Modification of the all-cause and cardiovascular disease related mortality risk with changes in the metabolic syndrome status: a population-based prospective cohort study in Taiwan |
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| Institution: | 1. School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;2. Department of Internal Medicine, Division of Endocrinology and Metabolism, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan;3. Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan;4. Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan;5. Section of Infectious Diseases, Taipei City Hospital, Yangming Branch, Taipei, Taiwan;6. Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan;7. Department of Education and Research, Taipei City Hospital, Taiwan;8. College of Public Health, National Taiwan University, Taipei, Taiwan;9. Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia;10. Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany;11. Graduate Institute of Sports and Health Management, National Chung Hsing University, Taichung, Taiwan;12. Department of Kinesiology, National Tsing Hua University, Hsinchu, Taiwan |
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| Abstract: | AimTo examine whether changes in metabolic syndrome (MetS) status over time are associated with risk of all-cause and cardiovascular disease related (CVD) mortality.MethodsThis prospective cohort study consisted of 544,749 individuals who participated in a self-funded comprehensive health surveillance program offered by Taiwan MJ Health Management Institution between 1998 and 2016. We included 236,216 adults who had at least two repeated MetS measures 5.9 (4.6) years apart and were followed up for mortality over 18.8 (5.2) years. Participants were classified according to the change in their MetS status as follows: MetS-free at both time points (n = 173,116), MetS-developed (n = 22,607), MetS-recovered (n = 13,616), and MetS-persistent (n = 26,877). Multivariable Cox proportional hazards model was used to determine the association between change in MetS status and risk of all-cause and CVD mortality.ResultsOver the 4,436,842 person-years follow-up period, 14,226 participants died, including 2671 (19%) of CVD-related causes. The crude CVD mortality rate per 1000 person-years in the study groups were MetS-free, 0.32; MetS-developed, 0.75; MetS-recovered, 1.22; and MetS-persistent, 2.00 (P < 0.001). Compared to the persistent MetS group, participants in the MetS-recovered group had a lower risk of all-cause (adjusted hazard ratio aHR], 0.87; 95%CI, 0.82–0.92) and CVD mortality (aHR, 0.81; 95% confidence interval CI], 0.71–0.93). Development of MetS increased the risk for all-cause (aHR, 1.11; 95%CI, 1.05–1.17) and CVD mortality (aHR, 1.22; 95%CI, 1.07–1.39), compared to the MetS-free group.ConclusionRecovery from MetS was significantly associated with a lower risk of all-cause and CVD mortality, whereas development of MetS was associated with increased risk. |
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