Background
Methods
Study design and subjects
Clinical examination
Biochemical measurements
Assessment of metabolic syndrome and lipoprotein particle size
Criteria | Details |
---|---|
Raised blood pressure | Systolic blood pressure (SBP) ≥130 mmHg or diastolic blood pressure (DBP) ≥85 mmHg or use of blood pressure-lowering medication |
Elevated glucose level | Fasting blood glucose ≥5.6 mmol/l or use of blood glucose-lowering medication or diagnosis of type 2 diabetes |
Decreased high-density lipoprotein-cholesterol | <1.03 mmol/l in men or <1.30 mmol/l in women or lipid-lowering medical treatment |
Elevated triglycerides | ≥1.70 mmol/l or medication for elevated triglycerides |
Abdominal obesity (increased waist circumference) | ≥102 cm in men or ≥88 cm in women |
Data description
Statistical methods
Results
Characteristic | Men | Women | ||||||
---|---|---|---|---|---|---|---|---|
n = 24,389 (41.0%) | n = 35,078 (59.0%) | |||||||
BMI <25 | BMI 25 to 30 | BMI ≥30 |
Pvalue | BMI <25 | BMI 25 to 30 | BMI ≥30 |
Pvalue | |
n (%) | 9,112 (37.4%) | 11,763 (48.2%) | 3,514 (14.4%) | 17,750 (50.6%) | 11,667 (33.3%) | 5,661 (16.1%) | ||
Age, years | 42 ± 12 | 47 ± 11 | 48 ± 11 | <0.001 | 42 ± 12 | 47 ± 12 | 47 ± 12 | <0.001 |
BMI, kg/m2
| 23.0 ± 1.5 | 27.1 ± 1.4 | 32.8 ± 2.9 | <0.001 | 22.4 ± 1.7 | 27.1 ± 1.4 | 34.1 ± 3.9 | <0.001 |
Smoking status | ||||||||
Non-smoker, n (%) | 4,467 (49.0%) | 4,751 (40.4%) | 1,311 (37.3%) | 8,753 (49.3%) | 5,080 (43.5%) | 2,623 (46.3%) | ||
Former smoker, n (%) | 2,401 (26.3%) | 4,384 (37.3%) | 1,390 (39.6%) | 5,248 (29.6%) | 4,298 (36.8%) | 2,087 (36.9%) | ||
Current smoker, n (%) | 2,244 (24.6%) | 2,628 (22.3%) | 813 (23.1%) | 3,749 (21.1%) | 2,289 (19.6%) | 951 (16.8%) | ||
SBP, mmHg | 127 ± 12 | 133 ± 13 | 137 ± 14 | <0.001 | 119 ± 14 | 125 ± 15 | 130 ± 15 | <0.001 |
DBP, mmHg | 74 ± 8 | 78 ± 9 | 80 ± 9 | <0.001 | 70 ± 8 | 73 ± 9 | 75 ± 9 | <0.001 |
Total cholesterol, mmol/l | 4.9 ± 1.0 | 5.2 ± 1.0 | 5.2 ± 1.0 | <0.001 | 4.9 ± 1.0 | 5.1 ± 1.0 | 5.1 ± 1.0 | <0.001 |
LDL-C, mmol/l | 3.17 ± 0.86 | 3.47 ± 0.87 | 3.44 ± 0.91 | <0.001 | 2.91 ± 0.84 | 3.25 ± 0.90 | 3.26 ± 0.88 | <0.001 |
