Prevalence, ancillary clinical features and cardiovascular disease in the metabolic syndrome: The Bruneck study

The present study aimed at evaluating the prevalence of the Metabolic Syndrome, as assessed by WHO criteria, its ancillary clinical features and its risk of atherosclerosis and cardiovascular disease. We examined a population-based sample of 888 subjects, aged 40–79 years, living in Bruneck (northeastern Italy), among whom we identified subjects fulfilling the WHO criteria for diagnosing the Metabolic Syndrome. In these subjects and in the rest of the sample (Controls), several metabolic and nonmetabolic biochemical parameters were compared, and the 5-year change in carotid atherosclerosis (CA), and incident fatal and nonfatal coronary heart disease (CHD) were determined. The prevalence of the Metabolic Syndrome was 34.1%. Subjects with the Syndrome showed higher levels of oxidized low-density lipoprotein (LDL), apolipoprotein B, urate, leptin, fibrinogen, leukocytes, erythrocyte sedimentation rate (ESR), GOT, gamma-GT and soluble endothelial adhesion molecules (E-selectin, Vascular Adhesion Molecule-1/VCAM-1 and Intercellular Adhesion Molecule-1/ICAM-1), and lower apolipoprotein A concentrations. Insulin resistance increased with the increase in the number of abnormalities composing the Syndrome. Subjects with insulin resistance had more pronounced abnormalities in several classic and nonclassic parameters. Subjects with the Metabolic Syndrome had an increased 5-year incidence and progression of CA and incidence of CHD. The Metabolic Syndrome, in which insulin resistance plays a major role, occurs very frequently in the general population, has several ancillary features and is burdened by an increased risk of atherosclerosis and cardiovascular disease. © 2003, Elsevier B.V