Metabolic syndrome across Europe: different clusters of risk factors

Eur J Prev Cardiol. 2015 Apr;22(4):486-91. doi: 10.1177/2047487314525529. Epub 2014 Mar 19.

Abstract

Background: Metabolic syndrome (MetS) remains a controversial entity. Specific clusters of MetS components - rather than MetS per se - are associated with accelerated arterial ageing and with cardiovascular (CV) events. To investigate whether the distribution of clusters of MetS components differed cross-culturally, we studied 34,821 subjects from 12 cohorts from 10 European countries and one cohort from the USA in the MARE (Metabolic syndrome and Arteries REsearch) Consortium.

Methods: In accordance with the ATP III criteria, MetS was defined as an alteration three or more of the following five components: elevated glucose (G), fasting glucose ≥110 mg/dl; low HDL cholesterol, < 40mg/dl for men or <50 mg/dl for women; high triglycerides (T), ≥150 mg/dl; elevated blood pressure (B), ≥130/≥85 mmHg; abdominal obesity (W), waist circumference >102 cm for men or >88 cm for women.

Results: MetS had a 24.3% prevalence (8468 subjects: 23.9% in men vs. 24.6% in women, p < 0.001) with an age-associated increase in its prevalence in all the cohorts. The age-adjusted prevalence of the clusters of MetS components previously associated with greater arterial and CV burden differed across countries (p < 0.0001) and in men and women (p < 0.0001). In details, the cluster TBW was observed in 12% of the subjects with MetS, but was far more common in the cohorts from the UK (32.3%), Sardinia in Italy (19.6%), and Germany (18.5%) and less prevalent in the cohorts from Sweden (1.2%), Spain (2.6%), and the USA (2.5%). The cluster GBW accounted for 12.7% of subjects with MetS with higher occurrence in Southern Europe (Italy, Spain, and Portugal: 31.4, 18.4, and 17.1% respectively) and in Belgium (20.4%), than in Northern Europe (Germany, Sweden, and Lithuania: 7.6, 9.4, and 9.6% respectively).

Conclusions: The analysis of the distribution of MetS suggested that what follows under the common definition of MetS is not a unique entity rather a constellation of cluster of MetS components, likely selectively risky for CV disease, whose occurrence differs across countries.

Keywords: Blood pressure; Europe; HDL cholesterol; epidemiology; glucose; metabolic syndrome; triglycerides; waist circumference.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Blood Glucose / analysis
  • Blood Pressure
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / physiopathology
  • Cholesterol / blood
  • Cluster Analysis
  • Cross-Cultural Comparison
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / epidemiology
  • Dyslipidemias / blood
  • Dyslipidemias / diagnosis
  • Dyslipidemias / epidemiology
  • Europe / epidemiology
  • Female
  • Humans
  • Hypertension / diagnosis
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Male
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / diagnosis
  • Metabolic Syndrome / epidemiology*
  • Metabolic Syndrome / physiopathology
  • Middle Aged
  • Obesity, Abdominal / diagnosis
  • Obesity, Abdominal / epidemiology
  • Prevalence
  • Risk Factors
  • Sex Distribution
  • Sex Factors
  • Triglycerides / blood
  • United States / epidemiology
  • Waist Circumference
  • Young Adult

Substances

  • Biomarkers
  • Blood Glucose
  • Triglycerides
  • Cholesterol