Relation between atherogenic dyslipidemia and the Adult Treatment Program-III definition of metabolic syndrome (Genetic Epidemiology of Metabolic Syndrome Project).
Genetic Epidemiology of Metabolic Syndrome is a multinational, family-based study to explore the genetic basis of the metabolic syndrome. Atherogenic dyslipidemia (defined as low plasma high-density lipoprotein cholesterol with elevated triglycerides (<25th and >75th percentile for age, gender, and country, respectively) identified affected subjects for the metabolic syndrome. This report examines the frequency at which atherogenic dyslipidemia predicts the metabolic syndrome of the National Cholesterol Education Program Adult Treatment Panel III (ATP-III). One thousand four hundred thirty-six (854 men/582 women) affected patients by our criteria were compared with 1,672 (737 men/935 women) unaffected persons. Affected patients had more hypertension, obesity, and hyperglycemia, and they met a higher number of ATP-III criteria (3.2 +/- 1.1 SD vs 1.3 +/- 1.1 SD, p <0.001). Overall, 76% of affected persons also qualified for the ATP-III definition (Cohen's kappa 0.61, 95% confidence interval 0.59 to 0.64), similar to a separate group of 464 sporadic, unrelated cases (75%). Concordance increased from 41% to 82% and 88% for ages < or =35, 36 to 55, and > or =55 years, respectively. Affected status was also independently associated with waist circumference (p <0.001) and fasting glucose (p <0.001) but not systolic blood pressure (p = 0.43). Thus, the lipid-based criteria used to define affection status in this study substantially parallels the ATP-III definition of metabolic syndrome in subjects aged >35 years. In subjects aged <35 years, atherogenic dyslipidemia frequently occurs in the absence of other metabolic syndrome risk factors.
Wyszynski
Diego F
DF
Department of Medicine (Genetics Program), Boston University School of Medicine, Boston, MA, USA.
Waterworth
Dawn M
DM
Barter
Philip J
PJ
Cohen
Jonathan
J
Kesäniemi
Y Antero
YA
Mahley
Robert W
RW
McPherson
Ruth
R
Waeber
Gérard
G
Bersot
Thomas P
TP
Sharma
Sanjay S
SS
Nolan
Vikki
V
Middleton
Lefkos T
LT
Sundseth
Scott S
SS
Farrer
Lindsay A
LA
Mooser
Vincent
V
Grundy
Scott M
SM
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D005387:Finland / Q000453:epidemiology; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics*; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013557:Switzerland / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood; D014421:Turkey / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
D008076:Cholesterol, HDL; D014280:Triglycerides