Introduction Australian Aboriginal and Torres Strait Islands (TSI) people experience socioeconomic disadvantage and have higher prevalence of risk factors for cardiovascular diseases including overweight and obesity, smoking and alcohol drinking, higher blood triglycerides. In this population, diabetes and albuminuria have been reported to better predict some of the excess incident CHD than the “traditional” Framingham risk factors. This study aims to compare the relative performance of components of the metabolic syndrome (MetS) in predicting coronary heart disease morbidity and mortality in a cohort of Australian Aboriginal and Torres Strait Islander adults.
Methods Cohort study of 2100 adults (1283 Aborigines and 817 TSI) with 7-year follow-up from 2000. Outcome measures were all CHD events (deaths and hospitalisations). Baseline anthropometric measurements, blood pressure, fasting blood lipids and glucose were collected. Alcohol and tobacco intake was by self report.
Results MetS (both ATP-III and IDF criteria) was more prevalent in TSI males (50.5%) compared to Aborigines (37.7%). MetS at baseline doubled the risk of a CHD event in Aborigines. Increased fasting triglycerides was stronger in predicting CHD compared with MetS (HR: 2.8) after adjusted for age, sex, tobacco and alcohol consumption, and baseline diabetes and albuminuria for Aborigines but not among TSIs.
Conclusion Indigenous Australians have a high prevalence of CHD risk factors. MetS was not more powerful than its components in predicting CHD events. In Australian Aborigines, the “triglyceridemic waist” phenotype best predicts CHD events, while among TSIs, increased fasting glucose was a stronger predictor of CHD.
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