J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website https://jem.elmerpub.com

Original Article

Volume 15, Number 5, December 2025, pages 210-219

Diabetes Drives Cardiovascular Risk in the Metabolic Triad: An Eight-Year Occupational Cohort Study of Ten Thousand Workers

↓ Figure 2. Adjusted hazard ratios (aHR) for cardiovascular events according to metabolic triad categories. CI: confidence interval.

↓ **Table 1.** General Characteristics in the Worker Sample
Characteristics	N = 10,300
Data are presented as n (%) or mean (standard deviation).
Sex
Female	1,589 (15.43%)
Male	8,711 (84.57%)
Age	37.17 (11.53)
Age group
18 - 59 years	9,847 (95.60%)
60 years or older	453 (4.40%)
Smoking status
No	6,031 (58.55%)
Yes	4,269 (41.45%)
Alcohol consumption
No	5,143 (49.93%)
Yes	5,157 (50.07%)
Body mass index	27.18 (4.02)
Abdominal circumference	91.15 (10.41)
Systolic blood pressure	110.93 (12.14)
Diastolic blood pressure	71.68 (13.88)
Fasting glucose	94.11 (21.24)
Triglycerides	145.36 (82.55)
Cholesterol	196.32 (37.28)
Obesity by BMI
No	8,036 (78.02%)
Yes	2,264 (21.98%)
Abdominal obesity
No	8,213 (79.74%)
Yes	2,087 (20.26%)
Hypertension at baseline
No	9,763 (94.79%)
Yes	537 (5.21%)
Diabetes at baseline
No	10,044 (97.51%)
Yes	256 (2.49%)
Metabolic triad
Normal	7,049 (68.44%)
Obesity only	2,509 (24.36%)
Diabetes only	115 (1.12%)
Hypertension only	216 (2.10%)
Obesity + diabetes	90 (0.87%)
Obesity + hypertension	270 (2.62%)
Diabetes + hypertension	17 (0.17%)
Metabolic triad	34 (0.33%)

↓ Table 1. General Characteristics in the Worker Sample

Characteristics

N = 10,300

Data are presented as n (%) or mean (standard deviation).

Sex

Female

1,589 (15.43%)

Male

8,711 (84.57%)

Age

37.17 (11.53)

Age group

18 - 59 years

9,847 (95.60%)

60 years or older

453 (4.40%)

Smoking status

6,031 (58.55%)

Yes

4,269 (41.45%)

Alcohol consumption

5,143 (49.93%)

Yes

5,157 (50.07%)

Body mass index

27.18 (4.02)

Abdominal circumference

91.15 (10.41)

Systolic blood pressure

110.93 (12.14)

Diastolic blood pressure

71.68 (13.88)

Fasting glucose

94.11 (21.24)

Triglycerides

145.36 (82.55)

Cholesterol

196.32 (37.28)

Obesity by BMI

8,036 (78.02%)

Yes

2,264 (21.98%)

Abdominal obesity

8,213 (79.74%)

Yes

2,087 (20.26%)

Hypertension at baseline

9,763 (94.79%)

Yes

537 (5.21%)

Diabetes at baseline

10,044 (97.51%)

Yes

256 (2.49%)

Metabolic triad

Normal

7,049 (68.44%)

Obesity only

2,509 (24.36%)

Diabetes only

115 (1.12%)

Hypertension only

216 (2.10%)

Obesity + diabetes

90 (0.87%)

Obesity + hypertension

270 (2.62%)

Diabetes + hypertension

17 (0.17%)

Metabolic triad

34 (0.33%)

↓ **Table 2.** Incidence and Cardiovascular Risk by Metabolic Triad Categories
Metabolic triad	Incidence per 1,000 person-years (95% CI)	Number of cases	Follow-up time (years)	Univariate HRc	95% CI
^aStatistically significant associations. HRc: crude hazard ratio; CI: confidence interval; Ref.: reference category.
Normal	1.30 (0.77 - 1.84)	23	17,652.86	Ref.
Obesity only	2.15 (0.98 - 3.32)	13	6,039.32	1.89	0.95 - 3.75
Diabetes only	21.23 (4.24 - 38.21)	6	282.67	16.77	6.80 - 41.36^a
Hypertension only	6.82 (0.14 - 13.50)	4	586.69	5.13	1.77 - 14.90^a
Obesity + diabetes	14.17 (0.01 - 30.20)	3	211.72	13.28	3.97 - 44.45^a
Obesity + hypertension	7.35 (0.91 - 13.80)	5	679.84	6.50	2.45 - 17.23^a
Diabetes + hypertension	57.35 (0.01 - 122.25)	3	52.31	32.83	9.79 - 110.10^a
Metabolic triad	34.94 (0.01 - 74.47)	3	85.87	26.38	7.88 - 88.28^a

↓ Table 2. Incidence and Cardiovascular Risk by Metabolic Triad Categories

Metabolic triad

Incidence per 1,000 person-years (95% CI)

Number of cases

Follow-up time (years)

Univariate HRc

95% CI

^aStatistically significant associations. HRc: crude hazard ratio; CI: confidence interval; Ref.: reference category.

Normal

1.30 (0.77 - 1.84)

17,652.86

Ref.

Obesity only

2.15 (0.98 - 3.32)

6,039.32

1.89

0.95 - 3.75

Diabetes only

21.23 (4.24 - 38.21)

282.67

16.77

6.80 - 41.36^a

Hypertension only

6.82 (0.14 - 13.50)

586.69

5.13

1.77 - 14.90^a

Obesity + diabetes

14.17 (0.01 - 30.20)

211.72

13.28

3.97 - 44.45^a

Obesity + hypertension

7.35 (0.91 - 13.80)

679.84

6.50

2.45 - 17.23^a

Diabetes + hypertension

57.35 (0.01 - 122.25)

52.31

32.83

9.79 - 110.10^a

Metabolic triad

34.94 (0.01 - 74.47)

85.87

26.38

7.88 - 88.28^a