cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1022Research ArticleМЕТАБОЛИЧЕСКИЙ СИНДРОМMETABOLIC SYNDROMEРаспространенность метаболического синдрома и отдельных его компонентов у пациентов с артериальной гипертензией и ожирениемPrevalence of metabolic syndrome and its components in patients with arterial hypertension and obesityЧазоваИ. Е.ChazovaI. E.TOL_77@rambler.ruМычкаВ. Б.MychkaV. B.TOL_77@rambler.ruЭриванцеваТ. Н.ErivantsevaT. N.TOL_77@rambler.ruОлимпиеваС. П.OlimpievaS. P.TOL_77@rambler.ruКиликовскийВ. В.KilikovskyV. V.TOL_77@rambler.ruИнститут клинической кардиологии им. А.Л. Мясникова РКНПК РосздраваA.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex, Russian Federal Agency of Health and Social DevelopmentРоссийский государственный медицинский университет, МоскваRussian State Medical University, Moscow20052012200546, ч.I5161Copyright © Чазова И.Е., Мычка В.Б., Эриванцева Т.Н., Олимпиева С.П., Киликовский В.В., 20052005Чазова И.Е., Мычка В.Б., Эриванцева Т.Н., Олимпиева С.П., Киликовский В.В.Chazova I.E., Mychka V.B., Erivantseva T.N., Olimpieva S.P., Kilikovsky V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1022

Цель. Сравнить распространенность метаболического синдрома (МС), диагностируемого с использованием двух версий (ВОЗ и АТР III) у пациентов с артериальной гипертензией (АГ) и ожирением. Материал и методы. Распространенность МС изучалась у пациентов с АГ и ожирением: 517 мужчин и 1041 женщины в возрасте 20-75 лет. Использовались две наиболее распространенные версии определения, предложенные Всемирной организацией здравоохранения (ВОЗ) и экспертами Национального института здоровья США (ATP III). Результаты. Из общего числа 1558 участников исследования МС был выявлен у 72% по версии ATP III и у 17% по версии ВОЗ. Распространенность МС в зависимости от пола была различной: у мужчин частота выявления МС по версии ATP III составила 62% и по версии ВОЗ 19%, у женщин частота определения МС по версии ATP III составила 76% и по версии ВОЗ 16%. Согласованность диагностики МС по обеим версиям была подтверждена у 44% пациентов с АГ: у 16% пациентов МС был обнаружен по обеим версиям и еще у 28% МС отсутствовал по обеим версиям МС. Расхождение в установлении диагноза МС было выявлено у 57% пациентов, которые имели МС только по одной из версий. Заключение. Для широкого использования в практической медицине необходимо иметь единое определение МС, либо использовать методы, согласующие разные определения.

Aim. To compare prevalence of metabolic syndrome (MS) by WHO and ATP III criteria, in patients with arterial hypertension (AH) and obesity. Material and methods. MS prevalence in obese AH patients was studied in 517 males and 1041 females aged 20- 75 years. Two most well-known definitions of MS, proposed by World Health Organization (WHO) and National Cholesterol Education Program’s Adults Treatment Panel III, National Institutes of Health, USA (ATP III, USA) were used. Results. Among 1558 participants, MS was diagnosed in 72% by ATP III criteria, and in 17% by WHO criteria. MS prevalence was gender-specific: in males, it was 62% (ATP III) or 19% (WHO), in females - 76% or 16%, respectively. MS diagnostic agreement was observed in 44% of the participants: MS was diagnosed by both definitions in 16%, and not diagnosed by both definitions in 28%. 58% of the patients had MS verified by only one diagnostic version. Conclusion. For wider use in clinical practice, unified MS definition should be created, or methods integrating different diagnostic criteria, should be introduced.

