Frequency of Metabolic Syndrome among Hemodialysis Patients According to NCEP-ATP III and IDF Definitions

Abstract

Objective. Patients with chronic renal failure (CRF) have an increased risk of death from cardiovascular diseases. The metabolic syndrome is a common risk factor for cardiovascular diseases. In the present study, it was aimed to evaluate the frequency of metabolic syndrome using the National Cholesterol Education Program Adults Treatment Panel III (NCEP-ATP III) and the International Diabetes Federation (IDF) definitions in patients with end-stage CRF undergoing hemodialysis (HD). Materials and Methods. A total of 222 cases undergoing HD were enrolled in the study. After obtaining medical history and physical examination, blood samples were collected from each patient for the measurements of fasting blood glucose, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides. Results. Among HD patients evaluated according to both IDF and NCEP-ATP III definitions, the diagnosis of metabolic syndrome was confirmed by IDF in 56.5% of those fulfilling the criteria for NCEP-ATP III. Similarly, 86% of the undiagnosed patients according to NCEP-ATP III were confirmed by IDF definitions. The sensitivity and positive predictive value of NCEP-ATP III for metabolic syndrome were 81.25% and 64.8%, respectively. The area under the Receiver Operating Characteristic (ROC) curve for NECP-ATP III and IDF was 0.730. False-positive rate and probability ratio for NECP-ATP III were 0.352 and 2.49, respectively. In other words, among the patients who were diagnosed with metabolic syndrome according to NCEP-ATP III definitions, the proportion of subjects whose diagnosis was confirmed by IDF definitions was 2.49-fold higher than those with unconfirmed diagnosis. Conclusion. It is logical to evaluate patients with CRF for metabolic syndrome and cardiovascular risk factors at the time of diagnosis and regularly thereafter due to the high ratio of metabolic syndrome in this population.