HDL-C, mmol/l | 1.40 ± 0.32 | 1.25 ± 0.29 | 1.12 ± 0.26 | <0.001 | 1.69 ± 0.39 | 1.54 ± 0.36 | 1.38 ± 0.33 | <0.001 |
Triglycerides, mmol/la
| 0.98 (0.71 to 1.31) | 1.31 (0.91 to 1.80) | 1.62 (1.15 to 2.23) | <0.001 | 0.81 (0.61 to 1.04) | 0.99 (0.72 to 1.33) | 1.20 (0.86 to 1.61) | <0.001 |
Apolipoprotein A1, g/lb
| 1.47 ± 0.23 | 1.41 ± 0.21 | 1.36 ± 0.21 | <0.001 | 1.66 ± 0.28 | 1.60 ± 0.26 | 1.52 ± 0.26 | <0.001 |
HDL-C/apoA1 ratiob
| 0.93 ± 0.13 | 0.86 ± 0.12 | 0.81 ± 0.11 | <0.001 | 1.00 ± 0.14 | 0.95 ± 0.50 | 0.90 ± 0.49 | <0.001 |
Apolipoprotein B, g/lb
| 0.91 ± 0.23 | 1.01 ± 0.24 | 1.05 ± 0.24 | <0.001 | 0.84 ± 0.22 | 0.94 ± 0.24 | 0.97 ± 0.24 | <0.001 |
LDL-C/apoB ratiob
| 3.51 ± 0.35 | 3.44 ± 0.40 | 3.32 ± 0.42 | <0.001 | 3.45 ± 0.36 | 3.46 ± 0.36 | 3.37 ± 0.38 | <0.001 |
Blood glucose, mmol/la
| 4.94 (4.60 to 5.20) | 5.18 (4.80 to 5.40) | 5.52 (5.00 to 5.80) | <0.001 | 4.70 (4.40 to 4.90) | 4.94 (4.60 to 5.20) | 5.26 (4.80 to 5.50) | <0.001 |
Waist circumference, cm | 87 ± 6 | 98 ± 6 | 112 ± 9 | <0.001 | 79 ± 7 | 90 ± 7 | 105 ± 10 | <0.001 |
BP-lowering medication, n (%) | 462 (5.1%) | 1,516 (12.9%) | 843 (24.0%) | <0.001 | 1,050 (5.9%) | 1,563 (13.4%) | 1,351 (23.9%) | <0.001 |
Statin use, n (%) | 267 (2.9%) | 1,008 (8.6%) | 473 (13.5%) | <0.001 | 364 (2.1%) | 608 (5.2%) | 457 (8.1%) | <0.001 |
TG-lowering medication, n (%) | 6 (0.1%) | 32 (0.3%) | 13 (0.4%) | <0.001 | 3 (0.0%) | 11 (0.1%) | 8 (0.1%) | 0.0012 |
Type 2 diabetes, n (%) | 53 (0.6%) | 203 (1.7%) | 204 (5.8%) | <0.001 | 55 (0.3%) | 150 (1.3%) | 267 (4.7%) | <0.001 |
Oral antihyperglycemic medication, n (%) | 38 (0.4%) | 175 (1.5%) | 175 (5.0%) | <0.001 | 44 (0.2%) | 118 (1.0%) | 211 (3.7%) | <0.001 |
Percentage fulfilling ≥3 out of 5 metabolic syndrome criteriac
| 330 (3.6%) | 2,544 (21.6%) | 2,259 (64.3%) | <0.001 | 425 (2.4%) | 1,871 (16.0%) | 2,351 (41.5%) | <0.001 |
Smoking status | Men | Women | ||||||
---|---|---|---|---|---|---|---|---|
Non-smoker | Former smoker | Current smoker |
Pvalue | Non-smoker | Former smoker | Current smoker |
Pvalue | |
n (%) | 10,529 (43.2%) | 8,175 (33.5%) | 5,685 (23.3%) | 16,456 (46.9%) | 11,633 (33.2%) | 6,989 (19.9%) | ||
Age, years | 42 ± 11 | 51 ± 12 | 43 ± 11 | <0.001 | 43 ± 12 | 48 ± 11 | 42 ± 11 | <0.001 |
