Prevalence of vascular disease in metabolic syndrome using three proposed definitions

被引:69
作者
Athyros, Vasilios G.
Ganotakis, Emmanuel S.
Elisaf, Moses S. [1 ]
Liberopoulos, Evangelos N.
Goudevenos, Ioannis A.
Karagiannis, Asterios
机构
[1] Univ Ioannina, Sch Med, Dept Internal Med, Ioannina, Greece
[2] Univ Ioannina, Sch Med, Dept Cardiol, Ioannina, Greece
[3] Univ Crete, Sch Med, Dept Internal Med, Iraklion, Greece
[4] Hellen Soc Cardiol, Working Grp Epidemiol & Prevent, Athens, Greece
[5] Hellen Atherosclerosis Soc, Working Grp Identificat & Treatment Metab Syndrom, Athens, Greece
[6] Aristotle Univ Thessaloniki, Hippocrat Hosp, Dept Internal Med, Atherosclerisis & Metab Syndrome Units, Thessaloniki, Greece
关键词
American Heart association/National Heart Lung and Blood Institute; cardiovascular disease; International Diabetes Federation; metabolic syndrome; National Cholesterol Educational Program;
D O I
10.1016/j.ijcard.2006.04.078
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: There are a number of definitions available for the diagnosis of the metabolic syndrome (MetS). The MetS-associated increase in cardiovascular disease (CVD) risk may depend on the definition used. Aim: To investigate which of the 3 recently proposed definitions of MetS [the National Cholesterol Education Program-Adult Treatment Panel-III (NCEP-ATP-III), the International Diabetes Federation (IDF) and the American Heart Association/National Heart Lung and Blood Institute (AHA/NHLBI)] is related to excessive CVD risk and thus may be more appropriate to implement in clinical practice. Methods: A cross-sectional analysis of a representative sample of Greek adults (n=9669). Results: The age-adjusted CVD prevalence was 11.4% in the whole study population, 23.3% in the NCEP-ATP-III (+) subjects, 22.6% in AHA/NHLBI (+) subjects and 18.3% in IDF (+) subjects [p<0.001 for the comparison between the whole study population and all MetS groups and p<0.0001 for the comparison between IDF (+) and either NCEP-ATP-III (+) or AHA/NHLBI (+) MetS]. However, the CVD prevalence was only 11.2% in the IDF (+) but NCEP-ATP-III (-)/AHA/NHLBI (-) MetS subjects [p<0.0001 vs. either NCEP-ATP-III (+) or AHA/NHLBI (+)], which was not different compared with the whole study population. Furthermore, subjects with NCEP ATP III (+) or AHA/NHLBI (+) MetS but not diabetes (DM) had a persistently higher prevalence of CVD compared with the whole study population. However, there was no significant difference regarding CVD prevalence between the whole study population and IDF (+)/DM (-) MetS subjects. Conclusions: CVD prevalence was increased in the presence of MetS irrespective of the definition used. However, this increase was more pronounced when the NCEP-ATP-III and AHA/NHLBI criteria were implemented compared with the IDF definition. Furthermore, the IDF definition included a large proportion of subjects who did not have increased CVD prevalence compared with the whole study population. These findings may have implications regarding which definition should we use to diagnose the MetS. (c) 2006 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:204 / 210
页数:7
相关论文
共 27 条
[11]  
Balkau B, 1999, DIABETIC MED, V16, P442
[12]   Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) [J].
Cleeman, JI ;
Grundy, SM ;
Becker, D ;
Clark, LT ;
Cooper, RS ;
Denke, MA ;
Howard, WJ ;
Hunninghake, DB ;
Illingworth, DR ;
Luepker, RV ;
McBride, P ;
McKenney, JM ;
Pasternak, RC ;
Stone, NJ ;
Van Horn, L ;
Brewer, HB ;
Ernst, ND ;
Gordon, D ;
Levy, D ;
Rifkind, B ;
Rossouw, JE ;
Savage, P ;
Haffner, SM ;
Orloff, DG ;
Proschan, MA ;
Schwartz, JS ;
Sempos, CT ;
Shero, ST ;
Murray, EZ .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (19) :2486-2497
[13]   European guidelines on cardiovascular disease prevention in clinical practice -: Third Joint Task Force of European and other Societies on Cardiovascular Disease Prevention in Clinical Practice [J].
De Backer, G ;
Ambrosioni, E ;
Borch-Johnsen, K ;
Brotons, C ;
Cifkova, R ;
Dallongeville, J ;
Ebrahim, S ;
Faergeman, O ;
Graham, I ;
Mancia, G ;
Cats, VM ;
Orth-Gomér, K ;
Perk, J ;
Pyörälä, K ;
Rodicio, JL ;
Sans, S ;
Sansoy, V ;
Sechtem, U ;
Silber, S ;
Thomsen, T ;
Wood, D .
EUROPEAN HEART JOURNAL, 2003, 24 (17) :1601-1610
[14]   Metabolic syndrome and 10-year cardiovascular disease risk in the hoorn study [J].
Dekker, JM ;
Girman, C ;
Rhodes, T ;
Nijpels, G ;
Stehouwer, CDA ;
Bouter, LM ;
Heine, RJ .
CIRCULATION, 2005, 112 (05) :666-673
[15]   Effect of orlistat, micronised fenofibrate and their combination on metabolic parameters in overweight and obese patients with the metabolic syndrome: the FenOrli study [J].
Filippatos, TD ;
Kiortsis, DN ;
Liberopoulos, EN ;
Georgoula, M ;
Mikhailidis, DP ;
Elisaf, MS .
CURRENT MEDICAL RESEARCH AND OPINION, 2005, 21 (12) :1997-2006
[16]   The metabolic syndrome and mortality from cardiovascular disease and all-causes: findings from the National Health and Nutrition Examination Survey II Mortality Study [J].
Ford, ES .
ATHEROSCLEROSIS, 2004, 173 (02) :309-314
[17]   A comparison of the prevalence of the metabolic syndrome using two proposed definitions [J].
Ford, ES ;
Giles, WH .
DIABETES CARE, 2003, 26 (03) :575-581
[18]   Diagnosis and management of the metabolic syndrome - An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement [J].
Grundy, SM ;
Cleeman, JI ;
Daniels, SR ;
Donato, KA ;
Eckel, RH ;
Franklin, BA ;
Gordon, DJ ;
Krauss, RM ;
Savage, PJ ;
Smith, SC ;
Spertus, JA ;
Costa, F .
CIRCULATION, 2005, 112 (17) :2735-2752
[19]   Cardiovascular morbidity and mortality associated with the metabolic syndrome [J].
Isomaa, B ;
Almgren, P ;
Tuomi, T ;
Forsén, B ;
Lahti, K ;
Nissén, M ;
Taskinen, MR ;
Groop, L .
DIABETES CARE, 2001, 24 (04) :683-689
[20]   The metabolic syndrome: Time for a critical appraisal - Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes [J].
Kahn, R ;
Buse, J ;
Ferrannini, E ;
Stern, M .
DIABETES CARE, 2005, 28 (09) :2289-2304