Assessing the prevalence of the Metabolic Syndrome according to NCEP ATP III in Germany: feasibility and quality aspects of a two step approach in 1550 randomly selected primary health care practices.
OBJECTIVE
Metabolic Syndrome (MetSyn) describes a cluster of metabolic disorders and is considered a risk factor for development of cardiovascular disease. Although a high prevalence is commonly assumed in Germany data about the degree of its occurrence in the population and in subgroups are still missing. The aim of this study was to assess the prevalence of the MetSyn according to the NCEP ATP-III (National Cholesterol Education Program Adult Treatment Panel III) criteria in persons aged >or=18 years attending a general practitioner in Germany. Here we describe in detail the methods used and the feasibility of determining the MetSyn in a primary health care setting.


METHODS
The German-wide cross-sectional study was performed during two weeks in October 2005. Blood samples were analyzed in a central laboratory. Waist circumference and blood pressure were assessed, data on smoking, life style, fasting status, socio-demographic characteristics and core information from non-participants collected. Quality control procedures included telephone-monitoring and random on-site visits. In order to achieve a maximal number of fasting blood samples with a minimal need for follow-up appointments a stepwise approach was developed. Basic descriptive statistics were calculated, the Taylor expansion method used to estimate standard errors needed for calculation of confidence intervals for clustered observations.


RESULTS
In total, 1511 randomly selected general practices from 397 out of 438 German cities and administrative districts enrolled 35,869 patients (age range: 18-99, women 61.1%). More than 50,000 blood samples were taken. Fasting blood samples were available for 49% of the participants. Of the participating patients 99.3% returned questionnaires to the GP, only 12% were not filled out completely. The overall prevalence of the MetSyn (NCEP/ATP III 2001) was found to be 19.8%, with men showing higher prevalence rates than women (22.7% respective 18.0%).


CONCLUSIONS
This study was designed to provide data as robust as possible within the confines of an epidemiological study. Judging by the low degree of missing data and the high data quality, the feasibility for this kind of a research setting (short evaluation period, practitioners as data assessment sites) was found to be very good. The results will help to gain a more comprehensive insight into the prevalence of MetSyn for patients in primary health care in Germany.
Moebus
Susanne
S
Institute for Medical Informatics, Biometry and Epidemiology, University Hospital, University of Duisburg-Essen, Essen, Germany. susanne.moebus@uk-essen.de
Hanisch
Jens Ulrich
JU
Neuhäuser
Markus
M
Aidelsburger
Pamela
P
Wasem
Jürgen
J
Jöckel
Karl-Heinz
KH
Scand J Clin Lab Invest. 2001 May;61(3):169-79
11386604
Diabetes Care. 2001 Apr;24(4):683-9
11315831
Clin Cornerstone. 2005;7(2-3):7-16
16473256
Z Klin Chem Klin Biochem. 1974 May;12(5):256
4440167
Diabetes Care. 2003 Mar;26(3):575-81
12610004
Clin Chem. 1993 Jun;39(6):1012-22
8504530
Circulation. 2004 Jan 27;109(3):433-8
14744958
Curr Cardiol Rep. 2002 Nov;4(6):501-7
12379173
JAMA. 2001 May 16;285(19):2486-97
11368702
Diabet Med. 1998 Jul;15(7):539-53
9686693
Curr Med Res Opin. 2005 Apr;21(4):619-30
15899112
Circulation. 2005 Oct 25;112(17):2735-52
16157765
Scand J Prim Health Care. 1986 May;4(2):85-95
3726333
Diabetes Care. 2004 Mar;27(3):824-30
14988311
Diabetes Care. 1993 Feb;16(2):434-44
8432214
Lancet. 2005 Sep 24-30;366(9491):1059-62
16182882
Scand J Clin Lab Invest. 1981 Feb;41(1):35-40
7256191
N Engl J Med. 1996 Apr 11;334(15):952-7
8596596
Gesundheitswesen. 1998 Dec;60 Suppl 2:S59-68
10063725
Atheroscler Suppl. 2005 May;6(2):3-6
15823490
Diabetes Care. 2002 Oct;25(10):1790-4
12351479
Diabetes Care. 2005 Sep;28(9):2289-304
16123508
Am J Epidemiol. 2002 Dec 1;156(11):1070-7
12446265
BMC Fam Pract. 2006 Jul 07;7:43
16827937
Diabetes Care. 2003 Nov;26(11):3153-9
14578254
Clin Chem. 1992 Mar;38(3):411-3
1547561
Z Arztl Fortbild Qualitatssich. 2002 Mar;96(3):183-8
12017762