TY - JOUR
T1 - Risk classification for metabolic syndrome and the incidence of cardiovascular disease in japan with low prevalence of obesity
T2 - A pooled analysis of 10 prospective cohort studies
AU - Iso, Hiroyasu
AU - Cui, Renzhe
AU - Takamoto, Iseki
AU - Kiyama, Masahiko
AU - Saito, Isao
AU - Okamura, Tomonori
AU - Miyamoto, Yoshihiro
AU - Higashiyama, Aya
AU - Kiyohara, Yutaka
AU - Ninomiya, Toshiharu
AU - Yamada, Michiko
AU - Nakagawa, Hideaki
AU - Sakurai, Masaru
AU - Shimabukuro, Michio
AU - Higa, Moritake
AU - Shimamoto, Kazuaki
AU - Saito, Shigeyuki
AU - Daimon, Makoto
AU - Kayama, Takamasa
AU - Noda, Mitsuhiko
AU - Ito, Sadayoshi
AU - Yokote, Koutaro
AU - Ito, Chikako
AU - Nakao, Kazuwa
AU - Yamauchi, Toshimasa
AU - Kadowaki, Takashi
N1 - Funding Information:
This work was supported by Grant-in-Aid for Research in the Japanese Ministry of Health, Labour and Welfare (H19-Junkankitou [Seishu], Ippan021 and H22-Junkankitou [Seishu], Ippan005).
Publisher Copyright:
© 2021 The Authors.
PY - 2021/12/7
Y1 - 2021/12/7
N2 - BACKGROUND: It is uncertain whether risk classification under the nationwide program on screening and lifestyle modification for metabolic syndrome captures well high-risk individuals who could benefit from lifestyle interventions. We examined the validity of risk classification by linking the incidence of cardiovascular disease (CVD). CONCLUSIONS: Similar CVD excess and attributable risks among individuals with metabolic syndrome components in the absence and presence of obesity/overweight imply the need for lifestyle modification in both high-risk groups. METHODS AND RESULTS: Individual-level data of 29 288 Japanese individuals aged 40 to 74 years without a history of CVD from 10 prospective cohort studies were used. Metabolic syndrome was defined as the presence of high abdominal obesity and/ or overweight plus risk factors such as high blood pressure, high triglyceride or low high-density lipoprotein cholesterol levels, and high blood glucose levels. The risk categories for lifestyle intervention were information supply only, motivation-support intervention, and intensive support intervention. Sex-and age-specific hazard ratios and population attributable fractions of CVD, which were also further adjusted to consider non– high density lipoprotein cholesterol levels, were estimated with reference to nonobese/overweight individuals, using Cox proportional hazard regression. Since the reference category included those with risk factors, we set a supernormal group (nonobese/overweight with no risk factor) as another reference. We documented 1023 incident CVD cases (565 men and 458 women). The adjusted CVD risk was 60% to 70% higher in men and women aged 40 to 64 years receiving an intensive support intervention, and 30% higher in women aged 65 to 74 years receiving a motivation-support intervention, compared with nonobese/overweight individuals. The population attributable fractions in men and women aged 40 to 64 years receiving an intensive support intervention were 17.7% and 6.6%, respectively, while that in women aged 65 to 74 years receiving a motivation-support intervention was 9.4%. Compared with the supernormal group, nonobese/overweight individuals with risk factors had similar hazard ratios and population attributable fractions as individuals with metabolic syndrome.
AB - BACKGROUND: It is uncertain whether risk classification under the nationwide program on screening and lifestyle modification for metabolic syndrome captures well high-risk individuals who could benefit from lifestyle interventions. We examined the validity of risk classification by linking the incidence of cardiovascular disease (CVD). CONCLUSIONS: Similar CVD excess and attributable risks among individuals with metabolic syndrome components in the absence and presence of obesity/overweight imply the need for lifestyle modification in both high-risk groups. METHODS AND RESULTS: Individual-level data of 29 288 Japanese individuals aged 40 to 74 years without a history of CVD from 10 prospective cohort studies were used. Metabolic syndrome was defined as the presence of high abdominal obesity and/ or overweight plus risk factors such as high blood pressure, high triglyceride or low high-density lipoprotein cholesterol levels, and high blood glucose levels. The risk categories for lifestyle intervention were information supply only, motivation-support intervention, and intensive support intervention. Sex-and age-specific hazard ratios and population attributable fractions of CVD, which were also further adjusted to consider non– high density lipoprotein cholesterol levels, were estimated with reference to nonobese/overweight individuals, using Cox proportional hazard regression. Since the reference category included those with risk factors, we set a supernormal group (nonobese/overweight with no risk factor) as another reference. We documented 1023 incident CVD cases (565 men and 458 women). The adjusted CVD risk was 60% to 70% higher in men and women aged 40 to 64 years receiving an intensive support intervention, and 30% higher in women aged 65 to 74 years receiving a motivation-support intervention, compared with nonobese/overweight individuals. The population attributable fractions in men and women aged 40 to 64 years receiving an intensive support intervention were 17.7% and 6.6%, respectively, while that in women aged 65 to 74 years receiving a motivation-support intervention was 9.4%. Compared with the supernormal group, nonobese/overweight individuals with risk factors had similar hazard ratios and population attributable fractions as individuals with metabolic syndrome.
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U2 - 10.1161/JAHA.121.020760
DO - 10.1161/JAHA.121.020760
M3 - Article
C2 - 34796738
AN - SCOPUS:85121037144
SN - 2047-9980
VL - 10
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 23
M1 - e020760
ER -
