Aims: To evaluate the prevalence of the metabolic syndrome (MS) in dyslipidemia consultations, according to the criteria established by the National Cholesterol Education Program Adult Treatment Panel III (ATP III); to classify patients with MS according to ATP III risk categories and prevention type (primary versus secondary); and to evaluate evolution to type 2 diabetes in these patients.
Methods: A retrospective study was conducted based on analysis of the clinical records of 470 patients followed in dyslipidemia consultations at Internal Medicine II of Coimbra University Hospitals. MS was defined as the presence of three or more of the following abnormalities: waist circumference > 102/88 cm (male/female), triglyceride levels > or =150 mg/dl, HDL-cholesterol level < 40/50 mg/dl (male/female), blood pressure > or = 130/85 mmHg and fasting glucose > or = 110 mg/dl. The patients were classified into three risk categories according to the major risk factors defined by ATP III, regardless of LDL-cholesterol level.
Results: MS was diagnosed in 31.3% of the patients; 53.7% were male and mean age was 52.7+/-11.9 years. The most prevalent anomaly was hypertriglyceridemia (95.9%), followed by waist circumference (76.1%), HDL cholesterol (73.5%), blood pressure (69.4%) and fasting glycemia (36.7%). Based on the risk categories identified by ATP III, 30.6% of the patients had no or only one risk factor, 66.7% had multiple (2 or more) risk factors and 2.7% had coronary disease or an equivalent risk profile. 97.3% of the patients with MS were in primary prevention. 18.4% developed diabetes, the majority within 1-3 years of the first consultation.
Conclusions: Our study identified a high MS prevalence in patients followed in dyslipidemia consultations, particularly in older age-groups. More than half of the MS patients had an intermediate risk profile and most of them were in primary prevention. We also found that a fifth of non-diabetic patients developed diabetes during follow-up.