Screening for metabolic syndrome in hypertensive and/or obese subjects registered in primary health care in Hungary.
BACKGROUND
The screening of subjects at risk for metabolic syndrome is of considerable importance in order to prevent atherosclerosis.


METHODS
In order to assess the clinical-laboratory characteristics of metabolic syndrome,a screening procedure was performed in subjects (age 20 -65)who exhibited hypertension and/or abnormal body mass index (BMI)and/or elevated waist-hip ratio,excluding patients with known diabetes. An oral glucose tolerance test with 75 g glucose was performed. Plasma glucose and insulin values were measured,as well as plasma lipids.


RESULTS
In subjects available for complete statistical analysis (n=944;women/men ratio 1.37:1),hyperinsulinemia was detected in 52.9%. Hyperinsulinemia with normal glucose tolerance was more often detected (33.2%),hyperinsulinemia with impaired glucose tolerance [IGT ]or diabetes less frequently (13.0%and 6.7%,respectively). When abnormal clinical signs were separately analysed,hyperinsulinemia was found in 56.8%of subjects with abnormal BMI,in 43.8% of subjects with abnormal waist-hip ratio,and in 27.1% of subjects with hypertension. Metabolic syndrome (WHO criteria,modified)was diagnosed in 35.2%of subjects,with male predominance (men:40.6%;women:31.2%;p<0.01).


CONCLUSIONS
Obesity (abnormal BMI;abnormal waist-hip ratio)is of greater importance than hypertension alone for detecting subjects with hyperinsulinemia.Routine clinical and laboratory investigations (anthropometric data,measuring blood pressure,oral glucose tolerance test)are simple but useful for identifying subjects with metabolic syndrome,enabling the implementation of a primary strategy to prevent cardiovascular morbidity.
Hidvégi
Tibor
T
4th Medical Department, Aladár Petz Hospital, Györ, Hungary.
Hetyési
Katalin
K
Bíró
Lajos
L
Jermendy
György
G
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D006946:Hyperinsulinism / Q000453:epidemiology* / Q000378:metabolism; D006973:Hypertension / Q000453:epidemiology / Q000378:metabolism*; D007328:Insulin / Q000097:blood; D008297:Male; D008403:Mass Screening; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism*; D011320:Primary Health Care
D007328:Insulin