Papel de la dislipemia aterogénica en el desarrollo del síndrome metabólico

Abstract

Our goal was to know if the diagnosis of metabolic syndrome (MS) as defined by International Diabetes Federation (IDF) criteria 2005 identifies more subjects with atherogenic dyslipidemia and high cardiovascular risk than the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP-III) criteria. Cross-sectional study in an adult population (20-70 years) of 344 subjects (158 males and 186 females), who visited an out-patient clinic in the metropolitan area of Valencia over a period of one year. Opportunistic search method was used. We studied: anthropometrics parameters, blood pressure, plasma lipids -non-high-density lipoprotein cholesterol (no-HDL-c), and total cholesterol:high-density lipoprotein cholesterol index (TC-HDL-c)-, glucose and insulin, and HOMA (Homeostasis Model Assessment) index. We have separated the subjects on the basis to the IDF or ATP-III criteria to define the MS. The MS define a group of subjects with important plasma lipids alterations and cardiovascular risk: increase of no-HDL-c, of TC:HDL-c index and of apolipoprotein B. The TC:HDL-c index was > or = 6 in 28.6% of the subjects with MS and only in 9.4% of the subjects without MS (p < 0.0001) by IDF criteria and in 34.6% of the subjects with MS-ATP-III, and in 8.6% without MS-ATP-III (p < 0.0001). The apolipoprotein B > or = 1.2 g/l was observed in 44% of the subjects with MS and only in 26% without MS IDF criteria (p < 0.0001), and only in 47.6% and 28.6%, respectively, by ATP-III criteria (p < 0.0001). The MS defined by the IDF or ATP-III criteria equally identifies subjects with atherogenic dyslipidemia, with increase of no-HDL-c, of the TC: HDL-c index and of the apolipoprotein B and, for this reason, with high cardiovascular risk.