Association of Cardiovascular Risk Factors in Hypertensive Subjects with Metabolic Syndrome De ned by Three Different De nitions

Transcription

1 ORIGINAL ARTICLE J Nepal Med Assoc 2011;51(184): Association of Cardiovascular Risk Factors in Hypertensive Subjects with Metabolic Syndrome De ned by Three Different De nitions Shrestha R 1, Jha SC 2, Khanal M 3, Gyawali P 3, Yadav BK 3, Jha B 3 1 Department of Biochemistry, Nepal Medical College, Kathmandu, Nepal 2 Department of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. 3 Department of Biochemistry, Tribhuvan University Teaching Hospital, Kathmandu, Nepal ABSTRACT Introduction: Different authorities have put forward their criteria to define metabolic syndrome (MetS). The aim of this study was to find the prevalence of MetS in hypertensive individuals by the available three different definitions from National Cholesterol Education Program (NCEP), International diabetes Federation () and and their association with other cardiac risk factors. Methods: After anthropometric measurements fasting blood was analyzed for glucose, lipids, high sensitivity C-reactive protein (hscrp) and anti-oxidized LDL antibody in 150 hypertensive individuals. A ten-year coronary heart disease risk was predicted using the Framingham risk score (FRS). Results: The prevalence of MetS was 54.7 % by NCEP, 42.0 % by ) and 18.7 % by. As many as 63.4 % had MetS by any definition, while only 9.4 % fulfilled all the criteria of the three definitions. The association of cardiac risk factors also varied according to the definition used. hscrp was significantly elevated in MetS compared to non-mets. Body mass index, waist circumference and HDL-C were associated in MetS defined by NCEP and. FRS was higher in MetS defined by Adult Treatment Panel and definitions. An increase in urine albumin and a decrease in egfr were associated with MetS individuals defined by only. Conclusion: There is a wide variation in the prevalence of MetS and associated cardiac risk factors according to three different definitions used. The different cardiac risk factors among MetS also vary with the definitions used. However, hscrp and emerging risk factor are significantly elevated in hypertensive individuals with MetS as defined by all definitions Keywords: Cardiovascular risk factors, hypertension, metabolic syndrome INTRODUCTION Correspondence: Mr. Rojeet Shrestha, Department of Biochemistry, Nepal Medical College, Atterkhel, Jorpati, Kathmandu, PO Box 13344, - cl.bichem@gmail.com, Mob no:

2 METHODS RESULTS 158

3 Table 1. Prevalence of the components of metabolic syndrome by three definitions (NCEP-ATPIII, and ) NCEP ATP III Figure 1 MetS 35 (49.3) 47 (59.5) 82 (54.7) 2 5 NCEP NCEP NCEP MALE 5 79 FMALE TOTAL Figure 2 MetS 12 (16.9) 16 (20.3) 28 (18.7) MetS 32 (45.0) 31 (39.2) 63 (42.0) 159

4 Table 2. Baseline characteristics in relation to the presence of the metabolic syndrome, by three definitions (NCEP- ATPIII, and ) 160

5 Table 3. Proportion of individuals with MetS (NCEP-ATPIII, or ) fulfilling each criteria of the syndrome NECP ATPIII MetS (n) MetS criteria: Total HTN Subjects (N) Table 4. Association of the grade of risk according to hscrp and FRS among Mets by the three definitions NCEP ATP III 161

6 DISCUSSION 162

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