Far from easy and accurate - detection of metabolic syndrome by general practitioners

Eeva-Eerika Helminen,Pekka Mäntyselkä,Esko Kumpusalo,Irma Nykänen

doi:10.1186/1471-2296-10-76

Eeva-Eerika Helminen, Pekka Mäntyselkä + Show 2 more

Open Access

https://doi.org/10.1186/1471-2296-10-76

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Abstract

BackgroundMetabolic syndrome (MetS) is a major public health challenge. General practitioners (GPs) could play a key role in its recognition. However, it often remains undiagnosed in primary care. This study assesses how well GPs and patients recognise MetS among patients with coronary heart disease or at least one of its risk factors.MethodsTwenty-six health centres around Finland were randomly selected for the purpose of identifying, over a two-week period in April 2005, patients meeting the inclusion criteria of coronary heart disease or one of its risk factors. GPs and identified patients (n = 1880) were asked to complete surveys that included a question about the patient's MetS status. A trained nurse conducted health checks (n = 1180) of the identified patients, utilising criteria of MetS modified from the National Cholesterol Program. Data from the GPs' survey were compared with those from the health check to establish the extent of congruence of identification of MetS.ResultsAlmost half (49.4%) of the patients met the criteria of MetS as established by objective measures. However, in the GPs' survey responses, only 28.5% of the patients were identified as having MetS. Additionally, these groups of MetS patients were not congruent. The sensitivity of the GPs' diagnosis of MetS was 0.31 with a specificity of 0.73. Only 7.1% of the study patients stated that they were suffering from MetS.ConclusionDetection of MetS is inaccurate among GPs in Finland. Most patients were not aware of having MetS. The practical relevance of MetS in primary care should be reconsidered.

Highlights

Metabolic syndrome (MetS) is a major public health challenge
In this study we examined how well General practitioners (GPs) recognise MetS among patients with coronary heart disease (CHD) or at least one of its risk factors
The GPs had answered the question about metabolic syndrome in 1173 (99.4%) of the 1180 patient cases

Summary

Introduction

Metabolic syndrome (MetS) is a major public health challenge. General practitioners (GPs) could play a key role in its recognition. It often remains undiagnosed in primary care. General practitioners (GPs) play a key role in recognising MetS, but it is rarely recorded as a diagnosis in clinical practice [3]. Despite several efforts to make diagnosis feasible for clinicians, the syndrome often remains undiagnosed in primary health care [4]. In 2001 the National Cholesterol Education Program (NCEP) published a working definition of the syndrome based on five commonly measured clinical criteria that physicians could implement in their practices [6]. The IDF definition provides a stepwise approach to risk, with measurement of the waist as a simple initial screening test followed by assessment of four other components

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