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CLINICAL RESEARCH: HYPERLIPIDEMIA AND METABOLIC SYNDROME

Prevalence of the Metabolic Syndrome and its Relation to Cardiovascular Disease in an Elderly Chinese Population

Yao He, MD, PhD^_*,,_*, Bin Jiang, MD, PhD, Jie Wang, MD, PhD, Kang Feng, MD^_*, Qing Chang, MD^_*, Li Fan, MD^¶, Xiaoying Li, MD^¶ and Frank B. Hu, MD, PhD^,||,a

^_* Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
Department of Acupuncture, Chinese PLA General Hospital, Beijing, China
Department of Emergency, General Hospital of Chinese People’s Armed Forces, Beijing, China
^¶ Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
^|| Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts

Manuscript received September 27, 2005; revised manuscript received November 23, 2005, accepted November 28, 2005.

^_* Reprint requests and correspondence: Dr. Yao He, Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China. (Email: yhe301{at}x263.net).

OBJECTIVES: This study sought to assess the prevalence of the metabolic syndrome (MetS) and its association with cardiovascular disease (CVD) in elderly Chinese people.

BACKGROUND: The information available about the prevalence of MetS based on the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) in China is limited.

METHODS: We conducted a population-based cross-sectional study in an urban Beijing sample of 2,334 participants age 60 to 95 years (943 men, 1,391 women). The CVD included diagnosed coronary heart disease (CHD), stroke, and peripheral arterial disease (PAD).

RESULTS: The prevalence of MetS by the NCEP criteria was 30.5% (17.6% in men, 39.2% in women). Use of the new IDF definition significantly increased the prevalence to 46.3% (34.8% in men, 54.1% in women). Odds ratios (OR) for CHD, stroke, PAD, and CVD in those with MetS using the NCEP criteria were 1.43 (95% confidence interval [CI] 1.18 to 1.74), 1.45 (95% CI 1.14 to 1.85), 1.47 (95% CI 1.18 to 1.84), and 1.50 (95% CI 1.25 to 1.81), respectively. Corresponding ORs using new IDF criteria were 1.69 (95% CI 1.40 to 2.02), 1.58 (95% CI 1.26 to 2.00), 1.42 (95% CI 1.14 to 1.76), and 1.73 (95% CI 1.46 to 2.07), respectively. Those who met the IDF but not the NCEP criteria (n = 436, 18.7%) had significantly elevated ORs for CHD (1.66, 95% CI 1.31 to 2.10) and stroke (1.53, 95% CI 1.13 to 2.06).

CONCLUSIONS: The MetS is highly prevalent in elderly people in Beijing, particularly among women. Individuals with MetS defined by either criteria are at significantly elevated ORs for CHD, stroke, and PAD. The IDF criteria seem to be better suited than the NCEP criteria for screening and estimating risk of MetS in Chinese people.

Abbreviations and Acronyms   CHD = coronary heart disease   CI = confidence interval   CVD = cardiovascular disease   HDL = high-density lipoprotein   IDF = International Diabetes Federation   LDL = low-density lipoprotein   MetS = metabolic syndrome   NCEP ATP III = National Cholesterol Education Program Adult Treatment Panel III   OR = odds ratio   PAD = peripheral arterial disease   WHO = World Health Organization

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