Influence of metabolic syndrome superposition on familial combined hyperlipoproteinemia cardiovascular complication rate

Background: The recent literature suggest that the increased prevalence of the Metabolic Syndrome (MS) alone could account for a significant part of the elevated Cardiovascular Disease (CVD) risk associated with Familial Combined Hyperlipoproteinemia (FCH), one of the most common and aggressive genetic hyperlipoproteinemias. Aim: To evaluate the role of MS superposition on CVD complication prevalence of FCH subjects. Methods: We carried out a retrospective evaluation on the influence of the MS features on the prevalence of CVD in a large sample of adult Italian FCHL affected patients (64 familial clusters; 867 subjects). Results: Age is associated with early cardiovascular complications, both in men (OR 1,08, 95% CI 1,05-1,11, p<0.0001) and in women (OR 1,09, 95% CI 1,04-1,13, p=0.0001). No one component of MS appears to be related to cardiovascular complications in men, while only low plasma HDL-C in women. Among parameters not related to MS, LDL-C and Lp(a) plasma levels only are significantly associated to early cardiovascular complication in male FCH (LDL-C: OR 2,24, 95%CI 1,02-4,91, p=0,04; Lp(a): OR 4,64, 95%CI 1,85-11,62, p= 0,001), but not in women (LDL-C: OR 1,83, 95%CI 0,53-6,34, p= 0,34; Lp(a): OR 3,65, 95%CI 0,89-14,97, p=0.07). Conclusion: Our data support the hypothesis that the superposition of MS on FCH is not associated to a higher prevalence of cardiovascular complications, maybe because of the strongest risk increase associated to FCH per se.