Genetic Epidemiology of
Metabolic Syndrome is a multinational, family-based study to explore the genetic basis of the
metabolic syndrome. Atherogenic
dyslipidemia (defined as low plasma
high-density lipoprotein cholesterol with elevated
triglycerides (<25th and >75th percentile for age, gender, and country, respectively) identified affected subjects for the
metabolic syndrome. This report examines the frequency at which atherogenic
dyslipidemia predicts the
metabolic syndrome of the National
Cholesterol Education Program Adult Treatment Panel III (
ATP-III). One thousand four hundred thirty-six (854 men/582 women) affected patients by our criteria were compared with 1,672 (737
men/935 women) unaffected persons. Affected patients had more
hypertension,
obesity, and
hyperglycemia, and they met a higher number of
ATP-III criteria (3.2 +/- 1.1 SD vs 1.3 +/- 1.1 SD, p <0.001). Overall, 76% of affected persons also qualified for the
ATP-III definition (Cohen's kappa 0.61, 95% confidence interval 0.59 to 0.64), similar to a separate group of 464 sporadic, unrelated cases (75%). Concordance increased from 41% to 82% and 88% for ages < or =35, 36 to 55, and > or =55 years, respectively. Affected status was also independently associated with waist circumference (p <0.001) and fasting
glucose (p <0.001) but not systolic blood pressure (p = 0.43). Thus, the
lipid-based criteria used to define affection status in this study substantially parallels the
ATP-III definition of
metabolic syndrome in subjects aged >35 years. In subjects aged <35 years, atherogenic
dyslipidemia frequently occurs in the absence of other
metabolic syndrome risk factors.