The incidence and persistence of the NCEP (National Cholesterol Education Program) metabolic syndrome.: The French DESIR study

Context: In 2001 the "National Cholesterol and Education Program Expert Panel" gave a clinical definition of the metabolic syndrome. The frequency of this syndrome at baseline and its incidence and persistence at three years is studied in a French population. Subjects: 2109 men and 2184 women from the D.E.S.I.R. longitudinal cohort study (Data from an Epidemiological Study on the Insulin Resistance syndrome) in central-western France, aged 30 to 64 years, were examined at inclusion and three years later. Methods: Evaluation of the frequencies, incidences and persistance of the metabolic syndrome and its abnormalities. This syndrome is defined by the presence of three or more of five abnormalities: waist circumference > 102/88 cm (men/women); triglycerides greater than or equal to 1.69mmol/ 1, HDL-cholesterol < 1.04/1.29mmol/l (men/women); systolic/ diastolic blood pressure greater than or equal to 130 and/or 85mmHg; fasting plasma glucose greater than or equal to6.11 mmol/l. Results: At baseline, 10% of men and 7% of women had the metabolic syndrome. If the syndrome was defined to include a treatment in the abnormalities (for diabetes, hypertension, dyslipidemia), the syndrome frequencies increased to 16% and 11%. However only 12% and 8% respectively, had this syndrome both at inclusion and at three years. High blood pressure was the most frequent abnormality: 70% and 47% in men and women respectively, at inclusion. The most stable abnormality was high waist circumference (80% persisted), hyperglycaemia the least stable (60% persisted). Hyperinsulinaemia did not cluster closely with this syndrome. Conclusions: The age-specific frequency of the syndrome is more than 2.5 times higher in the US than in this French cohort and this ratio increased with age. The higher frequencies of abdominal obesity and low HDL-cholesterol in women than in men suggest that these gender-specific thresholds may need to be refined.