Table 4.
Sensitivity analyses. Estimates of primary endpoint events—myocardial infarction, stroke, or mortality from cardiovascular causes—for the association with metabolic syndrome and its components in the Rivana cohort (n = 3976) according to the NCEP-ATPIII definition [6] and specific waist circumference cut-off points previously developed for the Spanish population [32]
| Primary endpoint (myocardial infarction, stroke, and mortality from cardiovascular disease) | |||||
|---|---|---|---|---|---|
| IDF and AHA/NHLBI definition with specific waist circumference cut-off points for Spanish populationa | NCEP-ATPIII Metabolic Syndrome definitionb | ||||
| Cases | 228 | 228 | |||
| Person- years of follow up | 47,838 | 47,838 | |||
| Incidence rate/1000 person-year | 4.77 | 4.77 | |||
| HR (95% CI)c | RAP (95% CI) | HR (95% CI)c | RAP (95% CI) | ||
| Metabolic syndrome and componentsd, e | |||||
| Metabolic syndrome | 1.39 (1.05–1.83) | 3.64 (0.27, 7.01) | 1.36 (1.03–1.78) | 3.33 (0.10–6.56) | |
| Elevated waist circumference | 1.40 (1.03–1.90) | 3.66 (0.03, 7.29) | 1.30 (0.98–1.72) | 2.79 (− 0.44, 6.01) | |
| Elevated blood pressure | 1.64 (1.12–2.39) | 6.20 (1.37, 11.02) | 1.63 (1.12–2.35) | 6.07 (1.35, 10.80) | |
| Elevated fasting glucose | 1.21 (0.92–1.58) | 2.17 (− 0.93, 5.26) | 1.25 (0.94–1.66) | 2.23 (− 1.03, 5.50) | |
| Reduced HDL-cholesterol | 1.39 (1.02–1.89) | 3.68 (0.06, 7.29) | 1.42 (1.06–1.92) | 3.95 (0.54, 7.37) | |
| Elevated triglycerides | 1.38 (1.02–1.85) | 3.43 (− 0.03, 6.88) | 1.38 (1.02–1.85) | 3.41 (0.06, 6.75) | |
| Number of traitsd, e | |||||
| 0–1 trait | 1.00 (ref.) | 0.00 (ref.) | 1.00 (ref.) | 0.00 (ref.) | |
| 2 traits | 1.62 (1.06–2.47) | 5.91 (0.65, 11.17) | 1.39 (0.98–1.96) | 3.51 (− 0.57, 7.59) | |
| 3 traits | 1.66 (1.08–2.57) | 6.02 (0.54, 11.50) | 1.34 (0.92–1.97) | 3.11 (− 1.42, 7.64) | |
| 4 traits | 2.06 (1.30–3.26) | 8.42 (2.49, 14.35) | 2.03 (1.31–3.15) | 7.74 (2.39, 13.09) | |
| 5 traits | 2.57 (1.38–4.81) | 11.48 (3.64, 19.32) | 2.33 (1.19–4.58) | 9.78 (1.82, 17.80) | |
| Per additional trait | 1.22 (1.10–1.36) | 2.38 (0.96, 3.80) | 1.22 (1.09–1.36) | 2.31 (0.88, 3.74) | |
CI confidence interval, HDL high density lipoprotein, HR hazard ratio, RAP rate advancement period
aMetabolic syndrome according to the harmonized definition of the International Diabetes Federation (IDF) American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) with specific waist circumference cut-off points for Spanish population: 94.5 cm for men and 89.5 cm for women [32]
bMetabolic syndrome according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel-III (ATP-III) definition [6]
Italic values are statistically significant at p-value < .05
cModel adjusted for age (underlying variable), alcohol (never, sometimes, regularly), higher level of attained education (primary or less, secondary, college/university), LDL cholesterol level (continuous), Mediterranean diet adherence (continuous), physical activity (metabolic equivalent minutes per day, continuous), prevalent cardiovascular disease (dichotomous), renal disease (dichotomous), sex, smoking status (never, current, and former smoker), and stratified by age (in deciles)
dNumber of participants according to the harmonized definition of the IDF and AHA/NHLBI with specific waist circumference cut-off points for Spanish population with metabolic syndrome (n = 1,147); with elevated waist circumference (n = 1,630); with elevated blood pressure (n = 2,235); with elevated fasting glucose (n = 1,595); with reduced HDL-cholesterol (n = 665); with elevated triglycerides (n = 745). Number of participants with 0–1 trait (n = 1,879); with 2 traits (n = 950); with 3 traits (n = 710); with 4 traits (n = 327); with 5 traits (n = 110)
eNumber of participants according to the NCEP-ATPIII definition with metabolic syndrome (n = 839); with elevated waist circumference (n = 1,490); with elevated blood pressure (n = 2,235); with elevated fasting glucose (n = 740); with reduced HDL-cholesterol (n = 665); with elevated triglycerides (n = 745). Number of participants with 0–1 trait (n = 2,205); with 2 traits (n = 932); with 3 traits (n = 538); with 4 traits (n = 226); with 5 traits (n = 75)