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Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Remission of screen-detected metabolic syndrome and its determinants: an observational study

Authors: Corine den Engelsen, Kees J Gorter, Philippe L Salomé, Maureen van den Donk, Guy E Rutten

Published in: BMC Public Health | Issue 1/2012

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Abstract

Background

Early detection and treatment of the metabolic syndrome may prevent diabetes and cardiovascular disease. Our aim was to assess remission of the metabolic syndrome and its determinants after a population based screening without predefined intervention in the Netherlands.

Methods

In 2006 we detected 406 metabolic syndrome cases (The National Cholesterol Education Program’s Adult Treatment Panel III (NCEP ATP III) definition) among apparently healthy individuals with an increased waist circumference. They received usual care in a primary care setting. After three years metabolic syndrome status was re-measured. We evaluated which baseline determinants were independently associated with remission.

Results

The remission rate among the 194 participants was 53%. Baseline determinants independently associated with a remission were the presence of more than three metabolic syndrome components (OR 0.46) and higher levels of waist circumference (OR 0.91), blood pressure (OR 0.98) and fasting glucose (OR 0.60).

Conclusions

In a population with screen-detected metabolic syndrome receiving usual care, more than half of the participants achieved a remission after three years. This positive result after a relatively simple strategy provides a solid basis for a nation-wide implementation. Not so much socio-demographic variables but a higher number and level of the metabolic syndrome components were predictors of a lower chance of remission. In such cases, primary care physicians should be extra alert.
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Literature
1.
go back to reference Ford ES, Schulze MB, Pischon T, Bergmann MM, Joost HG, Boeing H: Metabolic syndrome and risk of incident diabetes: findings from the European Prospective Investigation into Cancer and Nutrition-Potsdam Study. Cardiovasc Diabetol. 2008, 7: 35-10.1186/1475-2840-7-35.CrossRefPubMedPubMedCentral Ford ES, Schulze MB, Pischon T, Bergmann MM, Joost HG, Boeing H: Metabolic syndrome and risk of incident diabetes: findings from the European Prospective Investigation into Cancer and Nutrition-Potsdam Study. Cardiovasc Diabetol. 2008, 7: 35-10.1186/1475-2840-7-35.CrossRefPubMedPubMedCentral
2.
go back to reference Galassi A, Reynolds K, He J: Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med. 2006, 119: 812-819. 10.1016/j.amjmed.2006.02.031.CrossRefPubMed Galassi A, Reynolds K, He J: Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med. 2006, 119: 812-819. 10.1016/j.amjmed.2006.02.031.CrossRefPubMed
3.
go back to reference Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, Montori VM: Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007, 49: 403-414. 10.1016/j.jacc.2006.09.032.CrossRefPubMed Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, Montori VM: Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007, 49: 403-414. 10.1016/j.jacc.2006.09.032.CrossRefPubMed
4.
go back to reference Lorenzo C, Okoloise M, Williams K, Stern MP, Haffner SM: The metabolic syndrome as predictor of type 2 diabetes: the San Antonio heart study. Diabetes Care. 2003, 26: 3153-3159. 10.2337/diacare.26.11.3153.CrossRefPubMed Lorenzo C, Okoloise M, Williams K, Stern MP, Haffner SM: The metabolic syndrome as predictor of type 2 diabetes: the San Antonio heart study. Diabetes Care. 2003, 26: 3153-3159. 10.2337/diacare.26.11.3153.CrossRefPubMed
