Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong).
Department of Health Service and Management, Wuhan Polytechnic University, Wuhan, China.
JMIR Public Health Surveill. 2023 Sep 5;9:e44073. doi: 10.2196/44073.
Metabolic syndrome (MetS) is a common metabolic disorder that results from the increasing prevalence of obesity, which has been an increasing concern in recent years. Previous evidence indicated that MetS was associated with mortality; however, different definitions of MetS were used. In 2005, the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III updated the definition of MetS, which has since been widely adopted. Therefore, it is necessary to conduct a novel study among other populations and countries with a larger sample size using the updated definition of MetS and death code to examine the association of MetS with all-cause and cause-specific mortality.
We aimed to examine the associations of MetS with all-cause and cause-specific mortality.
A total of 36,414 adults were included in this study, using data from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and the continuous NHANES (1999-2014) in the United States. Death outcomes were ascertained by linkage to National Death Index records through December 31, 2015. MetS was defined by the NCEP ATP III-2005 criterion. Complex survey design factors including sample weights, clustering, and stratification were considered for all analyses with instructions for using NHANES data. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for mortality from all causes, heart disease, diabetes, and cancer.
We observed 8494 deaths during the 16.71 years of follow-up. Compared with those without MetS, individuals with MetS were associated with a significantly elevated multiadjusted HR of 1.24 (95% CI 1.16-1.33), 1.44 (95% CI 1.25-1.66), and 5.15 (95% CI 3.15-8.43) for all cause, heart diseases, and diabetes mellitus, respectively, whereas no significant association was found for cancer mortality (HR 1.17, 95% CI 0.95-1.43).
Our study provides additional evidence that MetS and its components are significantly associated with all-cause, heart disease, and diabetes mortality, but not with cancer mortality. Health care professionals should pay more attention to MetS and its individual component.
代谢综合征（MetS）是一种常见的代谢紊乱，源于肥胖症的患病率不断上升，这在近年来引起了越来越多的关注。先前的证据表明，MetS 与死亡率有关；然而，不同的 MetS 定义被使用。2005 年，国家胆固醇教育计划（NCEP）成人治疗专家组（ATP）III 更新了 MetS 的定义，此后该定义被广泛采用。因此，有必要在其他人群和国家进行一项新的研究，使用更新的 MetS 定义和死亡代码，以较大的样本量来检验 MetS 与全因和特定原因死亡率的关系。
我们旨在检验 MetS 与全因和特定原因死亡率的关系。
本研究共纳入 36414 名成年人，数据来自美国国家健康和营养调查（NHANES）III（1988-1994 年）和连续 NHANES（1999-2014 年）。通过与国家死亡指数记录的链接，在 2015 年 12 月 31 日之前确定死亡结果。MetS 按照 NCEP ATP III-2005 标准定义。对于所有分析，都考虑了复杂的调查设计因素，包括样本权重、聚类和分层，并提供了使用 NHANES 数据的说明。使用 Cox 比例风险模型估计全因、心脏病、糖尿病和癌症死亡率的风险比（HRs）和 95%置信区间（CIs）。
在 16.71 年的随访期间，我们观察到 8494 例死亡。与没有 MetS 的个体相比，患有 MetS 的个体的多因素调整后 HR 显著升高，分别为全因死亡（HR 1.24，95%CI 1.16-1.33）、心脏病（HR 1.44，95%CI 1.25-1.66）和糖尿病（HR 5.15，95%CI 3.15-8.43），而癌症死亡率（HR 1.17，95%CI 0.95-1.43）无显著相关性。
我们的研究提供了额外的证据，表明 MetS 及其组成部分与全因、心脏病和糖尿病死亡率显著相关，但与癌症死亡率无关。医疗保健专业人员应更加关注 MetS 及其各个组成部分。
