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Published in: BMC Cardiovascular Disorders 1/2012

Open Access 01-12-2012 | Research article

Prevalence of the metabolic syndrome in patients with carotid disease according to NHLBI/AHA and IDF criteria: a cross-sectional study

Authors: Milos Z Maksimovic, Hristina D Vlajinac, Djordje J Radak, Jelena M Marinkovic, Jagoda B Jorga

Published in: BMC Cardiovascular Disorders | Issue 1/2012

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Abstract

Background

Metabolic syndrome (MetS) has been related to type 2 diabetes and cardiovascular diseases. Different criteria for diagnosis of MetS have been recommended, but there is no agreement about which criteria are best to use. The aim of the present study was to investigate agreement between the National Heart, Lung, and Blood Institute, American Heart Association (NHLBI/AHA) and the International Diabetes Federation (IDF) definitions of MetS in patients with symptomatic carotid disease and to compare the frequency of cardiovascular risk factor in patients with MetS diagnosed by these two sets of criteria.

Methods

The study was a cross-sectional one involving 644 consecutive patients with verified carotid disease who referred to the Vascular Surgery Clinic Dedinje in Belgrade during the period April 2006 - November 2007. Anthropometric parameters blood pressure, fasting plasma glucose and lipoproteins were measured using standard procedures.

Results

MetS was present in 67.9% of participants, according to IDF criteria, and in 64.9% of participants, according to the NHLBI/AHA criteria. A total of 119 patients were categorized differently by the two definitions. Out of all participants 10.7% had MetS by IDF criteria only and 7.8% of patients had MetS by NHLBI/AHA criteria only. The overall agreement of IDF and NHLBI/AHA criteria was 81.5% (Kappa 0.59, p < 0.001). In comparison with patients who met only IDF criteria, patients who met only NHLBI/AHA criteria had significantly more frequently cardiovascular risk factors with the exception of obesity which was significantly more frequent in patients with MetS diagnosed by IDF criteria.