5.
go back to reference Hansson L, Lindholm LH, Niskanen L, Lanke J, Hedner T, Niklason A, Luomanmaki K, Dahlof B, Morlin C, Karlberg BE, Wester PO, Bjorck JE, De FU: JE: Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomised trial. Lancet. 1999, 353: 611-616. 10.1016/S0140-6736(98)05012-0.CrossRefPubMed Hansson L, Lindholm LH, Niskanen L, Lanke J, Hedner T, Niklason A, Luomanmaki K, Dahlof B, Morlin C, Karlberg BE, Wester PO, Bjorck JE, De FU: JE: Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomised trial. Lancet. 1999, 353: 611-616. 10.1016/S0140-6736(98)05012-0.CrossRefPubMed
6.
go back to reference Hansson L, Hedner T, Lund-Johansen P, Kjeldsen SE, Lindholm LH, Syvertsen JO, Lanke J, De FU, Dahlof B, Karlberg BE: Randomised trial of effects of calcium antagonists compared with diuretics and beta-blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study. Lancet. 2000, 356: 359-365. 10.1016/S0140-6736(00)02526-5.CrossRefPubMed Hansson L, Hedner T, Lund-Johansen P, Kjeldsen SE, Lindholm LH, Syvertsen JO, Lanke J, De FU, Dahlof B, Karlberg BE: Randomised trial of effects of calcium antagonists compared with diuretics and beta-blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study. Lancet. 2000, 356: 359-365. 10.1016/S0140-6736(00)02526-5.CrossRefPubMed
7.
go back to reference UK Prospective Diabetes Study (UKPDS) Group: Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998, 352: 854-865.CrossRef UK Prospective Diabetes Study (UKPDS) Group: Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998, 352: 854-865.CrossRef
8.
go back to reference Wong ND, Pio JR, Franklin SS, L'Italien GJ, Kamath TV, Williams GR: Preventing coronary events by optimal control of blood pressure and lipids in patients with the metabolic syndrome. Am J Cardiol. 2003, 91: 1421-1426. 10.1016/S0002-9149(03)00392-8.CrossRefPubMed Wong ND, Pio JR, Franklin SS, L'Italien GJ, Kamath TV, Williams GR: Preventing coronary events by optimal control of blood pressure and lipids in patients with the metabolic syndrome. Am J Cardiol. 2003, 91: 1421-1426. 10.1016/S0002-9149(03)00392-8.CrossRefPubMed
9.
go back to reference Bagshaw SM, Bellomo R: The need to reform our assessment of evidence from clinical trials: a commentary. Philos Ethics Humanit Med. 2008, 3: 23-10.1186/1747-5341-3-23.CrossRefPubMedPubMedCentral Bagshaw SM, Bellomo R: The need to reform our assessment of evidence from clinical trials: a commentary. Philos Ethics Humanit Med. 2008, 3: 23-10.1186/1747-5341-3-23.CrossRefPubMedPubMedCentral
10.
go back to reference Van den Donk M, Bobbink IWG, Gorter KJ, Salomé PL, Rutten GEHM: Identifying people with metabolic syndrome in primary care by screening with a mailed tape measure. A survey in 14,000 people in the Netherlands. Prev Med. 2009, 48: 345-350. 10.1016/j.ypmed.2009.02.004.CrossRefPubMed Van den Donk M, Bobbink IWG, Gorter KJ, Salomé PL, Rutten GEHM: Identifying people with metabolic syndrome in primary care by screening with a mailed tape measure. A survey in 14,000 people in the Netherlands. Prev Med. 2009, 48: 345-350. 10.1016/j.ypmed.2009.02.004.CrossRefPubMed
11.
go back to reference Stalman WA, Scheltens T, Burgers JS, Hukkelhoven CW, Smorenburg SM, Banga JD, Dippel DW: NHG-Standaard Cardiovasculair risicomanagement. 2006, Houten: Bohn Stafleu van Loghum Stalman WA, Scheltens T, Burgers JS, Hukkelhoven CW, Smorenburg SM, Banga JD, Dippel DW: NHG-Standaard Cardiovasculair risicomanagement. 2006, Houten: Bohn Stafleu van Loghum
12.
