Effect of Metabolic Syndrome Score, Metabolic Syndrome, and Its Individual Components on the Prevalence and Severity of Angiographic Coronary Artery Disease

Background： The clinical significance of metabolic syndrome （MS） score, MS, and its individual components with respect to risk prediction of coronary artery disease （CAD） remains unclear. The objective of this study was to investigate whether and to what extent MS score, MS, and its individual components were related to the risk of CAD. Methods： Among 1191 participants who underwent coronary angiography for the confirmation of suspected myocardial ischemia, 858 were included in this study according to the inclusion criteria from September 2010 to June 2013. MS was diagnosed with the 2005 National Cholesterol Education Program Adult Treatment Panel III criteria. The severity of coronary atherosclerosis was assessed by Gensini score. Results： The results showed that the age- and sex-adjusted odds ratios （ORs） tbr CAD were as follows： MS score, 1.327; MS, 2.013; elevated waist circumference, 1.447; reduced high-density lipoprotein cholesterol, 1.654： and elevated fasting glucose, 1.782： all P〈 0.05： whereas for elevated triglycerides, 1.324, and elevated blood pressure, 1.342, both P 〉 0.05. Alter multivariate adjustment, results showed that only MS and elevated fasting glucose were significantly associated with CAD （OR, 1.628, 95% confidence interval [CI], 1.151-2.305, P = 0.006 for elevated fasting glucose, and OR, 1.631, 95% CI, 1.208-2.203, P = 0.001 for MS）. The study showed that only MS score and elevated fasting glucose were significantly associated with Gensini score （standardized coefficient, 0.101, P = 0.031 for elevated fasting glucose and standardized coefficient, 0.103, P = 0.009 for MS score）. Conclusions： The present study demonstrated that MS score, MS, and its individual components might have different contributions to CAD prevalence and severity. MS and elevated fasting glucose were independent risk factors for the prevalence of angiographic CAD whereas MS score and elevated fasting glucose were significantly associated with the severity of CAD.

Physical activity, sedentary behavior, and long-term cardiovascular risk in young people: A review and discussion of methodology in prospective studies

The long-term effects of physical activity （PA） or sedentary behavior on cardiovascular health in young people are not well understood. In this study, we use a narrative format to review the evidence for a prospective association with adiposity and other well-established biological cardiovascular risk factors in healthy young people, considering only studies with at least 2 years of follow-up. PA appears to elicit a long-term beneficial effect on adiposity and particularly markers of cardiovascular health. With adiposity, however, a few studies also reported that higher levels of PA were associated with higher levels of adiposity. Time spent sedentary does not appear to be related to adiposity or markers of cardiovascular health independent of PA. We then discuss the uncertainties in the underlying causal chain and consider a number of alternative modeling strategies, which could improve our understanding of the relationship in future studies. Finally, we consider the current methodology for assessing PA and sedentary time.