@article{2988159,
    title = "Metabolic syndrome and 10-year cardiovascular disease incidence: The ATTICA study",
    author = "Kastorini, C.-M. and Panagiotakos, D.B. and Georgousopoulou, E.N. and Laskaris, A. and Skourlis, N. and Zana, A. and Chatzinikolaou, C. and Chrysohoou, C. and Puddu, P.E. and Tousoulis, D. and Stefanadis, C. and Pitsavos, C. and Skoumas, Y. and Katinioti, N. and Papadimitriou, L. and Masoura, C. and Vellas, S. and Lentzas, Y. and Kambaxis, M. and Palliou, K. and Metaxa, V. and Ntzouvani, A. and Mpougatsas, D. and Skourlis, N. and Papanikolaou, C. and Kouli, G.-M. and Christou, A. and Zana, A. and Ntertimani, M. and Kalogeropoulou, A. and Pitaraki, E. and Laskaris, A. and Mihail Hatzigeorgiou and Athanasios Grekas and Kokkou, E. and ATTICA Study Group",
    journal = "Nutrition, Metabolism and Cardiovascular Diseases",
    year = "2016",
    volume = "26",
    number = "3",
    pages = "223-231",
    publisher = "Elsevier B.V.",
    issn = "0939-4753",
    doi = "10.1016/j.numecd.2015.12.010",
    keywords = "C reactive protein;  interleukin 6;  triacylglycerol;  uric acid;  C reactive protein;  glucose blood level;  high density lipoprotein cholesterol;  IL6 protein, human;  interleukin 6;  low density lipoprotein cholesterol;  triacylglycerol;  uric acid, adult;  aged;  Article;  cardiovascular disease;  female;  glomerulus filtration rate;  human;  major clinical study;  male;  metabolic syndrome X;  morbidity;  obesity;  physical activity;  priority journal;  questionnaire;  very elderly;  waist circumference;  adolescent;  blood;  blood pressure;  body mass;  body weight;  Cardiovascular Diseases;  complication;  follow up;  glucose blood level;  Greece;  incidence;  metabolic syndrome X;  metabolism;  middle aged;  prospective study;  risk factor;  statistical model;  young adult, Adolescent;  Adult;  Aged;  Aged, 80 and over;  Blood Glucose;  Blood Pressure;  Body Mass Index;  Body Weight;  C-Reactive Protein;  Cardiovascular Diseases;  Cholesterol, HDL;  Cholesterol, LDL;  Female;  Follow-Up Studies;  Glomerular Filtration Rate;  Greece;  Humans;  Incidence;  Interleukin-6;  Logistic Models;  Male;  Metabolic Syndrome X;  Middle Aged;  Prospective Studies;  Risk Factors;  Triglycerides;  Uric Acid;  Waist Circumference;  Young Adult",
    abstract = "Aims: To evaluate the influence of metabolic syndrome (MetS) as well as inflammatory and renal markers on cardiovascular disease (CVD) incidence. Methods and results: During 2001-2002, 1514 men and 1528 women (>18y) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, Greece, were enrolled. In 2011-2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD was defined according to WHO-ICD-10 criteria. MetS was defined using three definitions, provided by the National Cholesterol Education Program Adult Treatment panel III (revised NCEP ATP III), the International Diabetes Federation (IDF) or the Harmonized definition. Furthermore, the contributory predictive role of C-reactive protein (CRP), inteleukin-6, uric acid and estimated glomerular filtration rate in the aforementioned models was evaluated. History of MetS-NCEP was positively associated with CVD, adjusting for potential confounding factors (OR:1.83, 95%CI:1.24-2.72). Not statistically significant associations with CVD incidence were observed when using the IDF or the Harmonized definition. Additionally, none of the added inflammatory and renal function markers mediated the influence of MetS on CVD incidence (all p's from Sobel test >0.40). C-statistic values for the MetS definitions used exceeded 0.789 (CI:0.751-0.827), indicating fair-to-good predictive probability of the models. Conclusion: Results of the present work revealed the negative impact of MetS-NCEP, but not of the other MetS definitions, on CVD incidence, a key-point that may help in better understanding the role of IDF and Harmonized MetS definitions on CVD. © 2015 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University."
}