TY - JOUR
T1 - Metabolic syndrome is associated with similar long-term prognosis in those living with and without obesity
T2 - an analysis of 45 615 patients from the nationwide LIPIDOGRAM 2004-2015 studies
AU - Osadnik, Kamila
AU - Osadnik, Tadeusz
AU - Gierlotka, Marek
AU - Windak, Adam
AU - Tomasik, Tomasz
AU - Mastej, Mirosław
AU - Kuras, Agnieszka
AU - Jóźwiak, Kacper
AU - Penson, Peter E.
AU - Lip, Gregory Y. H.
AU - Mikhailidis, Dimitri P.
AU - Toth, Peter P.
AU - Catapano, Alberico L.
AU - Ray, Kausik K.
AU - Howard, George
AU - Tomaszewski, Maciej
AU - Charchar, Fadi J.
AU - Sattar, Naveed
AU - Williams, Bryan
AU - MacDonald, Thomas M.
AU - Banach, Maciej
AU - Jóźwiak, Jacek
N1 - Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: [email protected].
PY - 2023/9
Y1 - 2023/9
N2 - Aims: We aimed to evaluate the association between metabolic syndrome (MetS) and long-term all-cause mortality. Methods and results: The LIPIDOGRAM studies were carried out in the primary care in Poland in 2004, 2006, and 2015. MetS was diagnosed based on the National Cholesterol Education Program, Adult Treatment Panel III (NCEP/ATP III), and Joint Interim Statement (JIS) criteria. The cohort was divided into four groups: non-obese patients without MetS, obese patients without MetS, non-obese patients with MetS, and obese patients with MetS. Differences in all-cause mortality were analysed using Kaplan-Meier and Cox regression analyses. A total of 45 615 participants were enrolled (mean age 56.3, standard deviation: 11.8 years; 61.7% female). MetS was diagnosed in 14 202 (31%) by NCEP/ATP III criteria and 17 216 (37.7%) by JIS criteria. Follow-up was available for 44 620 (97.8%, median duration 15.3 years) patients. MetS was associated with increased mortality risk among the obese {hazard ratio, HR: 1.88 [95% confidence interval (CI) 1.79-1.99] and HR: 1.93 [95% CI 1.82-2.04], according to NCEP/ATP III and JIS criteria, respectively} and non-obese individuals [HR: 2.11 (95% CI 1.85-2.40) and 1.7 (95% CI 1.56-1.85) according to NCEP/ATP III and JIS criteria, respectively]. Obese patients without MetS had a higher mortality risk than non-obese patients without MetS [HR: 1.16 (95% CI 1.10-1.23) and HR: 1.22 (95% CI 1.15-1.30), respectively in subgroups with NCEP/ATP III and JIS criteria applied]. Conclusions: MetS is associated with increased all-cause mortality risk in non-obese and obese patients. In patients without MetS, obesity remains significantly associated with mortality. The concept of metabolically healthy obesity should be revised.
AB - Aims: We aimed to evaluate the association between metabolic syndrome (MetS) and long-term all-cause mortality. Methods and results: The LIPIDOGRAM studies were carried out in the primary care in Poland in 2004, 2006, and 2015. MetS was diagnosed based on the National Cholesterol Education Program, Adult Treatment Panel III (NCEP/ATP III), and Joint Interim Statement (JIS) criteria. The cohort was divided into four groups: non-obese patients without MetS, obese patients without MetS, non-obese patients with MetS, and obese patients with MetS. Differences in all-cause mortality were analysed using Kaplan-Meier and Cox regression analyses. A total of 45 615 participants were enrolled (mean age 56.3, standard deviation: 11.8 years; 61.7% female). MetS was diagnosed in 14 202 (31%) by NCEP/ATP III criteria and 17 216 (37.7%) by JIS criteria. Follow-up was available for 44 620 (97.8%, median duration 15.3 years) patients. MetS was associated with increased mortality risk among the obese {hazard ratio, HR: 1.88 [95% confidence interval (CI) 1.79-1.99] and HR: 1.93 [95% CI 1.82-2.04], according to NCEP/ATP III and JIS criteria, respectively} and non-obese individuals [HR: 2.11 (95% CI 1.85-2.40) and 1.7 (95% CI 1.56-1.85) according to NCEP/ATP III and JIS criteria, respectively]. Obese patients without MetS had a higher mortality risk than non-obese patients without MetS [HR: 1.16 (95% CI 1.10-1.23) and HR: 1.22 (95% CI 1.15-1.30), respectively in subgroups with NCEP/ATP III and JIS criteria applied]. Conclusions: MetS is associated with increased all-cause mortality risk in non-obese and obese patients. In patients without MetS, obesity remains significantly associated with mortality. The concept of metabolically healthy obesity should be revised.
KW - Metabolic syndrome
KW - Lean metabolic syndrome
KW - obesity
KW - Obesity
U2 - 10.1093/eurjpc/zwad101
DO - 10.1093/eurjpc/zwad101
M3 - Article
C2 - 37039119
SN - 2047-4873
VL - 30
SP - 1195
EP - 1204
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
IS - 12
M1 - zwad101
ER -