BMI, kg/m2
| 26.1 ± 3.7 | 27.0 ± 3.5 | 26.2 ± 3.7 | <0.001 | 25.6 ± 4.8 | 26.3 ± 4.7 | 25.4 ± 4.6 | <0.001 |
BMI ≥30 kg/m2, n (%) | 1,311 (12.5%) | 1,390 (17.0%) | 812 (14.3%) | 2,623 (15.9%) | 2,087 (17.9%) | 951 (13.6%) | ||
SBP, mmHg | 130 ± 13 | 133 ± 14 | 131 ± 13 | <0.001 | 122 ± 15 | 124 ± 16 | 121 ± 14 | <0.001 |
DBP, mmHg | 76 ± 9 | 78 ± 9 | 76 ± 9 | <0.001 | 72 ± 9 | 73 ± 9 | 72 ± 9 | <0.001 |
Total cholesterol, mmol/l | 5.0 ± 1.0 | 5.2 ± 1.0 | 5.1 ± 1.0 | <0.001 | 4.9 ± 1.0 | 5.1 ± 1.0 | 5.0 ± 1.0 | <0.001 |
LDL-C, mmol/l | 3.28 ± 0.86 | 3.43 ± 0.89 | 3.39 ± 0.92 | <0.001 | 2.99 ±0.85 | 3.18 ± 0.89 | 3.14 ± 0.92 | <0.001 |
HDL-C, mmol/l | 1.31 ± 0.31 | 1.31 ± 0.32 | 1.21 ± 0.30 | <0.001 | 1.59 ± 0.38 | 1.65 ± 0.40 | 1.49 ± 0.38 | <0.001 |
Triglycerides, mmol/la
| 1.12 (0.78 to 1.54) | 1.25 (0.87 to 1.73) | 1.35 (0.92 to 1.91) | <0.001 | 0.87 (0.64 to 1.16) | 0.93 (0.68 to 1.25) | 1.01 (0.73 to 1.36) | <0.001 |
Apolipoprotein A1, g/l | 1.43 ± 0.22 | 1.46 ± 0.22 | 1.40 ± 0.22 | <0.001 | 1.61 ± 0.27 | 1.66 ± 0.27 | 1.57 ± 0.28 | <0.001 |
HDL-C/apoA1 ratio | 0.89 ± 0.13 | 0.88 ± 0.13 | 0.85 ± 0.13 | <0.001 | 0.97 ± 0.14 | 0.98 ± 0.60 | 0.92 ± 0.13 | <0.001 |
Apolipoprotein B, g/l | 0.94 ± 0.23 | 1.00 ± 0.24 | 1.00 ± 0.25 | <0.001 | 0.87 ± 0.23 | 0.91 ± 0.23 | 0.93 ± 0.24 | <0.001 |
LDL-C/apoB ratio | 3.49 ± 0.37 | 3.45 ± 0.41 | 3.37 ± 0.40 | <0.001 | 3.44 ± 0.37 | 3.47 ± 0.36 | 3.38 ± 0.36 | <0.001 |
Blood glucose, mmol/la
| 5.05 (4.70 to 5.30) | 5.26 (4.90 to 5.50) | 5.11 (4.70 to 5.40) | <0.001 | 4.83 (4.50 to 5.10) | 4.94 (4.60 to 5.20) | 4.84 (4.50 to 5.10) | <0.001 |
Waist circumference, cm | 94 ± 11 | 98 ± 10 | 95 ± 11 | <0.001 | 86 ± 12 | 89 ± 12 | 87 ± 12 | <0.001 |
BP-lowering medication, n (%) | 821 (7.8%) | 1,497 (18.3%) | 503 (8.8%) | <0.001 | 1,683 (10.2%) | 1,660 (14.3%) | 621 (8.9%) | <0.001 |
Statin use, n (%) | 411 (3.9% | 918 (11.2% | 419 (7.4%) | <0.001 | 560 (3.4%) | 594 (5.1%) | 275 (3.9%) | <0.001 |
TG-lowering medication, n (%) | 13 (0.1%) | 24 (0.3%) | 14 (0.2%) | NS | 6 (0.1%) | 10 (0.1%) | 6 (0.1%) | NS |
Type 2 diabetes, n (%) | 113 (1.1%) | 264 (3.2%) | 83 (1.5%) | <0.001 | 188 (1.1%) | 216 (1.9%) | 68 (1.0%) | NS |
