Metabolic syndrome including both elevated blood pressure and elevated fasting plasma glucose is associated with higher mortality risk: a prospective study

Authors

Shu Li, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Chi Pang Wen, National Institute for Data Science in Health and Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Huakang Tu, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Sicong Wang, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Xue Li, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Andi Xu, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Wenyuan Li, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. wenyuanli@zju.edu.cn.
Xifeng Wu, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. xifengw@zju.edu.cn.

Document Type

Journal Article

Publication Date

2-25-2025

Journal

Diabetology & metabolic syndrome

Volume

17

Issue

1

DOI

10.1186/s13098-025-01628-5

Keywords

Mendelian randomization; Metabolic syndrome; Mortality

Abstract

BACKGROUND: Metabolic syndrome (MetS) encompasses a collection of metabolic abnormalities. This study aims to determine which combination of MetS components has the highest mortality risk, and to investigate the causal relationships between MetS components and longevity. METHODS: Prospective analyses were conducted on 340,196 participants from the MJ cohort at baseline, and 121,936 participants had follow-up MetS information. We defined MetS according to the NCEP ATP III criteria. The study's outcomes included mortality from cardiovascular disease (CVD), cancer, and all causes combined. We employed Cox proportional hazard models to calculate hazard ratios (HRs) and 95% confidence intervals. Multivariable Mendelian randomization (MVMR) was employed to infer causality using the genetic data of MetS components and longevity. RESULTS: Elevated blood pressure (BP) was the initial split for all-cause mortality, cancer mortality, and CVD mortality. Participants with MetS, especially those with elevated BP and elevated fasting plasma glucose (FPG), had higher mortality risks than those with other types of MetS. In the MJ cohort, participants with elevated BP and FPG (BG-type MetS) had a 44% (HR = 1.44, 95% CI = 1.37-1.51), 73% (HR = 1.73, 95% CI = 1.62-1.84), and 34% (HR = 1.34, 95% CI = 1.27-1.42) increased risk of all-cause mortality, cancer mortality, and CVD mortality, respectively, compared with non-BG-type MetS (12%, 24%, 5%). The highest mortality rate and mortality risk were observed in participants with BG-type MetS at baseline and follow-up (mortality rate/1000 person years = 9.73, 95% CI = 8.81-10.74; HR = 1.52, 95% CI = 1.35-1.72). SBP and FPG increases that were genetically proxied to a 1-standard deviation higher level decreased the probabilities of living to the 90th percentile age by 41% (OR = 0.59, 95% CI = 0.40-0.86) and 32% (OR = 0.68, 95% CI = 0.48-0.98) in MVMR, respectively. CONCLUSIONS: Individuals with BG-type MetS are at a higher risk of death than those with other types of MetS. Therefore, these individuals should be targeted to improve MetS outcomes.

APA Citation

Li, Shu; Wen, Chi Pang; Tu, Huakang; Wang, Sicong; Li, Xue; Xu, Andi; Li, Wenyuan; and Wu, Xifeng, "Metabolic syndrome including both elevated blood pressure and elevated fasting plasma glucose is associated with higher mortality risk: a prospective study" (2025). GW Authored Works. Paper 6527.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/6527

Department

Epidemiology