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Association of metabolic syndrome with risk of cardiovascular disease mortality and all-cause mortality among Malaysian adults: a retrospective cohort study

Chee Cheong K 1 , Lim KH 2 , Ghazali SM 2 , Teh CH 2 , Cheah YK 3 , Baharudin A 4 Show all authors , Lim HL 5 , Abdul Hamid AM 6 , Mustapha FI 7 , Omar MA 6

Affiliations 

  • 1 Sector for Biostatistics & Data Repository, National Institutes of Health, Shah Alam, Selangor, Malaysia kee@moh.gov.my
  • 2 Institute for Medical Research, Setia Alam, Shah Alam, Selangor, Malaysia
  • 3 Universiti Utara Malaysia, Sintok, Kedah, Malaysia
  • 4 Centre for Nutrition Epidemiology Research, Institute for Public Health, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  • 5 Hospital Sultan Ismail, Johor Bahru, Johor Darul Ta'zim, Malaysia
  • 6 Sector for Biostatistics & Data Repository, National Institutes of Health, Shah Alam, Selangor, Malaysia
  • 7 NCD Section, Disease Control Division, Ministry of Health Malaysia, Putrajaya, Wilayah Persekutuan, Malaysia
BMJ Open, 2021 08 18;11(8):e047849.
PMID: 34408040 DOI: 10.1136/bmjopen-2020-047849

Abstract

OBJECTIVES: This study is aimed at determining the association between metabolic syndrome and risk of cardiovascular disease (CVD) mortality and all-cause mortality among Malaysian adults.

DESIGN: Retrospective cohort study.

SETTING: The Malaysian Non-Communicable Disease Surveillance (MyNCDS-1) 2005/2006.

PARTICIPANTS: A total of 2525 adults (1013 men and 1512 women), aged 24-64 years, who participated in the MyNCDS-1 2005/2006.

METHODS: Participants' anthropometric indices, blood pressure, fasting lipid profile and fasting blood glucose levels were evaluated to determine the prevalence of metabolic syndrome by the Harmonized criteria. Participants' mortality status were followed up for 13 years from 2006 to 2018. Mortality data were obtained via record linkage with the Malaysian National Registration Department. The Cox proportional hazards regression model was applied to determine association between metabolic syndrome (MetS) and risk of CVD mortality and all-cause mortality with adjustment for selected sociodemographic and lifestyle behavioural factors.

RESULTS: The overall point prevalence of MetS was 30.6% (95% CI: 28.0 to 33.3). Total follow-up time was 31 668 person-years with 213 deaths (111 (11.3%) in MetS subjects and 102 (6.1%) in non-MetS subjects) from all-causes, and 50 deaths (33 (2.9%) in MetS group and 17 (1.2%) in non-MetS group) from CVD. Metabolic syndrome was associated with a significantly increased hazard of CVD mortality (adjusted HR: 2.18 (95% CI: 1.03 to 4.61), p=0.041) and all-cause mortality (adjusted HR: 1.47 (95% CI: 1.00 to 2.14), p=0.048). These associations remained significant after excluding mortalities in the first 2 years.

CONCLUSIONS: Our study shows that individuals with MetS have a higher hazard of death from all-causes and CVD compared with those without MetS. It is thus imperative to prescribe individuals with MetS, a lifestyle intervention along with pharmacological intervention to improve the individual components of MetS and reduce this risk.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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