Conclusion

The MetS prevalence in patients with symptomatic carotid disease was high regardless of criteria used for its diagnosis. Since some patients with known cardiovascular risk factors were lost by the use of IDF criteria it seems that NHLBI/AHA definition is more suitable for diagnosis of MetS. Large follow-up studies are needed to test prognostic value of these definitions.
Literature
1.
go back to reference Eckel RH, Grundy SM, Zimmet PZ: The metabolic syndrome. Lancet. 2005, 365: 1415-1428. 10.1016/S0140-6736(05)66378-7.CrossRefPubMed Eckel RH, Grundy SM, Zimmet PZ: The metabolic syndrome. Lancet. 2005, 365: 1415-1428. 10.1016/S0140-6736(05)66378-7.CrossRefPubMed
2.
go back to reference Reaven GM: Banting lecture 1988: role of insulin resistance in human disease. Diabetes. 1988, 37: 1595-1607. 10.2337/diabetes.37.12.1595.CrossRefPubMed Reaven GM: Banting lecture 1988: role of insulin resistance in human disease. Diabetes. 1988, 37: 1595-1607. 10.2337/diabetes.37.12.1595.CrossRefPubMed
3.
go back to reference Ferrannini E, Haffner SM, Mitchell BD, Stern MP: Hyperinsulinemia: the key feature of a cardiovascular and metabolic syndrome. Diabetologia. 1991, 34: 416-422. 10.1007/BF00403180.CrossRefPubMed Ferrannini E, Haffner SM, Mitchell BD, Stern MP: Hyperinsulinemia: the key feature of a cardiovascular and metabolic syndrome. Diabetologia. 1991, 34: 416-422. 10.1007/BF00403180.CrossRefPubMed
4.
go back to reference WHO-International Society of Hypertension guidelines for the management of hypertension. J Hypertens. 1999, 17: 151-183. WHO-International Society of Hypertension guidelines for the management of hypertension. J Hypertens. 1999, 17: 151-183.
5.
go back to reference Third report of the National Cholesterol Education Program (NECP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment panel III). Final report. Circulation. 2002, 106: 3143-3421. Third report of the National Cholesterol Education Program (NECP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment panel III). Final report. Circulation. 2002, 106: 3143-3421.
6.
go back to reference Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Spertus JA, Costa F: Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005, 112: 2735-2752. 10.1161/CIRCULATIONAHA.105.169404.CrossRefPubMed Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Spertus JA, Costa F: Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005, 112: 2735-2752. 10.1161/CIRCULATIONAHA.105.169404.CrossRefPubMed
7.
go back to reference Alberti KGMM, Zimmet PZ, Shaw JE, IDF Epidemiology Task Force Consensus Group: The metabolic syndrome: a new world-wide definition from the International Diabetes Federation consensus. Lancet. 2005, 366: 1059-1062. 10.1016/S0140-6736(05)67402-8.CrossRefPubMed Alberti KGMM, Zimmet PZ, Shaw JE, IDF Epidemiology Task Force Consensus Group: The metabolic syndrome: a new world-wide definition from the International Diabetes Federation consensus. Lancet. 2005, 366: 1059-1062. 10.1016/S0140-6736(05)67402-8.CrossRefPubMed
8.
go back to reference Hildrum B, Mykletun A, Hole T, Midthjell K, Dahl AA: Age-specific prevalence of the metabolic syndrome defined by the International Diabetes Federation and the National Cholesterol Education Program: the Norwegian HUNT 2 study. BMC Public Health. 2007, 7: 220-10.1186/1471-2458-7-220.CrossRefPubMedPubMedCentral Hildrum B, Mykletun A, Hole T, Midthjell K, Dahl AA: Age-specific prevalence of the metabolic syndrome defined by the International Diabetes Federation and the National Cholesterol Education Program: the Norwegian HUNT 2 study. BMC Public Health. 2007, 7: 220-10.1186/1471-2458-7-220.CrossRefPubMedPubMedCentral
9.
go back to reference Athyros VG, Ganotakis ES, Bathianaki M, Monedas I, Goudevenos IA, Papageorgiou AA: Awareness, treatment and control of the metabolic syndrome and its components: A Multicentre Greek Study. Hellenic J Cardiol. 2005, 46: 380-386.PubMed Athyros VG, Ganotakis ES, Bathianaki M, Monedas I, Goudevenos IA, Papageorgiou AA: Awareness, treatment and control of the metabolic syndrome and its components: A Multicentre Greek Study. Hellenic J Cardiol. 2005, 46: 380-386.PubMed
10.
go back to reference Li WJ, Xue H, Sun K, Song XD, Wang YB, Zhen YS, Han YF, Hui RT: Cardiovascular risk and prevalence of metabolic syndrome by differing criteria. Chin Med J (Engl). 2008, 121: 1532-1536. Li WJ, Xue H, Sun K, Song XD, Wang YB, Zhen YS, Han YF, Hui RT: Cardiovascular risk and prevalence of metabolic syndrome by differing criteria. Chin Med J (Engl). 2008, 121: 1532-1536.
11.
go back to reference Moy FM, Bulgiba A: The modified NCEP ATP III criteria maybe better than the IDF criteria in diagnosing Metabolic Syndrome among Malays in Kuala Lumpur. BMC Public Health. 2010, 10: 678-10.1186/1471-2458-10-678.CrossRefPubMedPubMedCentral Moy FM, Bulgiba A: The modified NCEP ATP III criteria maybe better than the IDF criteria in diagnosing Metabolic Syndrome among Malays in Kuala Lumpur. BMC Public Health. 2010, 10: 678-10.1186/1471-2458-10-678.CrossRefPubMedPubMedCentral
12.
go back to reference Barnett HJM, Taylor DW, Eliasziw M, Fox AJ, Ferguson GG, Haynes RB, Rankin RN, Clagett GP, Hachinski VC, Sackett DL, Thorpe KE, Meldrum HE, Spence JD: Benefit of Carotid Endarectomy in Patients with Symptomatic Moderate or severe Stenosis. N Engl J Med. 1998, 339: 1415-1425. 10.1056/NEJM199811123392002.CrossRefPubMed Barnett HJM, Taylor DW, Eliasziw M, Fox AJ, Ferguson GG, Haynes RB, Rankin RN, Clagett GP, Hachinski VC, Sackett DL, Thorpe KE, Meldrum HE, Spence JD: Benefit of Carotid Endarectomy in Patients with Symptomatic Moderate or severe Stenosis. N Engl J Med. 1998, 339: 1415-1425. 10.1056/NEJM199811123392002.CrossRefPubMed
