Premium
The Value of the Metabolic Syndrome Concept in Elderly Adults: Is It Worth Less Than the Sum of Its Parts?
Author(s) -
Samaras Katherine,
Crawford John,
Baune Bernard T.,
Campbell Lesley V.,
Smith Evelyn,
Lux Ora,
Brodaty Henry,
Trollor Julian N.,
Sachdev Perminder
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2012.04105.x
Subject(s) - medicine , metabolic syndrome , abdominal obesity , homocysteine , waist , diabetes mellitus , odds ratio , population , national cholesterol education program , disease , myocardial infarction , dyslipidemia , cancer , dementia , obesity , gerontology , endocrinology , environmental health
Objectives To determine whether the metabolic syndrome (MetS) or its components were more closely associated with disease states and inflammation in elderly adults. Design Sydney Memory and Ageing Study. Cross‐sectional, observational cohort. Setting Population‐derived, community‐dwelling elderly adults. Participants Nine hundred thirty individuals aged 70 to 90. Measurements Age‐ and sex‐adjusted odds ratios ( OR s) for disease states; fasting circulating inflammatory markers and oxidative metabolism byproducts. Results MetS was associated with diabetes mellitus ( OR = 4.1, P < .001) and bowel cancer ( OR = 9.1, P = .03) but not in analyses that controlled for component conditions. Models containing component conditions had the strongest associations with heart disease. Disease associations were improved after addition of component conditions to the MetS model. The reverse did not hold: disease associations were not improved when MetS was added to the components model. Low high‐density lipoprotein cholesterol ( HDL ‐C) was independently associated with myocardial infarction ( OR = 2.32) and angina pectoris ( OR = 2.59) (both P < .008). Waist circumference was independently associated with cancer ( OR = 1.82, P = .008). Although MetS was associated with higher C‐reactive protein, vascular cell adhesion molecule, interleukin‐6, amyloid A, homocysteine, and malondialdehyde, it explained less than half of the variance of models containing its components. Conclusion The observation that MetS is associated with disease states and markers of circulating inflammation in the elderly is explained mainly by abdominal obesity and low HDL‐C. Longitudinal data will further clarify these cross‐sectional findings that MetS appears to be less than the sum of its parts in elderly adults.