метаболический синдромраспространенностьартериальная гипертензияmetabolic syndromeprevalencearterial hypertensionReferencesHanson RL, Imperatore G, Bennett PH, Knowler WC. Components of the «metabolic syndrome» and the incidence of type 2 diabetes. Diabetes 2002; 51: 3120-7.Hanson RL, Imperatore G, Bennett PH, Knowler WC. Components of the «metabolic syndrome» and the incidence of type 2 diabetes. Diabetes 2002; 51: 3120-7.Lakka H-M, Laaksonen DE, Lakka TA, et al. The metabolic syndrome and total and cardiovascular disease mortality in middleaged men. JAMA 2002; 288: 2909-16.Lakka H-M, Laaksonen DE, Lakka TA, et al. The metabolic syndrome and total and cardiovascular disease mortality in middleaged men. JAMA 2002; 288: 2909-16.Pyorala M, Miettinen H, Halonen P, et al. Insulin resistance syndrome predicts the risk of coronary heart disease and stroke in healthy middle aged men: the 22-year follow-up results of the Helsinki Policemen Study. Arterioscler Thromb Vasc Biol 2000; 20: 538-44.Pyorala M, Miettinen H, Halonen P, et al. Insulin resistance syndrome predicts the risk of coronary heart disease and stroke in healthy middle aged men: the 22-year follow-up results of the Helsinki Policemen Study. Arterioscler Thromb Vasc Biol 2000; 20: 538-44.Zimmet P, Boyko EJ, Collier GR, et al. Etiology of the metabolic syndrome: potential role of insulin resistance, leptin resistance, and other players. Ann N Y Acad Sci 1999; 892: 25-44.Zimmet P, Boyko EJ, Collier GR, et al. Etiology of the metabolic syndrome: potential role of insulin resistance, leptin resistance, and other players. Ann N Y Acad Sci 1999; 892: 25-44.Xavier F. Pi-Sunyer Pathophysiology and Long-Term Management of the Metabolic Syndrome. Obesity Research 2004; 12: 174S-80.Xavier F. Pi-Sunyer Pathophysiology and Long-Term Management of the Metabolic Syndrome. Obesity Research 2004; 12: 174S-80.Mota M, Panus C, Mota E, et al. The metabolic syndrome-a multifaced disease. Rom J Intern Med 2004; 42(2): 247-55.Mota M, Panus C, Mota E, et al. The metabolic syndrome-a multifaced disease. Rom J Intern Med 2004; 42(2): 247-55.Reaven G. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595-607.Reaven G. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595-607.Liese AD, Mayer-Davis EJ, Haffner SM, et al. Development of the multiple metabolic syndrome: an epidemiologic perspective. Epidemiol Rev 1998; 20: 157-72.Liese AD, Mayer-Davis EJ, Haffner SM, et al. Development of the multiple metabolic syndrome: an epidemiologic perspective. Epidemiol Rev 1998; 20: 157-72.Ford ES, Giles WH. Comparison of the Prevalence of the Metabolic Syndrome Using Two Proposed Definitions. Diabetes Care 2003; 26(3): 575-81.Ford ES, Giles WH. Comparison of the Prevalence of the Metabolic Syndrome Using Two Proposed Definitions. Diabetes Care 2003; 26(3): 575-81.Jaber LA, Brown MB, Hammad A, et al. The Prevalence of the Metabolic Syndrome Among Arab Americans. Diabetes Care 2004; 27(1): 234-8.Jaber LA, Brown MB, Hammad A, et al. The Prevalence of the Metabolic Syndrome Among Arab Americans. Diabetes Care 2004; 27(1): 234-8.Keller KB, Lemberg L. Obesity and the metabolic syndrome. Am J Crit Care 2003; 12(2): 167-70.Keller KB, Lemberg L. Obesity and the metabolic syndrome. Am J Crit Care 2003; 12(2): 167-70.Андреева Г.Ф., Оганов Р.Г. Качество жизни у пациентов, страдающих артериальной гипертонией. Тер архив 2002; 1: 8-16.Андреева Г.Ф., Оганов Р.Г. Качество жизни у пациентов, страдающих артериальной гипертонией. Тер архив 2002; 1: 8-16.Barbagallo CM, Cavera G, Sapienza M, et al. Prevalence of overweight and obesity in a rural southern Italy population and relationships with total and cardiovascular mortality: the Ventimiglia di Sicilia project. Int J Obes Relat Metab Disord 2001; 25(2): 185-90.Barbagallo CM, Cavera G, Sapienza M, et al. Prevalence of overweight and obesity in a rural southern Italy population and relationships with total and cardiovascular mortality: the Ventimiglia di Sicilia project. Int J Obes Relat Metab Disord 2001; 25(2): 185-90.Widlansky ME, Sesso HD, Rexrode KM, et al. Body mass index and total and cardiovascular mortality in men with a history of cardiovascular disease. Arch Intern Med 2004; 164(21): 2326-32.Widlansky ME, Sesso HD, Rexrode KM, et al. Body mass index and total and cardiovascular mortality in men with a history of cardiovascular disease. Arch Intern Med 2004; 164(21): 2326-32.Stevens J, Cai J, Pamuk ER, et al. The effect of age on the association between body–mass index and mortality. N Engl J Med 1998; 338(1): 1-7.Stevens J, Cai J, Pamuk ER, et al. The effect of age on the association between body–mass index and mortality. N Engl J Med 1998; 338(1): 1-7.Arauz-Pacheco C, Parrott MA, Raskin P. The Treatment of Hypertension in Adult Patients With Diabetes. Diabetes Care 2002; 25(1): 134-47.Arauz-Pacheco C, Parrott MA, Raskin P. The Treatment of Hypertension in Adult Patients With Diabetes. Diabetes Care 2002; 25(1): 134-47.Katzmarzyk PT, Church TS, Janssen I, et al. Metabolic Syndrome, Obesity, and Mortality: Impact of cardiorespiratory