Prevalencia del síndrome metabólico en la población adulta de Yecla (Murcia). Grado de acuerdo entre tres definiciones

Abstract

Objectives. To determine the prevalence of metabolic syndrome (MS), its components and insulin resistance (IR) in the adult population of Yecla. To study the variability between 3 definitions of the syndrome and IR. To identify the variables that predict the presence of IR and to verify the diagnostic validity of several strategies for predicting it. Design. Descriptive, cross-sectional study. Setting. Primary care, Yecla (Murcia), Spain. Participants. We studied 317 persons (292 with analysis) out of 424 selected by stratified (age and sex) random sampling from 18 059 people ≥30 years old and possessing a health card. Main measurements. We used WHO-98, NCEP III, and EGIR criteria for diagnosing MS, and WHO-99 for defining DM2, impaired basal glucose and impaired glucose tolerance. The following variables were collected: social, demographic and personal details, plasma lipid, glycosylated haemoglobin, microalbuminuria, and insulin levels. IR was defined by the HOMA method at ≥3.8 or as the highest quartile of basal insulinemia in normoglycaemic persons. Results. MS prevalence was NCEP 20.2% (95% CI, 15.6-24.8), WHO 35.3% (95% CI, 29.8-40.8), EGIR 24% (95% CI, 19.1-28.9), and IR was 27.7% (95% CI, 22.6-32.8). The sensitivity and specificity of NCEP, WHO, and EGIR criteria for detecting IR were (46% and 90%), (78% and 81%), and (73% and 95%), respectively. Insulin resistance was associated significantly with age, basal glycaemia, triglycerides, and waist circumference. Conclusions. Metabolic syndrome is common in Yecla (more so in men). There is disagreement between several diagnostic criteria for the syndrome, with NCEP criteria less sensitive in determining IR. A generally accepted definition is needed.