Metabolic syndrome in the prediction of cardiovascular events: the potential additive role of hsCRP and adiponectin

BACKGROUND: Highly prevalent metabolic syndrome (MS) is a major public health problem worldwide. Insulin resistance and central obesity are postulated to be the key components of this metabolic syndrome, and inflammation also plays a role in cardiovascular events. In previous years, many definitions of metabolic syndrome have emerged. DESIGN AND METHODS: The value of MS as a predictor of cardiovascular events in median 18-year follow-up was studied in a prospective study cohort that included 1004 Finnish males and females. Cardiovascular disease included major coronary heart disease and stroke (excluding subarachnoid hemorrhage)-whichever of these happened first. RESULTS: Subjects with metabolic syndrome had a 2.01-fold (95% CI 1.46-2.77) higher probability for any cardiovascular event compared with subjects with no MS. hsCRP seemed to increase the risk prediction, whereas adiponectin was not helpful. Those having five components of MS had hazard ratios of 7.89 (2.26-27.60) for any cardiovascular event in the follow-up when compared with those having no components and adjusting by traditional risk factors (p < 0.01). CONCLUSIONS: MS is an important predictor of cardiovascular events and is most harmful in combination with high plasma hsCRP. The clustering of components is especially harmful.