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Risk Classification for Metabolic Syndrome and the Incidence of Cardiovascular Disease in Japan With Low Prevalence of Obesity: A Pooled Analysis of 10 Prospective Cohort Studies
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 incid...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075363/ https://www.ncbi.nlm.nih.gov/pubmed/34796738 http://dx.doi.org/10.1161/JAHA.121.020760 |
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author | Iso, Hiroyasu Cui, Renzhe Takamoto, Iseki Kiyama, Masahiko Saito, Isao Okamura, Tomonori Miyamoto, Yoshihiro Higashiyama, Aya Kiyohara, Yutaka Ninomiya, Toshiharu Yamada, Michiko Nakagawa, Hideaki Sakurai, Masaru Shimabukuro, Michio Higa, Moritake Shimamoto, Kazuaki Saito, Shigeyuki Daimon, Makoto Kayama, Takamasa Noda, Mitsuhiko Ito, Sadayoshi Yokote, Koutaro Ito, Chikako Nakao, Kazuwa Yamauchi, Toshimasa Kadowaki, Takashi |
author_facet | Iso, Hiroyasu Cui, Renzhe Takamoto, Iseki Kiyama, Masahiko Saito, Isao Okamura, Tomonori Miyamoto, Yoshihiro Higashiyama, Aya Kiyohara, Yutaka Ninomiya, Toshiharu Yamada, Michiko Nakagawa, Hideaki Sakurai, Masaru Shimabukuro, Michio Higa, Moritake Shimamoto, Kazuaki Saito, Shigeyuki Daimon, Makoto Kayama, Takamasa Noda, Mitsuhiko Ito, Sadayoshi Yokote, Koutaro Ito, Chikako Nakao, Kazuwa Yamauchi, Toshimasa Kadowaki, Takashi |
author_sort | Iso, Hiroyasu |
collection | PubMed |
description | 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). 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. 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. |
format | Online Article Text |
id | pubmed-9075363 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90753632022-05-10 Risk Classification for Metabolic Syndrome and the Incidence of Cardiovascular Disease in Japan With Low Prevalence of Obesity: A Pooled Analysis of 10 Prospective Cohort Studies Iso, Hiroyasu Cui, Renzhe Takamoto, Iseki Kiyama, Masahiko Saito, Isao Okamura, Tomonori Miyamoto, Yoshihiro Higashiyama, Aya Kiyohara, Yutaka Ninomiya, Toshiharu Yamada, Michiko Nakagawa, Hideaki Sakurai, Masaru Shimabukuro, Michio Higa, Moritake Shimamoto, Kazuaki Saito, Shigeyuki Daimon, Makoto Kayama, Takamasa Noda, Mitsuhiko Ito, Sadayoshi Yokote, Koutaro Ito, Chikako Nakao, Kazuwa Yamauchi, Toshimasa Kadowaki, Takashi J Am Heart Assoc Original Research 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). 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. 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. John Wiley and Sons Inc. 2021-11-19 /pmc/articles/PMC9075363/ /pubmed/34796738 http://dx.doi.org/10.1161/JAHA.121.020760 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Iso, Hiroyasu Cui, Renzhe Takamoto, Iseki Kiyama, Masahiko Saito, Isao Okamura, Tomonori Miyamoto, Yoshihiro Higashiyama, Aya Kiyohara, Yutaka Ninomiya, Toshiharu Yamada, Michiko Nakagawa, Hideaki Sakurai, Masaru Shimabukuro, Michio Higa, Moritake Shimamoto, Kazuaki Saito, Shigeyuki Daimon, Makoto Kayama, Takamasa Noda, Mitsuhiko Ito, Sadayoshi Yokote, Koutaro Ito, Chikako Nakao, Kazuwa Yamauchi, Toshimasa Kadowaki, Takashi Risk Classification for Metabolic Syndrome and the Incidence of Cardiovascular Disease in Japan With Low Prevalence of Obesity: A Pooled Analysis of 10 Prospective Cohort Studies |
title | Risk Classification for Metabolic Syndrome and the Incidence of Cardiovascular Disease in Japan With Low Prevalence of Obesity: A Pooled Analysis of 10 Prospective Cohort Studies |
title_full | Risk Classification for Metabolic Syndrome and the Incidence of Cardiovascular Disease in Japan With Low Prevalence of Obesity: A Pooled Analysis of 10 Prospective Cohort Studies |
title_fullStr | Risk Classification for Metabolic Syndrome and the Incidence of Cardiovascular Disease in Japan With Low Prevalence of Obesity: A Pooled Analysis of 10 Prospective Cohort Studies |
title_full_unstemmed | Risk Classification for Metabolic Syndrome and the Incidence of Cardiovascular Disease in Japan With Low Prevalence of Obesity: A Pooled Analysis of 10 Prospective Cohort Studies |
title_short | Risk Classification for Metabolic Syndrome and the Incidence of Cardiovascular Disease in Japan With Low Prevalence of Obesity: A Pooled Analysis of 10 Prospective Cohort Studies |
title_sort | risk classification for metabolic syndrome and the incidence of cardiovascular disease in japan with low prevalence of obesity: a pooled analysis of 10 prospective cohort studies |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075363/ https://www.ncbi.nlm.nih.gov/pubmed/34796738 http://dx.doi.org/10.1161/JAHA.121.020760 |
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