title: Relation between atherogenic dyslipidemia and the Adult Treatment Program-III definition of metabolic syndrome (Genetic Epidemiology of Metabolic Syndrome Project).
abstract: 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.
authors.affiliation: Department of Medicine (Genetics Program), Boston University School of Medicine, Boston, MA, USA.
authors.forename: Diego F
authors.initials: DF
authors.lastname: Wyszynski
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Waterworth
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Barter
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cohen
authors.forename: Y Antero
authors.initials: YA
authors.lastname: Kesäniemi
authors.forename: Robert W
authors.initials: RW
authors.lastname: Mahley
authors.forename: Ruth
authors.initials: R
authors.lastname: McPherson
authors.forename: Gérard
authors.initials: G
authors.lastname: Waeber
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Bersot
authors.forename: Sanjay S
authors.initials: SS
authors.lastname: Sharma
authors.forename: Vikki
authors.initials: V
authors.lastname: Nolan
authors.forename: Lefkos T
authors.initials: LT
authors.lastname: Middleton
authors.forename: Scott S
authors.initials: SS
authors.lastname: Sundseth
authors.forename: Lindsay A
authors.initials: LA
authors.lastname: Farrer
authors.forename: Vincent
authors.initials: V
authors.lastname: Mooser
authors.forename: Scott M
authors.initials: SM
authors.lastname: Grundy
mesh_terms: 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
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides