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Title: Metabolic syndrome and mortality in the elderly: A time-dependent association
Authors: Ghaem Maralani, H.
Tai, B.C. 
Wong, T.Y. 
Tai, E.S.
Li, J. 
Wang, J.J.
Mitchell, P.
Keywords: All-cause mortality
Blue Mountains Eye Study
Cause-specific mortality
Metabolic syndrome
Issue Date: Feb-2013
Citation: Ghaem Maralani, H., Tai, B.C., Wong, T.Y., Tai, E.S., Li, J., Wang, J.J., Mitchell, P. (2013-02). Metabolic syndrome and mortality in the elderly: A time-dependent association. Diabetes Research and Clinical Practice 99 (2) : 209-216. ScholarBank@NUS Repository.
Abstract: Aims: To evaluate the association between metabolic syndrome (MetS) components and mortality over time. Methods: 3086 residents aged ≥49 years were followed in the Blue Mountains Eye Study, Australia. MetS components as defined by the International Diabetes Federation criteria were measured at baseline (1992-1994), 5-year (1997-1999) and 10-year (2002-2004). Using Cox proportional hazards and competing risks models with MetS as a time-dependent covariate, we estimated the effects of MetS on all-cause and cause-specific mortality. Time-dependent receiver-operating-characteristic curve, integrated-discrimination-improvement and net-reclassification-improvement tests assessed predicting abilities of individual and combined MetS components. Results: Effect of MetS on mortality increased with time: all cause: 2-year: adjusted hazard ratio 0.96 [95% confidence interval 0.69-1.34]; 5-year: 1.06 [0.84-1.32]; 10-year: 1.23 [1.01-1.51]; and CHD: 2-year: 0.46 [0.20-1.03]; 5-year: 0.70 [0.41-1.21]; 10-year: 1.62 [1.02-2.59]. Conversely, MetS was associated with an increased risk of cancer death at 2-year only: 1.62 [1.01-2.62]; but not 5-year: 1.30 [0.94-1.81] or 10-year: 0.90 [0.57-1.44]. The discrimination analyses showed that different MetS components were associated with different causes of death. Conclusions: The long-term effect of MetS on all-cause and CHD mortality in an older population was detected using time-dependent models while simulating the real scenarios of MetS changes over time. © 2012 Elsevier Ireland Ltd.
Source Title: Diabetes Research and Clinical Practice
ISSN: 01688227
DOI: 10.1016/j.diabres.2012.11.005
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