Prevalence of the metabolic syndrome in a Turkish adult population.

AIM: The aim of the present study was to determine the prevalence of the metabolic syndrome using Adult Treatment Panel III (ATP III) criteria in Adana, a southern province of Turkey. METHODS: The randomly selected study population included 1637 adults who were 20-79 yr of age. The presence of > or = 3 of components like hypertension (defined as blood pressure > or = 130/> or = 85 mmHg on two separate examinations, or usage of antihypertensive agents), visceral obesity (waist circumference >88 cm in females and >102 cm in men), low HDL cholesterol level (<1.04 mmol/l in men and <1.29 mmol/l in females), high triglyceride level (a fasting triglyceride level > or = 1.7 mmol/l), fasting glucose level > or = 6.1 mmol/l, or usage of antihyperglycaemic drugs, indicated the metabolic syndrome. RESULTS: The prevalence of the metabolic syndrome was 33.4% and more common in women than in men (39.1 vs 23.7%; p<0.0001). Both women and men with the metabolic syndrome were older than subjects without. In men, frequencies of the metabolic syndrome in urban and rural areas were similar (23.1 vs 24.3%; p>0.05), but were markedly higher among women in rural than urban areas (44.5 vs 31.2%; p<0.0001). CONCLUSIONS: Developing countries like Turkey also need to start action to prevent and treat the components of the metabolic syndrome. Prevention of the modifiable risk factors, such as obesity and physical inactivity, and blood pressure control should be the key strategy for avoiding mortality and financial costs of the healthcare system, especially in view of limited resources.

Silent coronary artery disease in patients with type 2 diabetes mellitus.

The purpose of this study was to estimate the prevalence and risk factors of silent CAD in asymptomatic type 2 diabetic patients aged over 40 years. A total of 172 asymptomatic type 2 diabetic patients, mean age 54.42 years, with normal resting electrocardiogram were included in the study. Technetium-99m (Tc-99m) tetrofosmin cardiac single photon emission computed tomography myocardial scintigraphy with exercise testing or dipyridamole injection was performed on all patients. If this test was positive, coronary angiography was carried out and was considered to be positive with a stenosis of > or =70%. Abnormal perfusion pattern was found in 14 patients (8.14%). Significant coronary artery stenosis was found in 13 subjects (7.56%), confirming a high positive predictive value (92.86%) of this diagnostic procedure. A significant correlation was observed between silent CAD and male sex, retinopathy, hypertension, post-prandial blood glucose level, and low HDL-cholesterol level. Sex (OR=4.026; 95% CI, 1.187-13.659), hypertension (OR=5.564; 95% CI, 1.446-21.400) and retinopathy (OR=3.766; 95% CI, 1.096-12.948) were risk factors for CAD. Overall, 14.06% of asymptomatic male patients with type 2 diabetes mellitus presented silent CAD with significant angiographically documented coronary stenosis. This finding, along with the high positive predictive value of a noninvasive technique, indicates that routine screening for silent CAD would be useful in this patient subgroup especially when they have retinopathy or hypertension.