This study compared the ability of the metabolic syndrome and the Framingham risk score to predict all-cause and cardiovascular disease (CVD) mortality in 5,699 Chinese, Malays, and Asian Indians living in Singapore. Slightly modified criteria of the metabolic syndrome were used, with waist circumference being replaced by body mass index. During the over 14 years of follow-up, 382 deaths occurred (128 from CVD as an underlying cause). In both men and women, the metabolic syndrome similarly increased CVD mortality risk. However, after adjusting for classical CVD risk factors, this relationship was much less significant in women than in men. When taken separately, the Framingham risk score yielded a greater area under the receiver-operating characteristic curve than the metabolic syndrome, this difference being higher in men than in women. This study underlines the importance of individual metabolic syndrome criteria in predicting cardiovascular events in Asian populations.
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