Background:
Metabolic syndrome is associated with a significantly increased risk of
sudden cardiac death (SCD). However, whether temporal changes in the
metabolic syndrome status are associated with SCD is unknown. We aimed to determine whether
metabolic syndrome and gamma-glutamyl
transferase (ɣ-
GTP), including their temporal changes, are associated with the risk of SCD. Methods: We performed a nationwide population-based analysis using the Korean National Health Insurance Service. People who underwent a national health check-up in 2009 and 2011 were enrolled. The influence of
metabolic syndrome and ɣ-
GTP on SCD risk was evaluated. Results: In 2009, 4,056,423 (848,498 with
metabolic syndrome) people underwent health screenings, 2,706,788 of whom underwent follow-up health screenings in 2011.
Metabolic syndrome was associated with a 50.7% increased SCD risk (adjusted hazard ratio (aHR) = 1.507; p < 0.001). The SCD risk increased linearly as the
metabolic syndrome diagnostic criteria increased. The ɣ-
GTP significantly impacted the SCD risk; the highest quartile had a 51.9% increased risk versus the lowest quartile (aHR = 1.519; p < 0.001). A temporal change in the
metabolic syndrome status and ɣ-
GTP between 2009 and 2011 was significantly correlated with the SCD risk. Having
metabolic syndrome in 2009 or 2011 indicated a lower SCD risk than having
metabolic syndrome in 2009 and 2011 but a higher risk than having no
metabolic syndrome. People with a ≥20-unit increase in ɣ-
GTP between 2009 and 2011 had an 81.0% increased SCD risk versus those with a change ≤5 units (aHR = 1.810; p < 0.001). Conclusions:
Metabolic syndrome and ɣ-
GTP significantly correlated with an increased SCD risk. SCD was also influenced by temporal changes in the
metabolic syndrome status and ɣ-
GTP, suggesting that appropriate medical treatment and lifestyle modifications may reduce future SCD risk.