OBJECTIVETo explore the association and interaction between the components of metabolic syndrome (MS) and cardiovascular disease (CVD).

METHODIn this cohort study, participants (total 3598, male 1451) were recruited and followed up for five years from the program "prevention of multiple metabolic disorders and MS in Jiangsu province". We used modified Asian criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) to define the presence of MS. COX regression was used to analyze the association between the MS and its components with CVD; both the multiplication of blood pressure (BP) and 2, 3, or 4 other components of MS in the logistic regression model and the estimation of the relative excess risk due to interaction (RERI), the attributable proportion due to interaction (AP), and the synergy index (S) and 95% confidence intervals (95%CI) were used to evaluate the interactions between the components of MS.

RESULTSAfter adjustment for traditional CVD risks, the adjusted risk ratio (aRR) of CVD was 2.49 (95%CI: 1.59 - 3.90) in the MS group compared with the non-MS group at baseline. The aRRs of MS components to CVD were as follows: 1.44 (95%CI: 0.88 - 2.37) for waist circumference; 2.84 (95%CI: 1.73 - 4.68) for BP; 1.31 (95%CI: 0.83 - 2.07) for low high density lipoprotein; 1.84 (95%CI: 1.19 - 2.85) for triglyceride; 1.55(95%CI: 0.98 - 2.45) for fasting plasma glucose, respectively. BP was the single component significantly related to CVD (aRR = 2.58, 95%CI: 1.55 - 4.29). The risk of CVD was significantly increased (aOR = 4.47, 95%CI: 2.35 - 8.51) when BP was combined with 2, 3 or 4 other components of MS in the participants.

CONCLUSIONSOnly BP is an independent CVD risk factor in the components of MS, the risk of CVD was significantly increased when BP was combined with other components of MS in this cohort.