Background Population-scale evidence for the association between dynamic changes in metabolic syndrome (MetS) status and alterations in the risk for major adverse cardiovascular events (MACE) is lacking. Objective To investigate whether recovery from or development of MetS in a population is associated with an altered risk for MACE. Design Nationwide cohort study. Setting An analysis based on the National Health Insurance Database of Korea. Participants A total of 27 161 051 persons who received national health screenings from 2009 to 2014 were screened. Those with a history of MACE were excluded. We determined the MetS status of 9 553 042 persons using the following harmonizing criteria: MetS-chronic (n = 1 486 485), MetS-developed (n = 587 088), MetS-recovery (n = 538 806), and MetS-free (n = 6 940 663). Measurements The outcome was the occurrence of MACE, including acute myocardial infarction, revascularization, and acute ischemic stroke, identified from the claims database. The incidence rate ratios (IRRs) were calculated with adjustments for body mass index, comorbidity scores, previous metabolic variables, and other clinical or demographic variables. Results At a median follow-up of 3.54 years, the MetS-recovery group (incidence rate, 4.55 per 1000 person-years) had a significantly lower MACE risk (adjusted IRR, 0.85 [95% CI, 0.83 to 0.87]) than that of the MetS-chronic group (incidence rate, 8.52 per 1000 person-years). The MetS-developed group (incidence rate, 6.05 per 1000 person-years) had a significantly higher MACE risk (adjusted IRR, 1.36 [CI, 1.33 to 1.39]) than that of the MetS-free group (incidence rate, 1.92 per 1000 person-years). Among the MetS components, change in hypertension was associated with the largest difference in MACE risk. Limitation Limited assessment of mortality and short follow-up. Conclusion Recovery from MetS was significantly associated with decreased risk for MACE, whereas development of MetS was associated with increased risk. Primary Funding Source Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea.

中文翻译：

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代谢综合征状态发生变化而导致心血管事件发生风险的改变：一项基于全国人口的研究，涉及大约1000万人。

背景技术缺乏代谢综合征（MetS）状态动态变化与重大不良心血管事件（MACE）风险改变之间相关性的人口规模证据。目的研究人群中MetS的恢复或发展是否与MACE风险改变相关。设计全国性队列研究。根据韩国国家健康保险数据库进行分析。参加者筛选了2009年至2014年接受国家健康筛查的27161051人。那些有MACE病史的人被排除在外。我们使用以下协调标准确定了9 553 042人的MetS状况：MetS慢性（n = 1 486 485），MetS发达（n = 587 088），MetS恢复（n = 538 806）和MetS-免费（n = 6 940 663）。测量结果是发生MACE，包括从索赔数据库中识别出的急性心肌梗塞，血运重建和急性缺血性中风。通过对体重指数，合并症评分，既往代谢变量以及其他临床或人口统计学变量进行调整，计算出发病率比率（IRR）。结果在平均随访时间为3.54年时，MetS恢复组（发生率，每1000人年4.55）的MACE风险显着降低（IRR调整后为0.85 [95％CI，0.83至0.87]）。 MetS慢性组的发病率（每千人年8.52）。MetS开发的组（发病率，每千人年6.05）比无MetS的组（发病率，1）具有更高的MACE风险（调整后的IRR，1.36 [CI，1.33至1.39]）。每千人年92个）。在MetS组件中，高血压的变化与MACE风险的最大差异有关。局限性死亡率和短期随访评估有限。结论从MetS恢复与降低MACE风险显着相关，而发展MetS与增加风险相关。主要资金来源大韩民国厚生省的韩国医疗技术研发项目。