Using Structural Equation Model to Illustrate the Relationship between Metabolic Risk Factors and Cardiovascular Complications in Taiwan

Background The objective of this study was to perform a population-based screening programme to determine the prevalence of the metabolic syndrome (MetS) and the relationship between metabolic risk factors and prevalent cardiovascular complications in Taiwan. Design A screening programme recruited residents aged 40 years and older in Sanchih, Taipei County, Taiwan, and collected demographic data, blood and urine samples. Fasting plasma glucose level, serum total cholesterol, high-density lipoprotein cholesterol, and triglyceride were measured.. Atherosclerotic complications, including myocardial infarction, stress-positive angina, ischaemic stroke, and proteinuria were confirmed. Methods A structural equation model (SEM) was constructed to identify the association between metabolic abnormality and atherosclerosis. Results A total of 1494 subjects, 776 male and 718 female, were recruited in this study. The crude prevalence of the MetS was 19.3% for men [95% confidence interval (CI) 16 .3-22.2%] and 18.7% for women (95% Cl 15.6-22.0%). The presence of the MetS posed a substantial risk to microvascular complications in both sexes [odds ratio (OR) 3.29, P < 0.001 ] and to macrovascular complications in men (OR 1.95, P = 0. 04) and also a trend in women (OR 2.24, P = 0.089). There was a positive association between metabolic abnormality and atherosclerosis (B = 0.55, P < 0.001). Conclusions This study has found the prevalence of the MetS and the association with atherosclerotic complications in Taiwan. The SEM approach has demonstrated a positive correlation between metabolic abnormality and atherosclerosis and can be used to explore new risk factors for cardiovascular diseases