open access

Vol 8, No 8-9 (2007): Practical Diabetology
Original articles (translated)
Published online: 2007-09-08
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Prevalence and prognostic impact of subclinical cardiovascular disease in individuals with the metabolic syndrome and diabetes

Erik Ingelsson, Lisa M. Sullivan, Joanne M. Murabito, Caroline S. Fox, Emelia J. Benjamin, Joseph F. Polak, James B. Meigs, Michelle J. Keyes, Christopher J. O’Donnell, Thomas J. Wang, Ralph B. D’Agostino Sr, Philip A. Wolf, Ramachandran S. Vasan
Diabetologia Praktyczna 2007;8(8-9):315-329.

open access

Vol 8, No 8-9 (2007): Practical Diabetology
Original articles (translated)
Published online: 2007-09-08

Abstract

Data are limited regarding prevalence and prognostic significance of subclinical cardiovascular disease (CVD) in individuals with metabolic syndrome. We investigated prevalence of subclinical CVD in 1,945 Framingham Offspring Study participants (mean age 58 years; 59% women) using electrocardiography, echocardiography, carotid ultrasound, ankle-brachial blood pressure, and urinary albumin excretion. We prospectively evaluated the incidence of CVD associated with metabolic syndrome and diabetes according to presence versus absence of subclinical disease. Cross-sectionally, 51% of 581 participants with metabolic syndrome had subclinical disease in at least one test, a frequency higher than individuals without metabolic syndrome [multivariable- adjusted odds ratio 2.06 (95% CI: 1.67- 2.55); p < 0.0001). On follow-up (mean 7.2 years), 139 individuals developed overt CVD, including 59 with metabolic syndrome (10.2%). Overall, metabolic syndrome was associated with increased CVD risk [multivariableadjusted hazards ratio (HR) 1.61 (95% CI: 1.12-2.33)]. Participants with metabolic syndrome and subclinical disease experienced increased risk of overt CVD [2.67 (1.62-4.41) compared with those without metabolic syndrome, diabetes, or subclinical disease], whereas the association of metabolic syndrome with CVD risk was attenuated in absence of subclinical disease [HR 1.59 (95% CI: 0.87–2.90)]. A similar attenuation of CVD risk in absence of subclinical disease was observed also for diabetes. Subclinical disease was a significant predictor of overt CVD in participants without metabolic syndrome or diabetes [1.93 (1.15-3.24)]. In our community-based sample, individuals with metabolic syndrome have a high prevalence of subclinical atherosclerosis that likely contributes to the increased risk of overt CVD associated with the condition.

Abstract

Data are limited regarding prevalence and prognostic significance of subclinical cardiovascular disease (CVD) in individuals with metabolic syndrome. We investigated prevalence of subclinical CVD in 1,945 Framingham Offspring Study participants (mean age 58 years; 59% women) using electrocardiography, echocardiography, carotid ultrasound, ankle-brachial blood pressure, and urinary albumin excretion. We prospectively evaluated the incidence of CVD associated with metabolic syndrome and diabetes according to presence versus absence of subclinical disease. Cross-sectionally, 51% of 581 participants with metabolic syndrome had subclinical disease in at least one test, a frequency higher than individuals without metabolic syndrome [multivariable- adjusted odds ratio 2.06 (95% CI: 1.67- 2.55); p < 0.0001). On follow-up (mean 7.2 years), 139 individuals developed overt CVD, including 59 with metabolic syndrome (10.2%). Overall, metabolic syndrome was associated with increased CVD risk [multivariableadjusted hazards ratio (HR) 1.61 (95% CI: 1.12-2.33)]. Participants with metabolic syndrome and subclinical disease experienced increased risk of overt CVD [2.67 (1.62-4.41) compared with those without metabolic syndrome, diabetes, or subclinical disease], whereas the association of metabolic syndrome with CVD risk was attenuated in absence of subclinical disease [HR 1.59 (95% CI: 0.87–2.90)]. A similar attenuation of CVD risk in absence of subclinical disease was observed also for diabetes. Subclinical disease was a significant predictor of overt CVD in participants without metabolic syndrome or diabetes [1.93 (1.15-3.24)]. In our community-based sample, individuals with metabolic syndrome have a high prevalence of subclinical atherosclerosis that likely contributes to the increased risk of overt CVD associated with the condition.
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About this article
Title

Prevalence and prognostic impact of subclinical cardiovascular disease in individuals with the metabolic syndrome and diabetes

Journal

Clinical Diabetology

Issue

Vol 8, No 8-9 (2007): Practical Diabetology

Pages

315-329

Published online

2007-09-08

Bibliographic record

Diabetologia Praktyczna 2007;8(8-9):315-329.

Authors

Erik Ingelsson
Lisa M. Sullivan
Joanne M. Murabito
Caroline S. Fox
Emelia J. Benjamin
Joseph F. Polak
James B. Meigs
Michelle J. Keyes
Christopher J. O’Donnell
Thomas J. Wang
Ralph B. D’Agostino Sr
Philip A. Wolf
Ramachandran S. Vasan

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