Abstract 11095: Prevalence of Metabolic Syndrome in Healthy Middle-Aged Adults: Insights from the Primary Care Audit of Global Risk Management (PARADIGM) Study

Abstract

BACKGROUND: The metabolic syndrome (MS) is associated with increased risk for cardiovascular disease and all-cause mortality. We assessed the prevalence of MS and associated clinical characteristics in healthy, middle-aged Canadians in the PARADIGM study.

METHODS: The PARADIGM study enrolled 3015 men >/=40y and women >/=50y in an observational primary prevention registry.The present analysis reports on those subjects who were found to have MS (NCEP ATP III criteria) within this cohort.

RESULTS:The overall prevalence of MS in the PARADIGM population was 29% (n=874). Subjects with MS were older than those without (56.9±8.2 vs 56±8.5y, p=.01). Gender distribution was similar (female 28.8% vs male 29.1%). Subjects with MS, compared to those without, had a larger waist circumference (40.8±5 vs 35.9±4.8 inches, p<.01), higher triglyceride levels (197.6±116.1 vs 114.3±67.1 mg/dL, p<.01), lower levels of high-density lipoprotein (45.1±11.9 vs 56.7±15 mg/dL, p <.01), and were more likely to have hypertension (54.3 vs 20.6%, p<.01) and impaired fasting glucose (IFG) (60.1 vs 23.8%, p<.01). There was no significant difference in levels of low density lipoprotein (LDL) (139.1±31.9 vs 137.1±32.6 mg/dL, p=NS) in subjects with MS vs non-MS. Past or current smoking was more common in MS (39.8 vs 32.6%, p<.01) as was family history of premature vascular disease (28.5 vs 22.6%, p<.01). MS was more prevalent in South Asians, compared to white Caucasians (37.6 vs. 30.1%, p<.05) or Chinese Canadians (17.3% p<.01). Levels of hsCRP were significantly higher in subjects with MS (4.2 vs 2.4 mg/L, p<.01) as was body mass index (BMI) (30.8±5.6 vs 26.5±4.5 kg/ m², p<.01). The mean total cardiovascular Framingham Risk Score (FRS) for MS vs non-MS was 19.7% vs 12.7% (p<.01). Despite being of similar age, 78% of MS subjects were at moderate to high risk by FRS, compared to 48% of non-MS subjects.

CONCLUSIONS: In PARADIGM, 29% of healthy, non-diabetic Canadian adults have MS. The highest prevalence of MS was amongst South Asians, and the lowest amongst Chinese Canadians. A number of traditional and novel risk markers/factors were more prevalent in MS subjects. Despite similar age and LDL levels, subjects with MS were more likely to have a moderate or high FRS than subjects without MS.