Oral antihyperglycemic medication, n (%) | 102 (1.0%) | 217 (2.7%) | 69 (1.2%) | <0.001 | 154 (0.9%) | 164 (1.4%) | 55 (0.8%) | <0.001 |
Component | Current smoking | |||||
---|---|---|---|---|---|---|
Men | Women | |||||
Light | Moderate | Heavy | Light | Moderate | Heavy | |
SBP, mmHg | ||||||
BMI <25 | 1.24 (0.46 to 2.03) | 1.93 (1.10 to 2.76) | 1.46 (−0.25 to 3.18) | −0.64 (−1.25 to −0.03) | 0.22 (−0.51 to 0.95) | −0.01 (−1.73 to 1.71) |
NS |
P
<0.001
| NS | NS | NS | NS | |
BMI 25 to 30 | −0.64 (−1.43 to 0.15) | 1.59 (0.73 to 2.45) | 0.21 (−1.30 to 1.72) | −1.46 (−2.30 to −0.61) | −0.06 (−1.05 to 0.92) | −1.13 (−3.37 to 1.11) |
NS |
P
<0.001
| NS |
P =
0.001
| NS | NS | |
BMI ≥30 | 0.58 (−1.08 to 2.25) | 0.65 (−1.02 to 2.31) | 2.16 (−0.24 to 4.55) | −0.93 (−2.39 to 0.53) | −0.74 (−2.24 to 0.77) | 2.04 (−0.83 to 4.91) |
NS | NS | NS | NS | NS | NS | |
DBP, mmHg | ||||||
BMI <25 | 0.44 (−0.07 to 0.95) | 0.94 (0.40 to 1.49) | 1.68 (0.56 to 2.81) | −0.08 (−0.46 to 0.30) | 0.49 (0.04 to 0.94) | 1.13 (0.06 to 2.19) |
NS |
P =
0.001
| NS | NS | NS | NS | |
BMI 25 to 30 | −0.38 (−0.91 to 0.15) | 0.66 (0.08 to 1.23) | 0.49 (−0.51 to 1.50) | −0.27 (−0.79 to 0.25) | 0.56 (0.05 to 1.16) | 0.66 (−0.72 to 2.04) |
NS | NS | NS | NS | NS | NS | |
BMI ≥30 | −0.54 (−1.61 to 0.54) | 0.35 (−0.71 to 1.42) | 0.22 (−1.32 to 1.76) | −0.24 (−1.12 to 0.65) | −0.52 (−1.44 to 0.39) | 0.86 (−0.88 to 2.59) |
NS | NS | NS | NS | NS | NS | |
HDL-C, mmol/l | ||||||
BMI <25 | −0.07 (−0.09 to −0.05) | −0.13 (−0.15 to −0.11) | −0.14 (−0.18 to −0.09) | −0.06 (−0.08 to −0.05) | −0.17 (−0.20 to −0.15) | −0.21 (−0.26 to −0.16) |
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
| |
BMI 25 to 30 | −0.04 (−0.06 to −0.02) | −0.10 (−0.12 to −0.08) | −0.13 (−0.16 to −0.09) | −0.06 (−0.08 to −0.04) | −0.17 (−0.20 to −0.15) | −0.15 (−0.20 to −0.09) |
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
| |
BMI ≥30 | −0.04 (−0.07 to 0.01) | −0.10 (−0.13 to −0.07) | −0.10 (−0.14 to −0.06) | −0.08 (−0.12 to −0.05) | −0.17 (−0.20 to −0.13) | −0.20 (−0.26 to −0.14) |
NS |
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
| |
Triglycerides, mmol/la
| ||||||
