Metabolic Syndrome

Table 1.

Risk Factor	Cutpoint
Abdominal obesity
Men	Waist circumference ≥ 40 inches
Women	Waist circumference ≥ 35 inches
Elevated triglycerides	≥ 150 mg/dL
Low HDL cholesterol:
Men	< 40 mg /dL
Women	< 50 mg/dL
Elevated blood pressure	≥ 130 / ≥ 85 mm Hg
Elevated fasting glucose	≥ 110 mg/dL

Table 1. ATP III Diagnostic Criteria for Metabolic Syndrome^[37]

Table 1.

Risk Factor	Cutpoint
Abdominal obesity
Men	Waist circumference ≥ 40 inches
Women	Waist circumference ≥ 35 inches
Elevated triglycerides	≥ 150 mg/dL
Low HDL cholesterol:
Men	< 40 mg /dL
Women	< 50 mg/dL
Elevated blood pressure	≥ 130 / ≥ 85 mm Hg
Elevated fasting glucose	≥ 110 mg/dL

Table 1. ATP III Diagnostic Criteria for Metabolic Syndrome^[37]

Table 2.

Risk Factor Component	Cutpoint for Abnormality
Overweight/obesity	BMI ≥ 25 kg/m²
Elevated triglycerides	≥ 150 mg/dL
Low HDL-C
Men	< 40 mg/dL
Women	< 50 mg/dL
Elevated blood pressure	≥ 130/85 mm Hg
2-hour postglucose challenge
Other risk factors	Family history of type 2 diabetes, hypertension, or cardiovascular disease
	Polycystic ovary syndrome
	Sedentary lifestyle
	Advancing age
	Ethnic groups having high risk for type 2 diabetes or cardiovascular disease

Table 2. AACE Diagnostic Criteria for the Insulin Resistance Syndrome*^[37]

AACE = American Association of Clinical Endocrinologists; BMI = body mass index
*Diagnosis depends on clinical judgment, which is based on risk factors.

Table 3.

Parameter	Mean (SD)
Parameter	Metabolic Syndrome (n = 194)	No Metabolic Syndrome (n = 382)
LDL-C, mg/dL
Baseline	187 (20)	186 (18)
Week 12	99 (31)	96 (25)
% change	-47 (15)	-48 (12)
HDL-C, mg/dL
Baseline	44 (9)	54 (13)
Week 12	49 (11)	58 (14)
% change	+10 (13)	+9 (12)
Triglycerides (mg/dL)
Baseline	216 (60)	155 (57)
Week 12	167 (64)	122 (50)
% change	-23 (20)	-19 (24)
Non-HDL-C (mg/dL)
Baseline	230 (23)	217 (21)
Week 12	132 (35)	120 (27)
% change	-43 (14)	-45 (12)
Non-HDL-C/HDL-C ratio
Baseline	5.4 (1.2)	4.2 (1.0)
Week 12	2.8 (1.1)	2.2 (0.8)
Δ %	-47 (15)	-48 (13)
ApoB (mg/dL)
Baseline	182 (22)	173 (20)
Week 12	115 (26)	106 (21)
% change	-37 (14)	-38 (12)
ApoA-I (mg/dL)
Baseline	141 (23)	155 (25)
Week 12	150 (25)	164 (27)
% change	+7 (13)	+6 (12)
ApoB/ApoA-1 ratio
Baseline	1.3 (0.3)	1.1 (0.2)
Week 12	0.8 (0.2)	0.7 (0.2)
% change	-40 (15)	-41 (13)

Table 3. Baseline and Week 12 Lipid Levels and Percent Change From Baseline in Patients With Hypercholesterolemia Treated With Rosuvastatin 10 mg

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Metabolic syndrome has emerged as a growing problem and a major clinical challenge. Multidisciplinary treatment combining therapeutic lifestyle counseling with lipid-altering pharmacotherapy is recommended to prevent or delay the development of CHD and/or type 2 diabetes in patients with metabolic syndrome. Future randomized controlled trials should be conducted in large numbers of patients with metabolic syndrome to evaluate the comparative benefits of different treatment approaches on hard endpoints (eg, mortality, cardiovascular events, and conversion to type 2 diabetes), as well as on surrogate endpoints (eg, glycemic regulation, lipid levels, and circulating thrombotic and inflammatory markers).

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References

Table 1.

Table 1.

Table 2.

Table 3.

Metabolic Syndrome: A Growing Clinical Challenge: Conclusions

Table of Contents

Table 1.

Table 1.

Table 2.

Table 3.

References

Faculty and Disclosures

Metabolic Syndrome: A Growing Clinical Challenge: Conclusions

Table of Contents