Ten-year risk of cardiovascular incidence related to diabetes, prediabetes, and the metabolic syndrome

Background: The relative contributions of the metabolic syndrome (MetS) and dysglycemia on the risk of cardiovascular disease (CVD) have not been dissected. We aimed to compare MetS with dysglycemia in their association with the 10-year incidence risk of CVD. Methods: A total of 30 378 subjects were recruited from 11 provinces in the CMCS and followed-up for new coronary heart disease (CHD) and stroke events (ischemic stroke and hemorrhagic stroke) for 10 years. Incidence rates and HRs were estimated by the presence or absence of MetS, impaired fasting glucose (IFG) and diabetes, and by the various traits of MetS. Results: Among the subjects, 18.2% were defined as having MetS; 21.1% had IFG, and 6.8% had diabetes. Metabolic syndrome prevalence in IFG and diabetes was 38.1% and 48.7%, respectively, and the prevalence of IFG and diabetes in MetS was 44.1% and 18.3%, respectively. After adjusting for nonmetabolic risk factors, HRs of total CVD, CHD, and ischemic stroke in MetS were significant and higher than those in non-MetS, regardless of glycemic status. In the absence of MetS, the impact of dysglycemia was found only in IFG to CHD and diabetes to ischemic stroke. Hyperglycemia without any concomitant disorders was not associated with significantly higher risk of CVD. Conclusions: The increased CVD risk in individuals with IFG or diabetes was largely driven by the coexistence of multiple metabolic disorders rather than hyperglycemia per se. Identification of clustering of metabolic abnormalities should be given more consideration in CVD prevention.