13.
go back to reference World Health Organization.Obesity: Preventing and Managing the Global Epidemic. Geneva: WHO. 1998 World Health Organization.Obesity: Preventing and Managing the Global Epidemic. Geneva: WHO. 1998
14.
go back to reference Durnin JVGA, Womersley J: Body Fat assessed from Total Body Density and its Estimation from Skin fold Thickness; Measurements on 481 men and Women Aged from 16 to 72 Years. Br J Nutr. 1974, 32: 77-97. 10.1079/BJN19740060.CrossRefPubMed Durnin JVGA, Womersley J: Body Fat assessed from Total Body Density and its Estimation from Skin fold Thickness; Measurements on 481 men and Women Aged from 16 to 72 Years. Br J Nutr. 1974, 32: 77-97. 10.1079/BJN19740060.CrossRefPubMed
15.
go back to reference Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ, Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, National Heart and Blood Institute; National High Blood Pressure Education Program Coordinating Committee: Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003, 42: 1206-1252. 10.1161/01.HYP.0000107251.49515.c2.CrossRefPubMed Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ, Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, National Heart and Blood Institute; National High Blood Pressure Education Program Coordinating Committee: Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003, 42: 1206-1252. 10.1161/01.HYP.0000107251.49515.c2.CrossRefPubMed
16.
go back to reference Gorter PM, Olijhoek JK, van der Graaf Y, Algra A, Rabelink TJ, Visseren FL, SMART Study Group: Prevalence of the metabolic syndrome in patients with coronary heart disease, cerebrovascular disease, peripheral arterial disease or abdominal aortic aneurysm. Atherosclerosis. 2004, 173: 363-369.CrossRefPubMed Gorter PM, Olijhoek JK, van der Graaf Y, Algra A, Rabelink TJ, Visseren FL, SMART Study Group: Prevalence of the metabolic syndrome in patients with coronary heart disease, cerebrovascular disease, peripheral arterial disease or abdominal aortic aneurysm. Atherosclerosis. 2004, 173: 363-369.CrossRefPubMed
17.
go back to reference Ford ES: Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S. Diabetes Care. 2005, 28: 2745-2749. 10.2337/diacare.28.11.2745.CrossRefPubMed Ford ES: Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S. Diabetes Care. 2005, 28: 2745-2749. 10.2337/diacare.28.11.2745.CrossRefPubMed
18.
go back to reference Lee C, Huxley R, Woodward M, Zimmet P, Shaw J, Cho N, Kim H, Viali S, Tominaga M, Vistisen D, Borch-Johnsen K, Colagiuri S: Comparisons of metabolic syndrome definitions in four populations of the Asia-Pacific region. Metab Syndr Relat Disord. 2008, 6: 37-46. 10.1089/met.2007.0024.CrossRefPubMed Lee C, Huxley R, Woodward M, Zimmet P, Shaw J, Cho N, Kim H, Viali S, Tominaga M, Vistisen D, Borch-Johnsen K, Colagiuri S: Comparisons of metabolic syndrome definitions in four populations of the Asia-Pacific region. Metab Syndr Relat Disord. 2008, 6: 37-46. 10.1089/met.2007.0024.CrossRefPubMed
19.
go back to reference Brown TM, Vaidya D, Rogers WJ, Waters DD, Howard BV, Tardif JC, Bittner V: Does Prevalence of the Metabolic Syndrome in Women with Coronary Artery Disease Differ by the ATP III and IDF Criteria?. Journal of Women's Health. 2008, 17: 841-847. 10.1089/jwh.2007.0536.CrossRefPubMedPubMedCentral Brown TM, Vaidya D, Rogers WJ, Waters DD, Howard BV, Tardif JC, Bittner V: Does Prevalence of the Metabolic Syndrome in Women with Coronary Artery Disease Differ by the ATP III and IDF Criteria?. Journal of Women's Health. 2008, 17: 841-847. 10.1089/jwh.2007.0536.CrossRefPubMedPubMedCentral
20.
go back to reference Yoon YS, Lee ES, Park C, Lee S, Oh SW: The new definition of metabolic syndrome by the international diabetes federation is less likely to identify metabolically abnormal but non-obese individuals than the definition by the revised national cholesterol education program: the Korea NHANES study. Int J Obes (Lond). 2007, 31: 528-534. 10.1038/sj.ijo.0803442.CrossRef Yoon YS, Lee ES, Park C, Lee S, Oh SW: The new definition of metabolic syndrome by the international diabetes federation is less likely to identify metabolically abnormal but non-obese individuals than the definition by the revised national cholesterol education program: the Korea NHANES study. Int J Obes (Lond). 2007, 31: 528-534. 10.1038/sj.ijo.0803442.CrossRef
21.
go back to reference Milionis HJ, Kostapanos MS, Liberopoulos EN, Goudevenos J, Athyros VG, Mikhailidis DP, Elisaf MS: Different definitions of the metabolic syndrome and risk of first-ever acute ischaemic non-embolic stroke in elderly subjects. Int J Clin Pract. 2007, 61: 545-551. 10.1111/j.1742-1241.2006.01269.x.CrossRefPubMed Milionis HJ, Kostapanos MS, Liberopoulos EN, Goudevenos J, Athyros VG, Mikhailidis DP, Elisaf MS: Different definitions of the metabolic syndrome and risk of first-ever acute ischaemic non-embolic stroke in elderly subjects. Int J Clin Pract. 2007, 61: 545-551. 10.1111/j.1742-1241.2006.01269.x.CrossRefPubMed
Metadata
Title
Prevalence of the metabolic syndrome in patients with carotid disease according to NHLBI/AHA and IDF criteria: a cross-sectional study
Authors
Milos Z Maksimovic
Hristina D Vlajinac
Djordje J Radak
Jelena M Marinkovic
Jagoda B Jorga
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2012
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/1471-2261-12-2

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