BMI <25 | 0.13 (0.10 to 0.15) | 0.26 (0.23 to 0.29) | 0.29 (0.22 to 0.37) | 0.08 (0.06 to 0.09) | 0.18 (0.16 to 0.19) | 0.26 (0.21 to 0.31) |
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
| |
BMI 25 to 30 | 0.16 (0.13 to 0.20) | 0.30 (0.25 to 0.34) | 0.40 (0.31 to 0.50) | 0.11 (0.09 to 0.13) | 0.21 (0.18 to 0.24) | 0.33 (0.25 to 0.41) |
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
| |
BMI ≥30 | 0.14 (0.07 to 0.22) | 0.32 (0.22 to 0.41) | 0.35 (0.20 to 0.53) | 0.11 (0.07 to 0.16) | 0.26 (0.23 to 0.31) | 0.33 (0.23 to 0.46) |
NS |
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
| |
Blood glucose, mmol/la
| ||||||
BMI <25 | 0.02 (0.01 to 0.04) | 0.07 (0.04 to 0.10) | 0.13 (0.05 to 0.21) | −0.01 (−0.02 to 0.01) | 0.05 (0.03 to 0.08) | 0.15 (0.08 to 0.24) |
NS |
P
<0.001
| NS | NS | NS |
P
<0.001
| |
BMI 25 to 30 | 0.01 (−0.02 to 0.03) | 0.07 (0.03 to 0.11) | 0.10 (0.03 to 0.16) | −0.03 (−0.05 to −0.01) | 0.06 (0.03 to 0.10) | 0.06 (−0.01 to 0.13) |
NS |
P =
0.001
| NS | NS |
P
<0.001
| NS | |
BMI ≥30 | 0.01 (−0.06 to 0.10) | 0.04 (−0.05 to 0.13) | 0.10 (−0.05 to 0.30) | −0.07 (−0.12 to −0.01) | 0.05 (−0.01 to 0.13) | 0.32 (0.17 to 0.50) |
NS | NS | NS | NS | NS |
P
<0.001
| |
Waist circumference, cm | ||||||
BMI <25 | 0.66 (0.27 to 1.05) | 0.81 (0.39 to 1.23) | 1.20 (0.34 to 2.06) | 0.30 (−0.03 to 0.621) | 0.83 (0.45 to 1.22) | 1.18 (0.26 to 2.09) |
P =
0.001
|
P
<0.001
| NS | NS |
P
<0.001
| NS | |
BMI 25 to 30 | 0.16 (−0.21 to 0.53) | 1.53 (1.13 to 1.93) | 1.99 (1.28 to 2.69) | 0.74 (0.30 to 1.17) | 1.75 (1.24 to 2.25) | 1.61 (0.46 to 2.76) |
NS |
P
<0.001
|
P
<0.001
|
P =
0.001
|
P
<0.001
| NS | |
BMI ≥30 | −0.97 (−2.05 to 0.11) | −0.06 (−1.14 to 1.01) | 2.44 (0.89 to 3.99) | −0.04 (−1.10 to 1.01) | 2.20 (1.10 to 3.29) | 6.44 (4.37 to 8.51) |
NS | NS | NS | NS |
P
<0.001
|
P
<0.001
| |
Apo A1, g/l | ||||||
BMI <25 | −0.02 (−0.04 to 0.00) | −0.05 (−0.06 to −0.03) | −0.04 (−0.08 to −0.00) | −0.00 (−0.02 to 0.02) | −0.06 (−0.08 to −0.04) | −0.07 (−0.12 to −0.02) |
NS |
P
<0.001
| NS | NS |
P
<0.001
| NS | |
BMI 25 to 30 | −0.02 (−0.03 to 0.00) | −0.03 (−0.05 to −0.01) | −0.04 (−0.07 to −0.01) | −0.03 (−0.05 to −0.01) | −0.07 (−0.09 to −0.04) | −0.02 (−0.07 to 0.03) |
NS |
P
<0.001
| NS | NS |
P
<0.001
