This study investigated the associations of combinations of body mass index (BMI) levels and presence/absence of the metabolic symdrome (MetS) with long-term risk of cardiovascular events and death in middle-aged men. The study sample included 1758 non-diabetic men tested for cadiovascular risk factors at age 50 years. During follow-up (median 30 years), 788 participants died, and 681 developed cardiovascular disease. This study reported that middle-aged men with Mets had an increased risk of cardiovascular events, regardless of BMI status. Moreover, the highest risk estimates were seen in obese participants with MetS. In contrast to the authors’ hypothesis, the overweight and obese subjects without MetS or without insulin resistance also had an increased risk for cardiovascular events and total death compared with normal-weight men without MetS or insulin resistance. In addition, obesity, independently of the presence of MetS, was associated with a higher risk for non-cardiovascular death and cancer incidence. These findings underline the fact that obesity is independently associated with an increased risk of chronic diseases and death.
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