Subgroups With Metabolic Syndrome Show Different Association With Ischemic Heart Disease and Stroke; Findings of Iran STEPS Survey 2021

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BACKGROUND: Metabolic syndrome (MetS) is defined as clustering of 3 or more of 5 metabolic risk factors in an individual. It has been greatly using in clinical practice; although some research illustrated that it might not act as a homogenous disorder in association with cardiovascular diseases. Therefore, we aimed to investigate its prevalence and association with ischemic heart disease (IHD) and stroke. METHODS: Using Iran STEPS (STEPwise Approach to NCD [Noncommunicable Diseases] Risk Factor Surveillance) Survey 2021, the prevalence and association of MetS, with prevalence of IHD and stroke was assessed. Given the definition of MetS, it includes 16 combinations (clusters) of 5 risk factors; we aggregated them into 6 groups and evaluated their association with prevalence of IHD and stroke. RESULTS: Overall, 54.19% of total population had MetS, where the most prevalent criterion was elevated waist circumference. MetS was associated with 1.70 times greater adjusted odds ratio (OR) of IHD prevalence (95% CI, 1.40-2.07). A closer look reveals that the greatest OR of IHD prevalence was observed in individuals with all 5 risk factors or 4 risk factors including both elevated blood pressure and fasting plasma glucose with ORs of 6.69 (3.52-12.68) and 6.38 (3.38-12.03), respectively, compared with individuals with none of the risk factors (0 components). CONCLUSIONS: The association of MetS cluster with IHD and stroke prevalence varied. In addition to the dose-response relationship, the clusters characterized by both elevated BP and FPG are the most critical for targeting preventive and therapeutic measures.