Gender differences in the impact of metabolic syndrome components on mortality in older people: A systematic review and meta-analysis |
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| Institution: | 1. Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy;2. UNSW Sydney, St Vincent''s Hospital, Sydney, Australia;3. Institute of Neuroscience, National Research Council, Padova, Italy;1. Discipline of Medicine, The University of Adelaide, Adelaide, South Australia;2. National Health and Medical Research Council, Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia;1. Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois;2. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois;3. Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama;4. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;5. Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado;6. Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland;7. Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland;1. Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran;2. Nutrition and Endocrine Research center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran;3. Department of Nutrition, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran;4. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran;1. Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran;2. Research Center for Evidence Based Medicine, Health Education and Health Promotion Department, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran;1. Department of Medicine/Nephrology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA;2. Geisinger, Danville, Pennsylvania, USA |
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| Abstract: | Background and aimsThe influence of metabolic syndrome (MetS) on mortality may be influenced by age- and gender-related changes affecting the impact of individual MetS components. We investigated gender differences in the association between MetS components and mortality in community-dwelling older adults.Methods and resultsProspective studies were identified through a systematic literature review up to June 2019. Random-effect meta-analyses were run to estimate the pooled relative risk (RR) and 95% confidence intervals (95% CI) of all-cause and cardiovascular (CV) mortality associated with the presence of MetS components (abdominal obesity, high triglycerides, low HDL cholesterol, high fasting glycemia, and high blood pressure) in older men and women. Meta-analyses considering all-cause (103,859 individuals, 48,830 men, 55,029 women; 10 studies) and CV mortality (94,965 individuals, 44,699 men, 50,266 women; 8 studies) did not reveal any significant association for abdominal obesity and high triglycerides in either gender. Low HDL was associated with increased all-cause (RR = 1.16, 95% CI: 1.02–1.32) and CV mortality (RR = 1.34, 95% CI: 1.03–1.74) among women, while weaker results were found for men. High fasting glycemia was associated with higher all-cause mortality in older women (RR = 1.35, 95% CI: 1.22–1.50) more than in older men (RR = 1.21, 95% CI: 1.13–1.30), and CV mortality only in the former (RR = 1.36, 95% CI: 1.04–1.78). Elevated blood pressure was associated with increased all-cause mortality (RR = 1.16, 95% CI: 1.03–1.32) and showed marginal significant results for CV death only among women.ConclusionsThe impact of MetS components on mortality in older people present some gender differences, with low HDL cholesterol, hyperglycemia, and elevated blood pressure being more strongly associated to all-cause and CV mortality in women. |
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| Keywords: | Metabolic syndrome components All-cause mortality Cardiovascular mortality Sex Older people |
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