THE PREVALENCE OF THE METABOLIC SYNDROME USING THREE PROPOSED DEFINITIONS. POLISH MULTICENTER STUDY ON DIABETES EPIDEMIOLOGY (PMSDE)

Abstract

ISEE-178 Introduction: The metabolic syndrome (MetS), a concurrence of disturbed glucose and insulin metabolism, overweight and abdominal fat distribution, dyslipidemia and hypertension, is associated with subsequent development of diabetes type 2 and cardiovascular disease. There are a number of definitions of the MetS using different criteria, among them the WHO, the European Group for the Study on Insulin Resistance (EGIR) and the National Cholesterol Education Program (NCEP) definitions. Aim: The aim of the study was to assess the prevalence of the MetS in the Polish population and to compare the metabolic indices of MetS between the WHO, EGIR and NCEP definitions. Methods: 6000 randomised subjects, aged 35–75 and participants of the Polish Multicenter Study on Diabetes Epidemiology, were invited to take part in the study. In 2838 participants following parameters were determined: BMI, waist and hip circumference, blood pressure, fasting and after glucose load glycaemia and insulinaemia and fasting lipids. After exclusion of patients with known diabetes, the MetS prevalence was assessed according to the WHO, EGIR and NCEP definitions. Insulin-resistance was defined as the highest quartile of the distribution of the insulin (EGIR) and HOMA (WHO) assessed for the population with normal glucose tolerance Results: Among 2674 examined subjects (1530 women (W) and 1144 men (M)) the MetS was present in 38% subjects (32% W, 45% M), 25% (23% W, 27% M) and 35% (37% W, 32% M) according to the WHO, EGIR and the NCEP definitions respectively. 22.6% and 25.2% of those with the MetS under the WHO definition had the MetS under the EGIR and the NCEP definition. 15.9% of subjects had the MetS according to all three definitions. Fasting glycaemia was higher in subjects with the MetS defined by the WHO than by the EGIR (6,21±1,12 vs 6,09±1,02, p<0,01). The highest insulinemia and HOMA index were found in subjects with the MetS under the EGIR definition, and the lowest under the NCEP definition (Insulin: 19,11±8,27 vs 13,4 ±8,95 p<0,001; HOMA: 5,19 ±2,56 vs 3,67 ±2,71 p<0,001). Higher triglycerides and lower HDL cholesterol were found in subjects with the MetS defined by the NCEP than by the WHO (Triglycerides: 2,43±1.32 vs 2,28 ±1,37 p<0,05; HDL cholesterol: 1,14 ±0,27 vs 1,21 ±0,30 p< 0,001). HDL cholesterol was higher in those with the MetS under the EGIR than by the NCEP definition (1,13 ± 0,27 vs 1,18±0,30 p<0,001). Conclusion: The MetS is common in the Polish population. However variables definitions used identify subjects with different metabolic phenotypes. Further investigations to create a universally accepted definition of the MetS are needed.