Metabolic syndrome – a risky combination

The metabolic syndrome is characterized by a cluster of related clinical, anthropometric and biochemical features such as central obesity, dysglycaemia, dyslipidaemia and hypertension. It is highly prevalent in the general population (approximately 22%), with differences in relation to race, gender, and age. It carries an increased cardiovascular morbidity and mortality, which makes an early and correct assessment mandatory. The prevalence of the metabolic syndrome is very high in type 2 diabetes patients, in whom it influences the risk of chronic complications. The aim of the present report is to explore the characteristics and the combination types of the metabolic syndrome and to assess the cardiovascular risk in patients presenting this clinical entity. 329 patients consecutively diagnosed with metabolic syndrome were included in the study, both men and women, no limit regarding age. Patient selection was made during the periodic medical visits in the outpatient clinics of Diabetes, Cardiology and Internal Medicine. Metabolic syndrome (MetS) was diagnosed according to 2005 International Diabetes Federation (IDF) Criteria. Women were more frequent than men, mean age was 59.08±888 and they all had central obesity (it is the major criteria of 2005 IDF definition for MetS) .The diagnosis of the metabolic syndrome was fulfilled with only 3 criteria, most of the times. The complete metabolic syndrome was the rarest, less than 25% of the patients presenting all 5 definition criteria and it was more frequent among men (men 39.2% vs women 15.9%: p < 0.0001). Apart from central obesity, which is mandatory for diagnosing MetS and thus present in all patients, arterial hypertension is the most common finding in our study population, with impaired glycaemia and increased triglycerides occupying the second and third place, respectively. Central obesity, arterial hypertension and impaired glycaemia represent the most frequent combination, a real „hard core” of MetS.

As expected, the cardiovascular risk was high in the study population. The cardiovascular „score” of our patients increased significantly with the number of components used for the diagnosis of MetS (MetS with 3 elements vs MetS with 4 elements vs MetS with 5 elements: SCORE - 5.36 ± 7.07 vs 7.66 ± 8.63 vs 8.52 ± 8.34, p < 0.01).