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The Influence of Metabolic Syndrome in Predicting Mortality Risk Among US Adults: Importance of Metabolic Syndrome Even in Adults With Normal Weight

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Log rank test showed significantly higher mortality among the overweight–MetS group than the obese–MetS group (P < .001) and significantly higher mortality among the normal-weight–MetS group than the overweight–MetS group (P < .001). At 150-month follow-up, the mortality rates were as follows: normal-MetS, 45.0%; overweight-MetS, 30.7%, obese-MetS, 20.7%; normal weight–no MetS, 12.6%; overweight–no MetS, 12.4%; and obese–no Met S, 8.7%.


Figure 1.

Unadjusted mortality curve during 150 person-month follow-up for each MetS–BMI category, National Health and Nutrition Examination Survey, 1999–2010, and National Death Index, 2011. Abbreviation: BMI, body mass index; MetS, metabolic syndrome.

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Figure 2.

Weight–MetS categories and all-cause and selected cause-specific mortality, National Health and Nutrition Examination Survey, 1999–2010, and National Death Index, 2011. The normal-weight–no-MetS group was used as the reference group. Models were adjusted for age, sex, race/ethnicity, education, poverty-income ratio, smoking history, and physical activity. Error bars indicate 95% confidence intervals. Abbreviations: MetS, metabolic syndrome; NWMS; normal-weight–MetS; OWNMS, overweight–no MetS; OWMS, overweight–MetS; OBNMS, obese–no MetS; OBMS, obese–MetS.

Weight–MetS categories and all-cause and selected cause-specific mortality, National Health and Nutrition Examination Survey, 1999–2010, and National Death Index, 2011. The normal-weight–no-MetS group was used as the reference group. Models were adjusted for age, sex, race/ethnicity, education, poverty-income ratio, smoking history, and physical activity. Error bars indicate 95% confidence intervals. Abbreviations: MetS, metabolic syndrome; NWMS; normal-weight–MetS; OWNMS, overweight–no MetS; OWMS, overweight–MetS; OBNMS, obese–no MetS; OBMS, obese–MetS.
Group All-Cause Mortality, Hazard Ratio (95% CI) Cardiovascular Mortality, Hazard Ratio (95% CI) Cancer Mortality, Hazard Ratio (95% CI)
Normal weight MetS 1.70 (1.16–2.51) 2.12 (1.17–3.83) 1.54 (0.59–4.01)
Overweight no Met S 0.99 (0.77–1.28) 0.80 (0.43–1.50) 1.04 (0.58–1.87)
Overweight Met S 1.10 (0.85–1.42) 0.90 (0.50–1.63) 1.86 (1.09–3.19)
Obese no MetS 1.08 (0.76–1.54) 0.71 (0.28–1.81) 1.45 (0.68–3.11)
Obese Met S 1.30 (1.07–1.60) 1.11 (0.64–1.92) 1.91 (1.15–3.17)
Normal weight no MetS 1 [Reference] 1 [Reference] 1 [Reference]

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