition of the syndrome, and both are similarly associated with CHD. Single components of the syndrome are associated with CHD to a similar magnitude as the syndrome as a whole. Thus, formal diagnosis of the syndrome may have no advantage over identifying and treating these individual components.
Impact. The metabolic syndrome (diagnosed by any of the current definitions) is predictive of CHD in elderly women. However, there is insufficient evidence that treatment of the syndrome offers any advantage over treating its individual components.
Copyright American Diabetes Association May 2005
Source: Diabetes Care
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