Metabolic syndrome increases cardiovascular risk in a population with prediabetes: A prospective study in a cohort of Chinese adults

AIMS/INTRODUCTION: The prevalence of prediabetes has become a global epidemic, and prediabetes is often accompanied with metabolic syndrome (MS). However, the association between MS and cardiovascular (CV) risk among individuals with prediabetes in China remains unknown. The present study aimed to identify the relationship of MS with CV risk in Chinese adults with prediabetes. MATERIALS AND METHODS: Altogether, 19,464 participants with prediabetes were enrolled at baseline and were followed up prospectively. Prediabetes is defined as a fasting plasma glucose level between 5.6 and 6.9 mmol/L, and with neither a history of diabetes nor current use of hypoglycemic drugs. Participants were classified on the basis of the presence of MS, according to the definition of the International Diabetes Federation. Main outcomes include major CV events. Incidence rates were expressed in cumulative incidence and person‐years incidence. Cox proportional hazards analysis was used to estimate the risk of major CV events. RESULTS: At baseline, the mean age was 51.9 ± 11.4 years, and 85.6% (n = 16,663) were men. During a median follow‐up period of 10.0 years, a total of 1,169 major CV events occurred, including 921 strokes and 273 cases of myocardial infarction. The cumulative incidences were 9.0% (8.1–10.0%), 6.8% (6.0–7.6%) and 2.5% (2.0–3.0%) for total CV events, strokes and myocardial infarction. Regardless of the risk of total CV events, or the risk of stroke or myocardial infarction, the number of prediabetes individuals with MS was higher than those without, and the hazard ratio was 1.50 (95% confidence interval 1.31–1.73), 1.42 (95% confidence interval 1.21–1.67), 1.78 (95% confidence interval 1.34–2.36), respectively. CONCLUSIONS: Among the Chinese population with prediabetes, the risk for major CV events was significantly higher in those with MS than those without.