Journal of Cardio-Thoracic Medicine

Journal of Cardio-Thoracic Medicine

Association between Metabolic Syndrome and Its Components with Cardiovascular Disease Risk in the MASHAD Cohort Study Population

Document Type : Original Article

Authors
Zahra Asadi 1
Hamideh Ghazizadeh 2, 3
Ameneh Timar 4
Mohammad Amin Khodadadegan 3
Hamed Ghazavi 5
Mohammad Nasrabadi 3
Toktam Sahranavard 2
Mohammad Reza Fazl Mashhadi 6
Mohammad Amin Mohammadi 6
Arezoo Rastegar-Moghadam 6
Ali Ebrahimi Dabagh 6
Sara Moazedi 6
Shadi Kadkhoda-Ahmadi 6
Mohammad Reza Shadmand Foumani Moghadam 6
Mohanna Zakariaei-Saraji 6
Reza Zare-Feyzabadi 2
Fatemeh Sadabadi 2
Susan Darroudi 2
Afsane Bahrami 7
Habibollah Esmaily 8, 9
Roshanak Ghaffarian Zirak 2
maryam Tayefi 2, 10
Mohsen Moohebati 11
Alireza Heidari Bakavoli 11
Gordon A. Ferns 12
Majid Ghayour-Mobarhan 2, 13
1 Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
2 International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Department of Biology, Faculty of Basic Sciences, Hakim Sabzevari University, P.O.Box:397, Sabzevar, Iran.
5 Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
6 Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran.
7 Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran.
8 Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
9 Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
10 Norwegian Center for E-Health Research, University Hospital of North Norway, Tromsø, Norway.
11 Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
12 Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK.
13 Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
10.22038/jctm.2025.70808.1416
Abstract
Introduction: The primary aim of this study was to evaluate the association of metabolic syndrome (MetS), based on different definitions, with the risk of total cardiovascular disease (CVD), unstable angina (UA), stable angina (SA), and myocardial infarction (MI). Additionally, we aimed to investigate which definition of MetS is a better predictor of CVD events in a large sample of Iranian adults.
Methods: The analysis was conducted among 7,910 adults from the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) cohort study. The presence of MetS at baseline was defined using the following criteria: International Diabetes Federation (IDF 2005), National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), and World Health Organization (WHO). Hazard ratios (HR) and 95% confidence intervals (CI) were used to estimate the association of MetS and its components with CVD events.
Results: The prevalence of MetS among CVD patients was 56.40%, 52.30%, and 23.90% based on the IDF, NCEP ATP III, and WHO criteria, respectively. The highest HR for total CVD (HR: 2.29; 95% CI: 1.54–3.40; P<0.001), UA (HR: 2.13; 95% CI: 1.22 – 3.72; P<0.01), and MI (HR: 3.11; 95% CI: 1.33–7.26; P<0.01) was found when using the WHO definition. The highest HR for SA (HR: 2.56; 95% CI: 1.37 – 4.81; P<0.001) was found when using the NCEP ATP III definition.
Conclusion: Having MetS based on the WHO definition was a significant predictor for the incidence of total CVD, MI, and UA, while having MetS based on the ATP III criteria was associated with a higher risk of SA in the MASHAD study population.
Keywords
Cardiovascular diseases
International Diabetes Federation
Metabolic syndrome
National Cholesterol Education Program Adult Treatment Panel III
World Health Organization
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Journal of Cardio-Thoracic Medicine
Volume 13, Issue 1
Winter 2025
Pages 1462-1475