Defining the metabolic syndrome: Resolving unresolved issues?
Jobien K Olijhoek1, Yolanda van der Graaf, Steven M Haffner
1Internal Medicine, Section of Vascular Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
European Journal of Internal Medicine
|June 19, 2007
Summary
Incorporating lipid-lowering therapy into the metabolic syndrome definition increases prevalence. The NCEP definition identifies patients with a worse cardiovascular risk profile than the IDF definition in vascular disease patients.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Disorders
Background:
- Metabolic syndrome definitions vary, with ongoing debate on incorporating lipid-lowering therapy.
- Statins, widely used for LDL-cholesterol, also impact triglycerides and HDL-cholesterol.
- Current definitions may not fully capture individuals with metabolic syndrome on lipid-lowering treatment.
Purpose of the Study:
- To evaluate the impact of including lipid-lowering therapy on metabolic syndrome prevalence.
- To compare patient characteristics identified by modified NCEP definitions versus the IDF definition.
Main Methods:
- A cross-sectional study of 2373 patients with established vascular disease.
- Modified NCEP definitions (NCEP-rev1, NCEP-rev2) were used to account for lipid-lowering agents.
- NCEP-rev1: lipid-lowering agents met hypertriglyceridemia criteria.
- NCEP-rev2: triglycerides and HDL-cholesterol recalculated for lipid-lowering agents.
Main Results:
- Metabolic syndrome prevalence: NCEP (41%), NCEP-rev1 (50%), NCEP-rev2 (44%), IDF (52%).
- Patients identified solely by NCEP had lower HDL-cholesterol and higher triglycerides/fasting glucose compared to IDF-identified patients.
- Modified NCEP definitions identified additional at-risk individuals.
Conclusions:
- Adding lipid-lowering drug use to the NCEP definition may identify more patients at elevated risk for cardiovascular disease and diabetes.
- The NCEP definition, particularly when modified, identifies patients with a worse cardiovascular risk profile than the IDF definition in this vascular disease cohort.
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