New Definition of Metabolic Syndrome
Improves Risk Prediction With Diabetes and CHD
According to new report, using a modified
version of the National Cholesterol Education
Program (NCEP) definition, diagnosis of metabolic
syndrome predicts an increased risk of coronary
heart disease (CHD) and new-onset diabetes in
men.
The new definition, therefore, appears useful
in identifying people who could benefit from lifestyle
changes to prevent these diseases, lead author
Dr. Naveed Sattar, from the Glasgow Royal Infirmary
in the UK, and colleagues note. The findings are
published in the July 29th issue of Circulation:
Journal of the American Heart Association.
Under the NCEP definition, metabolic syndrome
also known as syndrome X is diagnosed if at least
three of five criteria are present: increase waist
circumference, elevated triglyceride levels, low
HDL cholesterol levels, increased blood glucose
levels, and hypertension. In the new study, Dr.
Sattar's team used BMI instead of waist circumference.
The previous definition, which was created by
the World Health Organization, was more complex
and relied heavily on evidence of glucose dysregulation.
The problem was that by the time such dysregulation
was present, the opportunity for preventing diabetes
was limited, the researchers note.
Dr. Sattar's group followed more than 5000 men
for nearly 5 years to assess the incidence of
CHD and diabetes. At baseline, all of the subjects
were evaluated for metabolic syndrome based on
the modified definition.
Twenty-six percent of the men met criteria for
metabolic syndrome, the authors note. Overall,
such men were 76% more likely to develop CHD and
3.5-times more likely to develop diabetes than
were men without the disorder. When the analysis
was limited to men with four or five criteria,
the increased risks were even more dramatic--a
3.7-fold increase for CHD and a 24.4-fold increase
for diabetes (p < 0.0001 for both).
The diabetes finding is particularly striking
because currently there are fewer predictive screening
charts to identify people at high risk of becoming
diabetic than there are for CHD, he says.
Interestingly, the cholesterol-lowering drug seemed
equally beneficial for men with and without the
metabolic syndrome. It reduced the risk of CHD
by 27 percent in those with metabolic syndrome
and 31 percent in those without it, he says.
Sattar’s group also looked at another variable,
the inflammatory marker C-reactive protein (CRP)
that other studies have linked to the development
of heart disease and diabetes. They found that
CRP levels were higher in the men with the metabolic
syndrome than in those without it and improved
the ability to predict both diabetes and CHD.
Circulation 2003;108:000-000.
==========================================
Breakthrough
in Diabetes Education for Children
dbaza inc. has created a product can help you
use your education time more effectively, allowing
you to spend your time on the more difficult issues.
More
Information
