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Metabolic syndrome is associated with similar long-term prognosis in non-obese and obese patients. An analysis of 45 615 patients from the nationwide LIPIDOGRAM 2004-2015 cohort studies.

Osadnik, K, Osadnik, T, Gierlotka, M, Windak, A, Tomasik, T, Mastej, M, Kuras, A, Jóźwiak, K, Penson, PE, Lip, GYH, Mikhailidis, DP, Toth, PP, Catapano, AL, Ray, KK, Howard, G, Tomaszewski, M, Charchar, FJ, Sattar, N, Williams, B, MacDonald, TM , Banach, M, Jóźwiak, J and LIPIDOGRAM Investigators, (2023) Metabolic syndrome is associated with similar long-term prognosis in non-obese and obese patients. An analysis of 45 615 patients from the nationwide LIPIDOGRAM 2004-2015 cohort studies. European Journal of Preventive Cardiology. ISSN 2047-4881

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Abstract

AIMS: We aimed to evaluate the association between metabolic syndrome (MetS) and long-term all-cause mortality. METHODS: The LIPIDOGRAM studies were carried out in the primary care in Poland in 2004, 2006 and 2015. MetS was diagnosed based on the National Cholesterol Education Program, Adult Treatment Panel III (NCEP/ATP III) and Joint Interim Statement (JIS) criteria. The cohort was divided into four groups: non-obese patients without MetS, obese patients without MetS, non-obese patients with MetS and obese patients with MetS. Differences in all-cause mortality was analyzed using Kaplan-Meier and Cox regression analyses. RESULTS: 45,615 participants were enrolled (mean age 56.3, standard deviation: 11.8 years; 61.7% female). MetS was diagnosed in 14,202 (31%) by NCEP/ATP III criteria, and 17,216 (37.7%) by JIS criteria. Follow-up was available for 44,620 (97.8%, median duration 15.3 years) patients. MetS was associated with increased mortality risk among the obese (hazard ratio, HR: 1.88 [95% CI, 1.79-1.99] and HR: 1.93 [95% CI 1.82-2.04], according to NCEP/ATP III and JIS criteria, respectively) and non-obese individuals (HR: 2.11 [95% CI 1.85-2.40] and 1.7 [95% CI, 1.56-1.85] according to NCEP/ATP III and JIS criteria respectively). Obese patients without MetS had a higher mortality risk than non-obese patients without MetS (HR: 1.16 [95% CI 1.10-1.23] and HR: 1.22 [95%CI 1.15-1.30], respectively in subgroups with NCEP/ATP III and JIS criteria applied). CONCLUSIONS: MetS is associated with increased all-cause mortality risk in non-obese and obese patients. In patients without MetS obesity remains significantly associated with mortality. The concept of metabolically healthy obesity should be revised.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in European Journal of Preventative Cardiology following peer review. The version of record Kamila Osadnik, Tadeusz Osadnik, Marek Gierlotka, Adam Windak, Tomasz Tomasik, Mirosław Mastej, Agnieszka Kuras, Kacper Jóźwiak, Peter E Penson, Gregory Y H Lip, Dimitri P Mikhailidis, Peter P Toth, Alberico L Catapano, Kausik K Ray, George Howard, Maciej Tomaszewski, Fadi J Charchar, Naveed Sattar, Bryan Williams, Thomas M MacDonald, Maciej Banach, Jacek Jóźwiak, LIPIDOGRAM Investigators, Metabolic syndrome is associated with similar long-term prognosis in non-obese and obese patients. An analysis of 45 615 patients from the nationwide LIPIDOGRAM 2004-2015 cohort studies, European Journal of Preventive Cardiology, 2023;, zwad101, is available online at: https://doi.org/10.1093/eurjpc/zwad101
Uncontrolled Keywords: Lean metabolic syndrome; Metabolic syndrome; obesity
Subjects: Q Science > QP Physiology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Pharmacy & Biomolecular Sciences
Publisher: Oxford University Press
SWORD Depositor: A Symplectic
Date Deposited: 18 Apr 2023 16:05
Last Modified: 22 Jun 2023 12:15
DOI or ID number: 10.1093/eurjpc/zwad101
URI: https://researchonline.ljmu.ac.uk/id/eprint/19249
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