The metabolic syndrome adds incremental value to the Framingham risk score in identifying asymptomatic individuals with higher degrees of inflammation.

Recent studies have shown that elevated white blood cell (WBC) counts independently predict adverse cardiovascular disease (CVD) outcomes. The metabolic syndrome (MS) is known to be associated with a higher degree of inflammation and increased CVD risk. It is unclear, however, whether MS provides incremental information to the Framingham risk score (FRS). The authors studied 458 asymptomatic men, of whom 112 had MS. WBC count was used as a marker of inflammation. The odds ratio (OR) for presence of WBCs in the highest quartile vs the lower 3 quartiles was 2.2; 95% confidence interval (CI), 1.39-3.40 for MS. After further adjustment for the FRS, the relationship remained significant (OR, 1.97; 95% CI, 1.25-3.13). The ability to identify higher levels of WBCs with MS was especially important in the low-risk men (OR, 2.66; 95% CI, 1.39-5.07). The study findings suggest that MS adds value to the FRS in identifying those with higher degrees of inflammation, especially among those classified as low-risk by the FRS.