Biological and social values of metabolic syndrome in predicting cardiovascular disease

Background: Metabolic syndrome (MetS) is defined as a clustering of risk factors for cardiovascular disease. The aim of this analysis is to explore the social determinants of MetS and circulatory events and to clarify the role of this syndrome in predicting cardiovascular disease. Methods: In a population-based study on 6357 individuals (3117 men and 3240 women), we considered the prevalence of MetS and its components by gender and by education level. We also compared the risks of coronary, stroke and major atherosclerotic event (defined as first coronary event or stroke) by Mets and education level. Results: As expected, MetS prevalence was significantly lower in women under 60 years, but them it became higher than in men. Unadjusted prevalence of MetS decreased from the lower educational group (19.4%) to higher educational one (7.7%). After adjusting for age, total cholesterol, cigarette smoking and antihypertensive treatment, in women with MetS, the risk excess for stroke and for coronary event resulted always over two fold, whereas in men statistical significance was mantained only for atherosclerotic events. When we calculated Hazard Ratios (HRs) for all events by education in individuals with and without MetS, statistically significant distinctions were not revealed in different educational classes. Conclusions: Relationship between Mets and circulatory events was confirmed, mainly in women. High education level seems to be an important protective factor against this syndrome and for almost all its components, but our data do not support the assumption of a direct socio-pathogenic mechanism linking education level, MetS and cardiovascular disease.