[Predictive capacity of the diagnostic criteria of metabolic syndrome on the insulin-resistance and the coronary risk].
OBJECTIVE
Since at present several diagnostic criteria of the metabolic syndrome (MS) exist, the objective of the study is to verify the utility of the criteria of the International Diabetes Federation (IDF) to diagnose the MS, their agreement with other previous definitions and the insulin resistance (IR). It also studies its relation with the coronary risk (CR).


METHODS
Design of a cross-sectional descriptive study in the scope of the primary care of Yecla (Murcia). We studied 317 selected people from a stratified random sampling (age and sex) of 424 from a population of 18,059 with sanitary card and aged > or = 30 years. Socio-demographic, anthropometric and analytical (lipids, microalbuminuria, hemoglobin A1c and insulinemia) variables were registered. Criteria from the World Health Organization (WHO), Third Report of National Cholesterol Education Program (NCEP-III), European Group for the Study of Insuline Resistance (EGIR) and IDF were used to diagnose the MS. We defined IR when index HOMA > or = 3.8. The agreement between definitions of MS was determined by the kappa statistic. The CR was quantified according to Anderson (1991) method.


RESULTS
The prevalence of the MS was: WHO, 35.3% (95% confidence interval [CI], 29.8-40.8); NCEP, 20.2% (95% CI, 15.6-24.8); EGIR, 24% (95% CI, 19.1-28.9), and IDF, 28.9% (95% CI, 23.8-34). The prevalence of IR was 27.7% (95% CI, 22.6-32.8). The agreement between the most clinical criteria (NCEP, IDF) and the biochemists (WHO, EGIR, HOMA) was lower (kappa < 0.50). A 58.2% (WHO), 66.1% (NCEP), 50% (EGIR) and 57% (IDF) of subjects with MS presented a CR greater than 20%.


CONCLUSIONS
A high prevalence of the MS in Yecla exists, with a good agreement between the most clinical definitions of the syndrome (NCEP and IDF), that are associated with greater CR.
Martínez Candela
Juan
J
Centro de Salud Mariano Yago, Yecla, Murcia, Españal. jmartinezc@inicia.es
Franch Nadal
Josep
J
Romero Ortiz
Josefa
J
Cánovas Domínguez
Carmen
C
Gallardo Martín
Arístides
A
López Yepes
María Luisa
ML
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000209:etiology; D000886:Anthropometry; D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012306:Risk; D012494:Sampling Studies; D013030:Spain
D006442:Glycated Hemoglobin; D007328:Insulin; D008055:Lipids