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Diversity of metabolic syndrome criteria in association with cardiovascular diseases--a family medicine-based investigation.

Ivezić-Lalić D, Bergman Marković B, Kranjčević K, Kern J, Vrdoljak D, Vučak J - Med. Sci. Monit. (2013)

Bottom Line: A prospective multicenter study was conducted on 3245 participants≥40 years, who visited general practices from May to July 2008 for any reason.According to the NCEP ATP III (IDF), the prevalence was 38.7% (45.9%) [15.9% (18.6%) in men, and 22.7% (27.3%) in women, and 28.4% (33.9%) in the continental region, 10.2% (10.9%) in the coastal region, 26.2% (31.5%) in urban areas, and 12.4% (14.4%) in rural areas.The NCEP ATP III definition seems to provide the strongest association with CVD and should therefore be preferred for use in this population.

View Article: PubMed Central - PubMed

Affiliation: GP's Office, Novska, Croatia. divezic.lalic@gmail.com

ABSTRACT

Background: This study compared the association between the 3 definitions of metabolic syndrome (MetS) suggested by the World Health Organization (WHO), National Cholesterol Education Programme (NCEP ATP III), and International Diabetes Federation (IDF), and the risk of cardiovascular diseases (CVD) and shows the prevalence and characteristics of persons with MetS in continental vs. coastal regions and rural vs. urban residence in Croatia.

Material/methods: A prospective multicenter study was conducted on 3245 participants≥40 years, who visited general practices from May to July 2008 for any reason. This was a cross-sectional study of the Cardiovascular Risk and Intervention Study in Croatia-family medicine project (ISRCTN31857696).

Results: All analyzed MetS definitions showed an association with CVD, but the strongest was shown by NCEP ATP III; coronary disease OR 2.48 (95% CI 1.80-3.82), cerebrovascular disease OR 2.14 (1.19-3.86), and peripheral artery disease OR 1.55 (1.04-2.32), especially for age and male sex. According to the NCEP ATP III (IDF), the prevalence was 38.7% (45.9%) [15.9% (18.6%) in men, and 22.7% (27.3%) in women, and 28.4% (33.9%) in the continental region, 10.2% (10.9%) in the coastal region, 26.2% (31.5%) in urban areas, and 12.4% (14.4%) in rural areas. Older age, male sex, and residence in the continental area were positively associated with MetS diagnosis according to NCEP ATP III, and current smoking and Mediterranean diet adherence have protective effects.

Conclusions: The NCEP ATP III definition seems to provide the strongest association with CVD and should therefore be preferred for use in this population.

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Related in: MedlinePlus

Venn diagran- patients with MetS according to NCEP, IDF and WHO.
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f2-medscimonit-19-571: Venn diagran- patients with MetS according to NCEP, IDF and WHO.

Mentions: Fifty-nine family medicine doctors joined the study (response rate, 71%) with 2467 participants (38.1% men and 61.9% women) (response rate, 78%). In Figure 2 prevalence of MetS, according to the NCEP, IDF definitions was 38.7% (15.9% men and 22.7% women), 45.9% (18.6% men and 27.3% women); in the continental region 28.4%, 33.9%; in the coastal region 10.2%, 10.9%; in urban residents 26.2%, 31.5%; and in rural residents 12.4%, 14.4%. According to the NCEP criteria, there were significantly more obese people in rural areas (P=0.002) with elevated LDL cholesterol (P<0.001) and systolic pressure (P=0.029) compared to people in urban areas. Participants were older in the urban areas (P=0.022) of the continental region, and they were older (P=0.048) and had a higher waist circumference (P=0.035) in rural residents of the coastal region. Persons with MetS engaged in moderate physical activity more in continental rural than in urban s. The prevalence of prehypertension was significantly higher in urban residents of both coastal and continental regions. MetS was most prevalent in persons aged 50 to 59, except in coastal urban residents, in whom MetS was prevalent in older age (Tables 2 and 3). Association between MetS according to NCEP and socio-behavioural settings was significant (χ2=103.4; df=8; P<0.001) and correctly classified with 60% of subjects. Older age, male sex, and residence in the continental area were positively associated with MetS diagnosis according to NCEP, and current smoking and Mediterranean diet adherence were protective factors (Table 4). The association between MetS and cardiovascular disease was determined according to all 3 definitions, but the NCEP definition was the most sensitive (Table 5). Persons with MetS were, according to NCEP, at a 2.48 times higher risk of coronary disease. The association between MetS and cerebrovascular disease, according to the modified WHO definition, has not been supported by evidence, and according to NCEP and IDF definitions, it was equally significant. The association between MetS and peripheral vascular disease was strongest when expressed according to the modified WHO definition, a weaker association according to the NCEP definition, but the association was negligible according to the IDF definition. Age and sex also show a statistically significant correlation with CVD (Table 6).


