Features of metabolic syndrome in non-diabetic Italians and Brazilians: a discriminant analysis

This aim of this study was to compare the characteristics of metabolic syndrome (MetS) in a Brazilian and an Italian population. The subjects were non-diabetic men and women aged 40-74 years from population-based surveys: 1242 from Brazil and 1198 from Italy. Logistic regression models were used to compare adjusted prevalence rates and make a discrimination analysis to distinguish the subjects with a diagnosis of MetS in the two groups. Dyslipidemia [low high-density lipoprotein (HDL)-cholesterol] and impaired fasting glucose were more prevalent among the Brazilians, and increased blood pressure and abdominal obesity (in men) among the Italians. Generally, the Italians showed higher prevalence of overall obesity and high pulse-pressure, and the Brazilians had higher prevalence of metabolic markers of insulin resistance. Among the subjects with the syndrome, HDL-cholesterol was the most discriminant factor, followed by plasma uric acid levels (which were higher in the Brazilians). The Italian men had a larger waist circumference and the Italian women higher body mass index values than the Brazilians. Italians had higher systolic and lower diastolic pressure values. The patterns of the metabolic alterations seemed to be more linked to insulin resistance among Brazilian subjects, whereas obesity seemed to play a more important role among the Italians. Although they are not sufficient to support the hypothesis of differences in the underlying pathophysiological processes between these groups, our results illustrate the difficulty of using a single unifying definition of MetS, and suggest that different benefits may be obtained from treatments targeting obesity, blood pressure or insulin resistance.