Metabolic Syndrome: Comparison of Occurrence Using Three Definitions in Hypertensive Patients

Abstract

Objective:To compare the frequency of occurrence of metabolic syndrome using three international definitions and to study the distribution of cardiovascular risk factors among newly diagnosed hypertensive Nigerian subjects.Design: Cross sectional study.Settings: Cardiology unit of LAUTECH Teaching Hospital, Osogbo, Nigeria. Participants:One hundred forty newly diagnosed hypertensive Nigerian subjects, and 70 normotensive controls (age-and sex-matched) were included in this study. Methods:Clinical history and relevant laboratory investigations were performed on all study participants. The definition of metabolic syndrome was based on three international definitions: World Health Organization (WHO), International Diabetes Federation (IDF), and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). Ethical approval was obtained for the study. Statistical analyses were performed using SPSS 16.0.Results: There was no difference in age and gender distribution between the hypertensive subjects and controls. (55.14 ± 10.83 years, females 53.6% vs. 54.67 ± 10.89 years, females 52.9% respectively, P>0.05). The frequency of occurrence of metabolic syndrome among hypertensives was 34.5% according to WHO, 35.0% according to NCEP ATP III, and 42.5% according to IDF criteria. Visceral obesity and reduced high-density lipoprotein (HDL) were the other common cardiovascular risk factors among newly diagnosed hypertensive subjects. Female hypertensives had a higher prevalence of visceral obesity and low HDL. Conclusion:Frequency of occurrence of metabolic syndrome was similar using the NCEP ATP III and WHO definitions. However, the IDF definition resulted in a higher frequency because of the lower cut-off for waist circumference used for identification of visceral obesity. Metabolic syndrome is present in a significant proportion of newly diagnosed hypertensive subjects. Therefore, appropriate screening and treatment are required.

Influence of the 48867A>C (Asp358Ala) IL6R polymorphism on response to a lifestyle modification intervention in individuals with metabolic syndrome

“…The presence of MetS increases the risk for developing cardiovascular disease, diabetes, disability, and mortality (Lakka et al, 2002;Yamada et al, 2007;Cornier et al, 2008;Duvnjak and Duvnjak, 2009;Meshkani and Adeli, 2009;Gupta and Gupta, 2010;Akintunde et al, 2011). MetS development has been attributed to environmental factors (diet vs bad food habits; physical activity vs sedentary lifestyle), as well as to genetic polymorphisms known to be risk factors for cardiovascular disease, diabetes or inflammatory conditions (Lakka et al, 2002;Yamada et al, 2007;Ordovas and Shen, 2008;Meshkani and Adeli, 2009;Dalle et al, 2010;Monteiro and Azevedo, 2010).…”

Metabolic Syndrome among Apparently Healthy Nigerians with the Harmonized Criteria: Prevalence and Concordance with the International Diabetes Federation (IDF) and Third Report of the National Cholesterol Education Programme - Adult Treatment Panel III (NCEP-ATP III) Criteria

“…Generally, the prevalence was higher among women than men, 15-19-23-26 and with the IDF definition. [18][19][20][21][22][23][24][25][26] In order to make comparison among various studies possible, a new criterion which harmonizes the previous definitions was proposed. 34 However, there is scanty report on the prevalence of MS with the harmonized criteria Nigeria.…”

“…17,[18][19][20] Among patients with type 2 diabetes, prevalence of MS ranged between 59.1%-87.1%, [21][22][23][24] while in patients with hypertension, the prevalence ranged between 24.7%-40.74%. [17][18][19][20][21][22][23][24][25] These Nigerian authors used the WHO, IDF, and Adult Treatment Panel (ATP-III) criteria in their studies. Prevalence rates for MS in Ghana, 26 Cameroon, 27 South Africa, 28 India, 29 America, 30,31 United Kingdom 32 and Europe 33 ranged between 0% to 49.2% depending on the population studied and the criteria used.…”

Predictors for diagnosing metabolic syndrome among hypertensive patients in a tertiary care centre

“…However, some authors reported it as low as 29-35% [5,6]. This variation in prevalence of MS can be explained by different factors like ethnicity, age, gender distribution, duration of hypertension, sample size, type of study and criteria used.…”

“…So, it is important to know the proportion of hypertensive subjects having metabolic syndrome (MS). The prevalence of MS varies from 29% to 68% among hypertensive patients in different studies [3][4][5][6]. As a resource poor country, it may not be possible to screen all hypertensive subjects for the presence of MS.…”