[Differences in the prevalence of metabolic syndrome according to the ATP-III and WHO definitions]. / Diferencias en la prevalencia del síndrome metabólico según las definiciones del ATP-III y la OMS.

BACKGROUND AND OBJECTIVE: The objective of the study is to know the prevalence of the metabolic syndrome (MS), as well as to know the differences in its prevalence according to the Adult Treatment Panel of the National Cholesterol Education Program (ATP-III) and World Health Organization (WHO) criteria. PATIENTS AND METHOD: Cross-sectional descriptive study performed in primary care in population of both sexes aged between 40 and 74 years. Variables studied were risk factors as well as each one of the components of MS, according to both definitions. RESULTS: We studied 358 patients, 161 (45%) men and 197 women. The prevalence of MS using the WHO criteria was 17.9% and according with the ATP-III criteria it was 23.5%. The prevalence increased with age and the body mass index. Both definitions agreed in the classification of MS in 80% of cases (kappa = 0.38). If we considered the definition of MS according to the WHO taken as the "gold standard", the ATP-III definition displays a sensitivity of 59.4%, specificity of 84.4% and negative predictive value of 90.5%. The agreement is greater in women and older than 60 years. CONCLUSIONS: The prevalence of MS is smaller with the WHO criteria. The agreement between both methods is scarce and the clinical application of the ATP-III criteria in primary care needs its homologation with clinic-epidemiological studies.

Diferencias en la prevalencia del síndrome metabólico según las definiciones del ATP-III y la OMS / Differences in the prevalence of metabolic syndrome according to the ATP-III and WHO definitions

FUNDAMENTO Y OBJETIVO: El objetivo del estudio fue conocer y comparar las diferencias en la prevalencia del síndrome metabólico (SM) estimada según las definiciones del Adult Treatment Panel III the National Cholesterol Education Program (ATP-III) y de la Organización Mundial dela Salud (OMS).PACIENTES Y MÉTODO: Estudio descriptivo transversal en atención primaria, en población de 40 a74 años. Se estudiaron los factores de riesgo así como cada uno de los componentes del SM, según ambas definiciones. RESULTADOS: Estudiamos a 358 pacientes, 161 (45%) varones y 197 mujeres. La prevalencia del SM según criterios de la OMS fue del 17,9% y según los del ATP-III, del 23,5%. Esta prevalencia aumenta con la edad y con el índice de masa corporal. Ambas definiciones coinciden en la clasificación en el 80% de los casos (índice de kappa = 0,38). Considerando de referencia la definición de la OMS, el ATP-III presenta una sensibilidad del 59,4%, una especificidad del 84,4% y un valor predictivo negativo del 90,5%, y la concordancia mayor en mujeres y en pacientes mayores de 60 años. CONCLUSIONES: La prevalencia del SM es menor con los criterios de la OMS. La concordancia entre los criterios de la OMS y los del ATP III es escasa. La aplicación clínica de los criterios del ATP-III en atención primaria precisa su homologación con estudios clinic epidemiológicos

BACKGROUND AND OBJECTIVE: The objective of the study is to know the prevalence of the metabolic syndrome (MS), as well as to know the differences in its prevalence according to the Adult Treatment Panel of the National Cholesterol Education Program (ATP-III) and World Health Organization(WHO) criteria. PATIENTS AND METHOD: Cross-sectional descriptive study performed in primary care in population f both sexes aged between 40 and 74 years. Variables studied were risk factors as well as each one of the components of MS, according to both definitions. RESULTS: We studied 358 patients, 161 (45%) men and 197 women. The prevalence of MSusing the WHO criteria was 17.9% and according with the ATP-III criteria it was 23,5%. The prevalence increased with age and the body mass index. Both definitions agreed in the classification of MS in 80% of cases (kappa = 0.38). If we considered the definition of MS according to the WHO taken as the «gold standard», the ATP-III definition displays a sensitivity of59.4%, specificity of 84.4% and negative predictive value of 90.5%. The agreement is greater in women and older than 60 years. CONCLUSIONS: The prevalence of MS is smaller with the WHO criteria. The agreement between both methods is scarce and the clinical application of the ATP-III criteria in primary care needs its homologation with clinic-epidemiologal studies