Metabolic syndrome and risk of isolated ST-T abnormalities and type 2 diabetes in Japanese male office workers.

Using a modified National Cholesterol Education Program (NCEP) definition of the metabolic syndrome (MS) with body mass index instead of waist circumference, we examined the associations of the MS with the risk of developing ST-T abnormalities in 3405 Japanese men aged 35-59 yr who did not have a history of cardiovascular disease or ST-T abnormalities. Of 3405 participants, 3166 men without type 2 diabetes (as diagnosed with the revised criteria of American Diabetes Association) also constituted a non-diabetic cohort. Examinations including electrocardiogram and fasting plasma glucose were repeated annually for 7 subsequent years. The subjects were classified as having ST-T abnormalities or type 2 diabetes when evidence of either of these disorders was found during at least 2 consecutive annual examinations. After adjustment for potential risk factors, the relative risks of ST-T abnormalities were 1.0 (referent), 2.66, 3.07, 4.27, and 8.40 for the presence of 0, 1, 2, 3, and > or =24 components of the MS, respectively (P for trend <0.001). The corresponding results for the risk of type 2 diabetes were 1.0 (referent), 3.49, 7.45, 15.00, and 24.04 (P for trend <0.001). The estimated incident rates for men in the low-WBC count (<7.3 x 10(9) cells/L)/no MS, high-WBC count (> or =7.3 x 10(9) cells/L)/no MS, low-WBC count/yes MS, and high-WBC count/yes MS were 3.4%, 4.6%, 7.4%, and 13.1% for ST-T abnormalities, respectively and were 3.6%, 7.1%, 18.0%, and 27.2% for type 2 diabetes, respectively. The respective multivariate-adjusted relative risks were 1.0 (referent), 1.26, 2.07, and 3.45 for ST-T abnormalities and were 1.0 (referent), 1.75, 5.14, and 6.90 for type 2 diabetes. A modified NCEP MS definition predicts ST-T abnormalities and type 2 diabetes. WBC count adds clinically important information to new-onset ST-T abnormalities and type 2 diabetes.