Abstract
BackgroundMetabolic syndrome (MetS) has been related to type 2 diabetes and cardiovascular diseases. Different criteria for diagnosis of MetS have been recommended, but there is no agreement about which criteria are best to use. The aim of the present study was to investigate agreement between the National Heart, Lung, and Blood Institute, American Heart Association (NHLBI/AHA) and the International Diabetes Federation (IDF) definitions of MetS in patients with symptomatic carotid disease and to compare the frequency of cardiovascular risk factor in patients with MetS diagnosed by these two sets of criteria.MethodsThe study was a cross-sectional one involving 644 consecutive patients with verified carotid disease who referred to the Vascular Surgery Clinic Dedinje in Belgrade during the period April 2006 - November 2007. Anthropometric parameters blood pressure, fasting plasma glucose and lipoproteins were measured using standard procedures.ResultsMetS was present in 67.9% of participants, according to IDF criteria, and in 64.9% of participants, according to the NHLBI/AHA criteria. A total of 119 patients were categorized differently by the two definitions. Out of all participants 10.7% had MetS by IDF criteria only and 7.8% of patients had MetS by NHLBI/AHA criteria only. The overall agreement of IDF and NHLBI/AHA criteria was 81.5% (Kappa 0.59, p < 0.001). In comparison with patients who met only IDF criteria, patients who met only NHLBI/AHA criteria had significantly more frequently cardiovascular risk factors with the exception of obesity which was significantly more frequent in patients with MetS diagnosed by IDF criteria.ConclusionThe MetS prevalence in patients with symptomatic carotid disease was high regardless of criteria used for its diagnosis. Since some patients with known cardiovascular risk factors were lost by the use of IDF criteria it seems that NHLBI/AHA definition is more suitable for diagnosis of MetS. Large follow-up studies are needed to test prognostic value of these definitions.
Highlights
Metabolic syndrome (MetS) has been related to type 2 diabetes and cardiovascular diseases
Of 644 patients, 437 (67.9%) had metabolic syndrome according to International Diabetes Federation (IDF) criteria and 418 (64.9%) according to the NHLBI/American Heart Association (AHA) criteria
In the present study metabolic syndrome prevalence in patients with symptomatic carotid disease was high regardless of criteria used for its diagnosis
Summary
Metabolic syndrome (MetS) has been related to type 2 diabetes and cardiovascular diseases. The aim of the present study was to investigate agreement between the National Heart, Lung, and Blood Institute, American Heart Association (NHLBI/AHA) and the International Diabetes Federation (IDF) definitions of MetS in patients with symptomatic carotid disease and to compare the frequency of cardiovascular risk factor in patients with MetS diagnosed by these two sets of criteria. NCEP-ATP III criteria were revised in 2005 by the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI) modified NCEP-ATP III criteria, called NHLBIAHA criteria [6], and in 2006 International Diabetes Federation recommended a new definition of metabolic syndrome - IDF definition [7]
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