go back to reference Rutten GEHM, De Grauw WJC, Nijpels G, Goudswaard AN, Uitewaal PJM, Van der Does FEE, Heine RJ, Van Ballegooie E, Verduijn MM, Bouma M: NHG-Standaard Diabetes mellitus type 2 (Tweede herziening). Huisarts en Wetenschap. 2006, 49: 137-52. Rutten GEHM, De Grauw WJC, Nijpels G, Goudswaard AN, Uitewaal PJM, Van der Does FEE, Heine RJ, Van Ballegooie E, Verduijn MM, Bouma M: NHG-Standaard Diabetes mellitus type 2 (Tweede herziening). Huisarts en Wetenschap. 2006, 49: 137-52.
13.
go back to reference Wendel-Vos GC, Schuit AJ, Saris WH, Kromhout D: Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity. J Clin Epidemiol. 2003, 56: 1163-1169. 10.1016/S0895-4356(03)00220-8.CrossRefPubMed Wendel-Vos GC, Schuit AJ, Saris WH, Kromhout D: Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity. J Clin Epidemiol. 2003, 56: 1163-1169. 10.1016/S0895-4356(03)00220-8.CrossRefPubMed
14.
go back to reference Kemper HGC, Ooijendijk WTM, Stiggelbout M: Consensus over de Nederlandse Norm voor Gezond Bewegen. Tijdschrift voor Sociale Gezondheidszorg. 2000, 78: 180-183. Kemper HGC, Ooijendijk WTM, Stiggelbout M: Consensus over de Nederlandse Norm voor Gezond Bewegen. Tijdschrift voor Sociale Gezondheidszorg. 2000, 78: 180-183.
15.
go back to reference Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC: Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009, 120: 1640-1645. 10.1161/CIRCULATIONAHA.109.192644.CrossRefPubMed Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC: Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009, 120: 1640-1645. 10.1161/CIRCULATIONAHA.109.192644.CrossRefPubMed
16.
go back to reference Lerman RH, Minich DM, Darland G, Lamb JJ, Schiltz B, Babish JG, Bland JS, Tripp ML: Enhancement of a modified Mediterranean-style, low glycemic load diet with specific phytochemicals improves cardiometabolic risk factors in subjects with metabolic syndrome and hypercholesterolemia in a randomized trial. Nutr Metab (Lond). 2008, 5: 29-10.1186/1743-7075-5-29.CrossRef Lerman RH, Minich DM, Darland G, Lamb JJ, Schiltz B, Babish JG, Bland JS, Tripp ML: Enhancement of a modified Mediterranean-style, low glycemic load diet with specific phytochemicals improves cardiometabolic risk factors in subjects with metabolic syndrome and hypercholesterolemia in a randomized trial. Nutr Metab (Lond). 2008, 5: 29-10.1186/1743-7075-5-29.CrossRef
17.
go back to reference Lundgren JD, Malcolm R, Binks M, O'Neil PM: Remission of metabolic syndrome following a 15-week low-calorie lifestyle change program for weight loss. Int J Obes (Lond). 2009, 33: 144-150. 10.1038/ijo.2008.225.CrossRef Lundgren JD, Malcolm R, Binks M, O'Neil PM: Remission of metabolic syndrome following a 15-week low-calorie lifestyle change program for weight loss. Int J Obes (Lond). 2009, 33: 144-150. 10.1038/ijo.2008.225.CrossRef
18.
go back to reference Salas-Salvado J, Fernandez-Ballart J, Ros E, Martinez-Gonzalez MA, Fito M, Estruch R, Corella D, Fiol M, Gomez-Gracia E, Aros F, Flores G, Lapetra J, Lamuela-Raventos R, Ruiz-Gutierrez V, Bullo M, Basora J, Covas MI: Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status: one-year results of the PREDIMED randomized trial. Arch Intern Med. 2008, 168: 2449-2458. 10.1001/archinte.168.22.2449.CrossRefPubMed Salas-Salvado J, Fernandez-Ballart J, Ros E, Martinez-Gonzalez MA, Fito M, Estruch R, Corella D, Fiol M, Gomez-Gracia E, Aros F, Flores G, Lapetra J, Lamuela-Raventos R, Ruiz-Gutierrez V, Bullo M, Basora J, Covas MI: Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status: one-year results of the PREDIMED randomized trial. Arch Intern Med. 2008, 168: 2449-2458. 10.1001/archinte.168.22.2449.CrossRefPubMed
19.
