Summary Aims Different criteria have been proposed by the World Health Organization (WHO) and the Third Report of the National Cholesterol Education Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATPIII) for the diagnosis of the metabolic syndrome. Its identification is of primary importance for coronary risk assessment. Methods The prevalence of the metabolic syndrome was determined according to the 2 different proposals in 1,569 consecutive subjects with type 2 diabetes. Results By WHO proposal, 81% of cases (95% confidence interval, 79 – 83) were labelled as metabolic syndrome. Microalbuminuria had the highest specificity (99%), visceral obesity the highest sensitivity (93%). 78% of patients (95% CI, 76 – 80) fulfilled the ATPIII criteria for metabolic syndrome, low HDL-cholesterol having the highest specificity (95%), elevated blood pressure having the highest sensitivity. 1,113 patients were positive according to both proposals; 183 were concordantly negative, indicative of a fairly good agreement (k statistics, 0.464). Subjects only positive for WHO proposal were more frequently males, had a lower BMI and a higher arterial pressure. Only subjects identified by ATPIII proposal had a significantly higher prevalence of previously detected coronary heart disease. Conclusions Minimum criteria for the metabolic syndrome are met in most patients with type 2 diabetes. A correct identification of the syndrome is mandatory for an integrated approach to reduce the high costs and the associated disabilities. The ATPII proposal more clearly identifies the burden of coronary heart disease associated with the metabolic syndrome.
Comparison of WHO and ATPIII proposals for the definition of the metabolic syndrome in patients with Type 2 diabetes
MARCHESINI REGGIANI, GIULIO;ERMINI, GIULIANO;SAVORANI, GIANDOMENICO;ZOCCHI, DONATO;MELCHIONDA, NAZARIO
2004
Abstract
Summary Aims Different criteria have been proposed by the World Health Organization (WHO) and the Third Report of the National Cholesterol Education Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATPIII) for the diagnosis of the metabolic syndrome. Its identification is of primary importance for coronary risk assessment. Methods The prevalence of the metabolic syndrome was determined according to the 2 different proposals in 1,569 consecutive subjects with type 2 diabetes. Results By WHO proposal, 81% of cases (95% confidence interval, 79 – 83) were labelled as metabolic syndrome. Microalbuminuria had the highest specificity (99%), visceral obesity the highest sensitivity (93%). 78% of patients (95% CI, 76 – 80) fulfilled the ATPIII criteria for metabolic syndrome, low HDL-cholesterol having the highest specificity (95%), elevated blood pressure having the highest sensitivity. 1,113 patients were positive according to both proposals; 183 were concordantly negative, indicative of a fairly good agreement (k statistics, 0.464). Subjects only positive for WHO proposal were more frequently males, had a lower BMI and a higher arterial pressure. Only subjects identified by ATPIII proposal had a significantly higher prevalence of previously detected coronary heart disease. Conclusions Minimum criteria for the metabolic syndrome are met in most patients with type 2 diabetes. A correct identification of the syndrome is mandatory for an integrated approach to reduce the high costs and the associated disabilities. The ATPII proposal more clearly identifies the burden of coronary heart disease associated with the metabolic syndrome.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
