Racial and Ethnic Differences in the Presentation of Metabolic Syndrome

Abstract

This paper explores the effectiveness of the Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) recommendations for diagnosing metabolic syndrome in people from specific racial and ethnic groups. More than 50 million adult Americans have metabolic syndrome. Some racial and ethnic minority groups have much higher percentages of the metabolic syndrome than general population estimates suggest. However, some minority populations in the United States such as Hispanics appear to be underdiagnosed. A literature review was conducted to determine whether the general ATP III guidelines have sufficient screening criteria for detecting metabolic syndrome in various racial and ethnic minority groups. Research articles published in the United States from 2000 to 2005 were reviewed. Studies were included that presented data related to black, Hispanic, and Asian American male and female subjects older than age 18. Waist circumference appears to be the most predictive screening factor among the metabolic syndrome criteria. Patients with normal body mass indexes may still have elevated waist circumferences that meet the ATP III risk criteria for metabolic syndrome. Blacks have high rates of hypertension even without considering metabolic syndrome, and they may have more disease risk than other populations. Hispanics have an increased risk of diabetes associated with metabolic syndrome. Because the criteria may not be sufficient to diagnose metabolic syndrome in Asian Americans as a result of different body types, the diagnosis might be missed in this group. There is a need for more research on how the diagnosis of metabolic syndrome presents in different racial and ethnic minority groups in the United States. Practitioners need evidence-based screening tools that will provide the most accurate information for evaluating persons of racial and ethnic groups who are most at risk of diabetes, cardiovascular disease, and stroke. The determination of the applicability of screening criteria to diverse patient populations is vital to providers who are obligated to provide culturally competent care to their patients. This paper synthesizes selected literature and presents recommendations to assist nurse practitioners in the assessment of metabolic syndrome in specific racial and ethnic minority groups.