go back to reference Hightower KR, Olson RE, Gellish RL, Russi GD, Goslin BR, Moudgil VK: Reversal of metabolic syndrome characteristics. Metab Syndr Relat Disord. 2007, 5: 69-76. 10.1089/met.2006.0025.CrossRefPubMed Hightower KR, Olson RE, Gellish RL, Russi GD, Goslin BR, Moudgil VK: Reversal of metabolic syndrome characteristics. Metab Syndr Relat Disord. 2007, 5: 69-76. 10.1089/met.2006.0025.CrossRefPubMed
20.
go back to reference Maxwell MS, Goslin BR, Gellish RL, Hightower KR, Olson RE, Moudgil VK, Russi GD: Metabolic syndrome status changes with fitness level change: a retrospective analysis. Metab Syndr Relat Disord. 2008, 6: 8-14. 10.1089/met.2007.0013.CrossRefPubMed Maxwell MS, Goslin BR, Gellish RL, Hightower KR, Olson RE, Moudgil VK, Russi GD: Metabolic syndrome status changes with fitness level change: a retrospective analysis. Metab Syndr Relat Disord. 2008, 6: 8-14. 10.1089/met.2007.0013.CrossRefPubMed
21.
go back to reference Anderssen SA, Carroll S, Urdal P, Holme I: Combined diet and exercise intervention reverses the metabolic syndrome in middle-aged males: results from the Oslo Diet and Exercise Study. Scand J Med Sci Sports. 2007, 17: 687-695. 10.1111/j.1600-0838.2006.00631.x.CrossRefPubMed Anderssen SA, Carroll S, Urdal P, Holme I: Combined diet and exercise intervention reverses the metabolic syndrome in middle-aged males: results from the Oslo Diet and Exercise Study. Scand J Med Sci Sports. 2007, 17: 687-695. 10.1111/j.1600-0838.2006.00631.x.CrossRefPubMed
22.
go back to reference Lee WJ, Huang MT, Wang W, Lin CM, Chen TC, Lai IR: Effects of obesity surgery on the metabolic syndrome. Arch Surg. 2004, 139: 1088-1092. 10.1001/archsurg.139.10.1088.CrossRefPubMed Lee WJ, Huang MT, Wang W, Lin CM, Chen TC, Lai IR: Effects of obesity surgery on the metabolic syndrome. Arch Surg. 2004, 139: 1088-1092. 10.1001/archsurg.139.10.1088.CrossRefPubMed
23.
go back to reference Nugent C, Bai C, Elariny H, Gopalakrishnan P, Quigley C, Garone M, Afendy M, Chan O, Wheeler A, Afendy A, Younossi ZM: Metabolic syndrome after laparoscopic bariatric surgery. Obes Surg. 2008, 18: 1278-1286. 10.1007/s11695-008-9511-1.CrossRefPubMed Nugent C, Bai C, Elariny H, Gopalakrishnan P, Quigley C, Garone M, Afendy M, Chan O, Wheeler A, Afendy A, Younossi ZM: Metabolic syndrome after laparoscopic bariatric surgery. Obes Surg. 2008, 18: 1278-1286. 10.1007/s11695-008-9511-1.CrossRefPubMed
24.
go back to reference Rossi M, da SR BF, Chaves AG, Regina PF, Martin Bianco RF, Serpa NA, Zimberg CE: Remission of metabolic syndrome: a study of 140 patients six months after Roux-en-Y gastric bypass. Obes Surg. 2008, 18: 601-606. 10.1007/s11695-008-9468-0.CrossRefPubMed Rossi M, da SR BF, Chaves AG, Regina PF, Martin Bianco RF, Serpa NA, Zimberg CE: Remission of metabolic syndrome: a study of 140 patients six months after Roux-en-Y gastric bypass. Obes Surg. 2008, 18: 601-606. 10.1007/s11695-008-9468-0.CrossRefPubMed
25.
go back to reference Filippatos TD, Kiortsis DN, Liberopoulos EN, Georgoula M, Mikhailidis DP, Elisaf MS: Effect of orlistat, micronised fenofibrate and their combination on metabolic parameters in overweight and obese patients with the metabolic syndrome: the FenOrli study. Curr Med Res Opin. 2005, 21: 1997-2006. 10.1185/030079905X75078.CrossRefPubMed Filippatos TD, Kiortsis DN, Liberopoulos EN, Georgoula M, Mikhailidis DP, Elisaf MS: Effect of orlistat, micronised fenofibrate and their combination on metabolic parameters in overweight and obese patients with the metabolic syndrome: the FenOrli study. Curr Med Res Opin. 2005, 21: 1997-2006. 10.1185/030079905X75078.CrossRefPubMed
26.
go back to reference Orchard TJ, Temprosa M, Goldberg R, Haffner S, Ratner R, Marcovina S, Fowler S: The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med. 2005, 142: 611-619.CrossRefPubMedPubMedCentral Orchard TJ, Temprosa M, Goldberg R, Haffner S, Ratner R, Marcovina S, Fowler S: The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med. 2005, 142: 611-619.CrossRefPubMedPubMedCentral
