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- September 3, 2010 |
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"CVD in 'Prediabetes': The Hoorn Study Experience"Prof. Robert J. Heine (biography)
English - 2005-04-15 - 23 minutes
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Summary :
Various definitions of the metabolic syndrome are applied. Their value to assess cardiovascular disease (CVD) risk is unclear. We compared the definitions proposed by the Adult Treatment Panel III (ATP3), World Health Organisation (WHO), European Group for the study of Insulin Resistance (EGIR), and American College of Endocrinology (ACE) with respect to the prevalence of the metabolic syndrome and with 10-year risk of fatal and non-fatal CVD in a population-based cohort in the Netherlands, the Hoorn Study. For this particular study the population comprised 615 men and 749 women, aged 50-75 and without diabetes or a history of CVD at baseline in 1989-1990. The prevalence of the metabolic syndrome at baseline ranged from 17 % to 32 %. The ATP3 definition was associated with about a twofold increase in age-adjusted risk of fatal CVD in men and nonfatal CVD in women. The WHO, EGIR, and ACE definitions were associated with slightly lower hazard ratios.
The risk increased with the number of prevailing risk factors. The prevalence of hyperinsulinaemia was higher in subjects with multiple risk factors, but definitions of the metabolic syndrome requiring the presence of elevated insulin level were not more strongly associated with risk.
In conclusion, the metabolic syndrome, however defined, is associated with an about twofold increased risk of incident cardiovascular morbidity and mortality in a European population. A more accurate assessment of CVD risk can be obtained by taking into account a sum score of the prevailing risk factors.
Learning objectives :
After viewing this presentation the participant will be able to discuss results from the Hoorn Study:
- Metabolic syndrome (different definitions) and CVD risk
- Metabolic syndrome and incident diabetes
- The predictive value of the metabolic syndrome compared to the sum of its components
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