The association of metabolic syndrome and ischemic heart disease using resting electrocardiogram in the Northern Persian Gulf adults

Metabolic syndrome comprises insulin resistance, abdominal fat distribution, dyslipidemia, and hypertension. The metabolic syndrome is expected to be diagnosed in millions of subjects in the near future worldwide. There are very few data in literature clearly documenting that subjects with metabolic syndrome have an increased cardiovascular risk. In a cross-sectional study, we used National Cholesterol Education Program (NCEP)-Adult Treatment Panel (ATP)-III criteria and Minnesota Code of a 12-lead resting electrocardiogram (ECG) to assess in 3723 subjects, aged 25 years and over, selected by cluster random sampling in three Iranian ports in the northern Persian Gulf. Electrocardiogram with evidence of IHD (IHD ECG) was defined as myocardial infarction (Codes 1.1 and 1.2) and ischemia (Codes 1.3, 4.1-4.4, 5.1-5.3 and 7.1) together. An estimated 49.08% (52.04% of males and 46.34% of females) were identified as fulfilling NCEP-ATP III criteria for diagnosing the metabolic syndrome. Prevalence of EKG with evidence of ischemic heart disease (IHD ECG) was 12.7% (10.4% for men and 14.7% for women p<0.0001). In multiple logistic regression analysis, metabolic syndrome was found to have a significant association with IHD ECG [OR=1.35, C.I (1.09-1.66) p=0.005] after adjusting for sex and age. The association of metabolic syndrome and IHD ECG in the study population increased monotonically with increasing number of metabolic syndrome components. In conclusion, the metabolic syndrome, which occurs very frequently in the general population, has a significant association with nonfatal ischemic heart disease by electrocardiogram criteria.