Diversity of metabolic syndrome criteria in association with cardiovascular diseases--a family medicine-based investigation.

Ivezić-Lalić D, Bergman Marković B, Kranjčević K, Kern J, Vrdoljak D, Vučak J - Med. Sci. Monit. (2013)

Venn diagran- patients with MetS according to NCEP, IDF and WHO.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3713877&req=5

f2-medscimonit-19-571: Venn diagran- patients with MetS according to NCEP, IDF and WHO.
Mentions: Fifty-nine family medicine doctors joined the study (response rate, 71%) with 2467 participants (38.1% men and 61.9% women) (response rate, 78%). In Figure 2 prevalence of MetS, according to the NCEP, IDF definitions was 38.7% (15.9% men and 22.7% women), 45.9% (18.6% men and 27.3% women); in the continental region 28.4%, 33.9%; in the coastal region 10.2%, 10.9%; in urban residents 26.2%, 31.5%; and in rural residents 12.4%, 14.4%. According to the NCEP criteria, there were significantly more obese people in rural areas (P=0.002) with elevated LDL cholesterol (P<0.001) and systolic pressure (P=0.029) compared to people in urban areas. Participants were older in the urban areas (P=0.022) of the continental region, and they were older (P=0.048) and had a higher waist circumference (P=0.035) in rural residents of the coastal region. Persons with MetS engaged in moderate physical activity more in continental rural than in urban s. The prevalence of prehypertension was significantly higher in urban residents of both coastal and continental regions. MetS was most prevalent in persons aged 50 to 59, except in coastal urban residents, in whom MetS was prevalent in older age (Tables 2 and 3). Association between MetS according to NCEP and socio-behavioural settings was significant (χ2=103.4; df=8; P<0.001) and correctly classified with 60% of subjects. Older age, male sex, and residence in the continental area were positively associated with MetS diagnosis according to NCEP, and current smoking and Mediterranean diet adherence were protective factors (Table 4). The association between MetS and cardiovascular disease was determined according to all 3 definitions, but the NCEP definition was the most sensitive (Table 5). Persons with MetS were, according to NCEP, at a 2.48 times higher risk of coronary disease. The association between MetS and cerebrovascular disease, according to the modified WHO definition, has not been supported by evidence, and according to NCEP and IDF definitions, it was equally significant. The association between MetS and peripheral vascular disease was strongest when expressed according to the modified WHO definition, a weaker association according to the NCEP definition, but the association was negligible according to the IDF definition. Age and sex also show a statistically significant correlation with CVD (Table 6).

Bottom Line: A prospective multicenter study was conducted on 3245 participants≥40 years, who visited general practices from May to July 2008 for any reason.According to the NCEP ATP III (IDF), the prevalence was 38.7% (45.9%) [15.9% (18.6%) in men, and 22.7% (27.3%) in women, and 28.4% (33.9%) in the continental region, 10.2% (10.9%) in the coastal region, 26.2% (31.5%) in urban areas, and 12.4% (14.4%) in rural areas.The NCEP ATP III definition seems to provide the strongest association with CVD and should therefore be preferred for use in this population.

View Article: PubMed Central - PubMed

Affiliation: GP's Office, Novska, Croatia. divezic.lalic@gmail.com

ABSTRACT

Background: This study compared the association between the 3 definitions of metabolic syndrome (MetS) suggested by the World Health Organization (WHO), National Cholesterol Education Programme (NCEP ATP III), and International Diabetes Federation (IDF), and the risk of cardiovascular diseases (CVD) and shows the prevalence and characteristics of persons with MetS in continental vs. coastal regions and rural vs. urban residence in Croatia.

Material/methods: A prospective multicenter study was conducted on 3245 participants≥40 years, who visited general practices from May to July 2008 for any reason. This was a cross-sectional study of the Cardiovascular Risk and Intervention Study in Croatia-family medicine project (ISRCTN31857696).

Results: All analyzed MetS definitions showed an association with CVD, but the strongest was shown by NCEP ATP III; coronary disease OR 2.48 (95% CI 1.80-3.82), cerebrovascular disease OR 2.14 (1.19-3.86), and peripheral artery disease OR 1.55 (1.04-2.32), especially for age and male sex. According to the NCEP ATP III (IDF), the prevalence was 38.7% (45.9%) [15.9% (18.6%) in men, and 22.7% (27.3%) in women, and 28.4% (33.9%) in the continental region, 10.2% (10.9%) in the coastal region, 26.2% (31.5%) in urban areas, and 12.4% (14.4%) in rural areas. Older age, male sex, and residence in the continental area were positively associated with MetS diagnosis according to NCEP ATP III, and current smoking and Mediterranean diet adherence have protective effects.

Conclusions: The NCEP ATP III definition seems to provide the strongest association with CVD and should therefore be preferred for use in this population.

Show MeSH
Related in: MedlinePlus