Author:
Jeong Seungmin,Cho Sung-il,Kong So Yeon
Abstract
Abstract
Background
This study aimed to determine whether a simultaneous diagnosis of main components of metabolic syndrome (MetS) (hypertension, diabetes mellitus, and dyslipidemia) plays a mediator between income level and stroke.
Methods
We used the National Health Insurance Service National Sample Cohort database from 2006 to 2015. The mediator variables were the number of main MetS components diagnosed simultaneously (two or more/three or more). We used a weighting approach method of causal mediation analysis to apply counterfactual frameworks to the Cox proportional hazards regression model.
Results
A total of 213,526 people were included with 1,690,665.3 person-years of followed up. Compared with the high-income group, the risk of being diagnosed with two or more components of MetS significantly increased in all other income groups [middle-income OR 1.05 (95% CI 1.02–1.08); low-income OR 1.09 (95% CI 1.05–1.12); Medical Aid beneficiaries OR 1.39 (95% CI 1.32–1.47)]. A lower level of income was significantly associated with a higher risk of stroke compared with the high-income group [middle-income HR 1.15 (95% CI 1.07–1.25); low-income HR 1.19 (95% CI 1.10–1.29); Medical Aid beneficiaries HR 1.63 (95% CI 1.48–1.80)]. In the Medical Aid beneficiaries, simultaneous diagnosis of the main metabolic components acted as a significant mediator between income levels and stroke incidence, with 26.6% mediated when diagnosed with two or more diseases and 21.1% when diagnosed with all three.
Conclusions
Co-diagnosis of MetS components played a significant mediator role between income level and stroke incidence.
Publisher
Springer Science and Business Media LLC
Subject
Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献