27.
go back to reference Bo S, Ciccone G, Baldi C, Benini L, Dusio F, Forastiere G, Lucia C, Nuti C, Durazzo M, Cassader M, Gentile L, Pagano G: Effectiveness of a lifestyle intervention on metabolic syndrome. A randomized controlled trial. J Gen Intern Med. 2007, 22: 1695-1703.CrossRefPubMed Bo S, Ciccone G, Baldi C, Benini L, Dusio F, Forastiere G, Lucia C, Nuti C, Durazzo M, Cassader M, Gentile L, Pagano G: Effectiveness of a lifestyle intervention on metabolic syndrome. A randomized controlled trial. J Gen Intern Med. 2007, 22: 1695-1703.CrossRefPubMed
28.
go back to reference Bihan H, Takbou K, Cohen R, Michault A, Boitou F, Reach G, Le CH: Impact of short-duration lifestyle intervention in collaboration with general practitioners in patients with the metabolic syndrome. Diabetes Metab. 2009, 35: 185-191. 10.1016/j.diabet.2008.11.002.CrossRefPubMed Bihan H, Takbou K, Cohen R, Michault A, Boitou F, Reach G, Le CH: Impact of short-duration lifestyle intervention in collaboration with general practitioners in patients with the metabolic syndrome. Diabetes Metab. 2009, 35: 185-191. 10.1016/j.diabet.2008.11.002.CrossRefPubMed
29.
go back to reference Onat A, Hergenc G: Low-grade inflammation, and dysfunction of high-density lipoprotein and its apolipoproteins as a major driver of cardiometabolic risk. Metabolism. 2011, 60: 499-512. 10.1016/j.metabol.2010.04.018.CrossRefPubMed Onat A, Hergenc G: Low-grade inflammation, and dysfunction of high-density lipoprotein and its apolipoproteins as a major driver of cardiometabolic risk. Metabolism. 2011, 60: 499-512. 10.1016/j.metabol.2010.04.018.CrossRefPubMed
30.
go back to reference Onat A: Metabolic syndrome: nature, therapeutic solutions and options. Expert Opin Pharmacother. 2011, 12: 1887-1900. 10.1517/14656566.2011.585462.CrossRefPubMed Onat A: Metabolic syndrome: nature, therapeutic solutions and options. Expert Opin Pharmacother. 2011, 12: 1887-1900. 10.1517/14656566.2011.585462.CrossRefPubMed
31.
go back to reference Burke TA, Sturkenboom MC, Lu SE, Wentworth CE, Lin Y, Rhoads GG: Discontinuation of antihypertensive drugs among newly diagnosed hypertensive patients in UK general practice. J Hypertens. 2006, 24: 1193-1200. 10.1097/01.hjh.0000226211.95936.f5.CrossRefPubMed Burke TA, Sturkenboom MC, Lu SE, Wentworth CE, Lin Y, Rhoads GG: Discontinuation of antihypertensive drugs among newly diagnosed hypertensive patients in UK general practice. J Hypertens. 2006, 24: 1193-1200. 10.1097/01.hjh.0000226211.95936.f5.CrossRefPubMed
32.
go back to reference Tsuyuki RT, Bungard TJ: Poor adherence with hypolipidemic drugs: a lost opportunity. Pharmacotherapy. 2001, 21: 576-582. 10.1592/phco.21.6.576.34541.CrossRefPubMed Tsuyuki RT, Bungard TJ: Poor adherence with hypolipidemic drugs: a lost opportunity. Pharmacotherapy. 2001, 21: 576-582. 10.1592/phco.21.6.576.34541.CrossRefPubMed
33.
go back to reference Van Wijk BL, Klungel OH, Heerdink ER, De BA: Rate and determinants of 10-year persistence with antihypertensive drugs. J Hypertens. 2005, 23: 2101-2107. 10.1097/01.hjh.0000187261.40190.2e.CrossRefPubMed Van Wijk BL, Klungel OH, Heerdink ER, De BA: Rate and determinants of 10-year persistence with antihypertensive drugs. J Hypertens. 2005, 23: 2101-2107. 10.1097/01.hjh.0000187261.40190.2e.CrossRefPubMed
Metadata
Title
Remission of screen-detected metabolic syndrome and its determinants: an observational study
Authors
Corine den Engelsen
Kees J Gorter
Philippe L Salomé
Maureen van den Donk
Guy E Rutten
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-778

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