Metabolic Syndrome in Families of Patients With "Premature" Coronary Heart Disease: Impact of 2009 Joint Interim Statement Criteria

Aim. To assess effect of transition from metabolic syndrome (MS) definition of International Diabetic Federation (IDF, 2005) to definition of Joint Interim Statement (JIS, 2009) on proportion of persons with MS among patients with premature coronary heart disease (CHD) and members of their families. Material. We examined 817 members of 375 families: 353-probands with premature CHD (65.7% men, 77.6% after MI, age 23-67 years); their 212 consorts (18.9% men, 5.7% with CHD, age 28-67 years), and 252 their children (52.4% men, without overt CHD, age 16-46 years). Parameters analyzed included body mass index (BMI), waist circumference, systolic/diastolic BP, serum high density lipoprotein (HDL) cholesterol (CH), triglycerides (TG). Impaired fasting glucose (IFG) and diabetes mellitus (DM) we defined according to ADA criteria. High BP was defined as prehypertension or hypertension (NHBPEP 4 report on high BP in children/adolescents or INC 7 criteria, depending on age). Results. Portions of individuals with MS according to JIS and IDF definitions were in the whole population 335/817 (41.0%) and 305/817 (37.3%), among probands 62.9% and 56.1%, consorts 37.3% and 36.8%, adult children 13.5% and 11.5%, respectively. All 305 persons with IDF MS satisfied JIS definition but JIS criteria identified MS in 30 more persons (25 with CHD). They were predominantly men (22/30), not obese (BMI range 19.1-29.1; median 25.5 kg/m(2)), with 3-4 AHA/NHLBI (2005) MS components, most had low HDL-CH (27); high TG (26), high BP (24), 14 persons had IFG, 5 DM. Conclusion. In this heterogeneous population the use of JIS definition resulted in diagnosis of MS in small additional portion (9%) of persons with obvious high risk already requiring interventions because of CHD and/or level of CHD risk factors.