| NS | |
BMI ≥30 | −0.02 (−0.05 to 0.02) | −0.04 (−0.08 to −0.01) | −0.03 (−0.07 to −0.02) | −0.07 (−0.10 to −0.03) | −0.09 (−0.13 to −0.06) | −0.09 (−0.16 to −0.03) |
NS | NS | NS |
P
<0.001
|
P
<0.001
| NS | |
HDL-C/apoA1 ratio | ||||||
BMI <25 | −0.03 (−0.04 to −0.02) | −0.06 (−0.07 to −0.05) | −0.06 (−0.08 to −0.03) | −0.03 (−0.04 to −0.03) | −0.06 (−0.07 to −0.06) | −0.09 (−0.11 to −0.06) |
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
| |
BMI 25 to 30 | −0.02 (−0.03 to −0.01) | −0.05 (−0.06 to −0.04) | −0.06 (−0.08 to −0.05) | −0.04 (−0.05 to −0.03) | −0.06 (−0.07 to −0.05) | −0.06 (−0.09 to −0.04) |
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
| |
BMI ≥30 | −0.02 (−0.03 to 0.00) | −0.04 (−0.06 to −0.03) | −0.06 (−0.08 to −0.03) | −0.01 (−0.03 to 0.01) | −0.06 (−0.08 to −0.04) | −0.06 (−0.1 to −0.03) |
NS |
P
<0.001
|
P
<0.001
| NS |
P
<0.001
|
P =
<0.001
| |
Apo B, g/l | ||||||
BMI <25 | 0.03 (0.01 to 0.05) | 0.09 (0.07 to 0.11) | 0.09 (0.05 to 0.13) | 0.03 (0.02 to 0.04) | 0.09 (0.08 to 0.11) | 0.14 (0.11 to 0.18) |
NS |
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
| |
BMI 25 to 30 | 0.03 (0.02 to 0.05) | 0.08 (0.06 to 0.10) | 0.09 (0.06 to 0.12) | 0.05 (0.03 to 0.06) | 0.08 (0.06 to 0.10) | 0.08 (0.04 to 0.13) |
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
|
P
<0.001
| |
BMI ≥30 | 0.02 (−0.02 to 0.07) | 0.06 (0.02 to 0.09) | 0.07 (0.02 to 0.12) | 0.06 (0.03 to 0.09) | 0.09 (0.06 to 0.12) | 0.12 (0.06 to 0.17) |
NS | NS | NS |
P
<0.001
|
P
<0.001
|
P
<0.001
| |
LDL-C/apoB ratio | ||||||
BMI <25 | −0.11 (−0.14 to −0.08) | −0.13 (−0.16 to −0.10) | −0.09 (−0.15 to −0.03) | −0.06 (−0.08 to −0.04) | −0.07 (−0.10 to −0.05) | −0.11 (−0.17 to −0.05) |
P
<0.001
|
P
<0.001
| NS |
P
<0.001
|
P
<0.001
|
P =
0.001
| |
BMI 25 to 30 | −0.08 (−0.12 to −0.06) | −0.12 (−0.15 to −0.09) | −0.19 (−0.24 to −0.13) | −0.05 (−0.07 to −0.02) | −0.06 (−0.09 to −0.02) | −0.13 (−0.20 to −0.06) |
P
<0.001
|
P
<0.001
|
P
<0.001
| NS |
P =
0.001
|
P
<0.001
| |
BMI ≥30 | −0.06 (−0.12 to 0.01) | −0.13 (−0.20 to −0.07) | −0.14 (−0.23 to −0.05) | −0.02 (−0.07 to 0.03) | −0.07 (−0.13 to −0.02) | −0.08 (−0.18 to 0.02) |
NS |
P =
<0.001
| NS | NS | NS | NS |