fitness. Diabetes Care 2005; 28(2): 391-7.Katzmarzyk PT, Church TS, Janssen I, et al. Metabolic Syndrome, Obesity, and Mortality: Impact of cardiorespiratory fitness. Diabetes Care 2005; 28(2): 391-7.Kip KE, Marroquin OC, Kelley DE, et al. Clinical importance of obesity versus the metabolic syndrome in cardiovascular risk in women: a report from the Women’s Ischemia Syndrome Evaluation (WISE) study. Circulation 2004; 109(6): 706-13.Kip KE, Marroquin OC, Kelley DE, et al. Clinical importance of obesity versus the metabolic syndrome in cardiovascular risk in women: a report from the Women’s Ischemia Syndrome Evaluation (WISE) study. Circulation 2004; 109(6): 706-13.Wilson PW, Kannell WB, Silbershatz H, D’Agostino RB. Clustering of metabolic factors and coronary heart disease. Arch Intern Med 1999; 159: 1104-9.Wilson PW, Kannell WB, Silbershatz H, D’Agostino RB. Clustering of metabolic factors and coronary heart disease. Arch Intern Med 1999; 159: 1104-9.Malik S, Wong ND, Franklin SS, et al. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults. Circulation 2004; 110(10): 1245-50.Malik S, Wong ND, Franklin SS, et al. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults. Circulation 2004; 110(10): 1245-50.Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1. Diagnosis and classification of diabetes mellitus, provisional report of a WHO consultation. Diabet Med 1998; 15: 539-53.Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1. Diagnosis and classification of diabetes mellitus, provisional report of a WHO consultation. Diabet Med 1998; 15: 539-53.Nishtar S, Faruqui AM, Mattu MA, et al. The National Action Plan for the Prevention and Control of Non-communicable Diseases and Health Promotion in Pakistan--Cardiovascular diseases. J Pak Med Assoc 2004; 54(12 Suppl 3): S14-25.Nishtar S, Faruqui AM, Mattu MA, et al. The National Action Plan for the Prevention and Control of Non-communicable Diseases and Health Promotion in Pakistan--Cardiovascular diseases. J Pak Med Assoc 2004; 54(12 Suppl 3): S14-25.Rantala AO, Kauma H, Lilja M, et al. Prevalence of the metabolic syndrome in drug-treated hypertensive patients and control subjects. J Intern Med 1999; 245(2): 163-74.Rantala AO, Kauma H, Lilja M, et al. Prevalence of the metabolic syndrome in drug-treated hypertensive patients and control subjects. J Intern Med 1999; 245(2): 163-74.Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486-97.Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486-97.Alvarez Cosmea A, Lopez Fernandez V, Suarez Garcia S, et al. Differences in the prevalence of metabolic syndrome according to the ATP-III and WHO definitions. Med Clin (Barc) 2005; 124(10): 368-70.Alvarez Cosmea A, Lopez Fernandez V, Suarez Garcia S, et al. Differences in the prevalence of metabolic syndrome according to the ATP-III and WHO definitions. Med Clin (Barc) 2005; 124(10): 368-70.Enkhmaa B, Shiwaku K, Anuurad E, et al. Prevalence of the metabolic syndrome using the Third Report of the National Cholesterol Educational Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) and the modified ATP III definitions for Japanese and Mongolians. Clin Chim Acta 2005; 352(1-2): 105-13.Enkhmaa B, Shiwaku K, Anuurad E, et al. Prevalence of the metabolic syndrome using the Third Report of the National Cholesterol Educational Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) and the modified ATP III definitions for Japanese and Mongolians. Clin Chim Acta 2005; 352(1-2): 105-13.Tan CE, Ma S, Wai D, et al. Can we apply the National Cholesterol Education Program Adult Treatment Panel definition of the metabolic syndrome to Asians? Diabetes Care 2004; 27(5): 1182-6.Tan CE, Ma S, Wai D, et al. Can we apply the National Cholesterol Education Program Adult Treatment Panel definition of the metabolic syndrome to Asians? Diabetes Care 2004; 27(5): 1182-6.de Ferranti SD, Gauvreau K, Ludwig DS, et al. Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation 2004; 110(16): 2494-7.de Ferranti SD, Gauvreau K, Ludwig DS, et al. Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation 2004; 110(16): 2494-7.Alvarez Leon EE, Ribas Barba L, Serra Majem L. Prevalence of the metabolic syndrome in the population of Canary Islands, Spain. Med Clin (Barc) 2003; 120(5): 172-4.Alvarez Leon EE, Ribas Barba L, Serra Majem L. Prevalence of the metabolic syndrome in the population of Canary Islands, Spain. Med Clin (Barc) 2003; 120(5): 172-4.Oh JY, Hong YS, Sung YA, et al. Prevalence and factor analisis of metabolic syndrome in an urban Korean population. Diabetes Care 2004; 27(8): 2027-32.Oh JY, Hong YS, Sung YA, et al. Prevalence and factor analisis of metabolic syndrome in an urban Korean population. Diabetes Care 2004; 27(8): 2027-32.Wyszynski DF, Waterworth DM, Barter PJ, et al. Relation between atherogenic dyslipidemia and the Adult Treatment Program-III definition of metabolic syndrome (Genetic Epidemiology of Metabolic Syndrome Project): Am J Cardiol 2005; 95(2): 194-8.Wyszynski DF, Waterworth DM, Barter PJ, et al. Relation between atherogenic dyslipidemia and the Adult Treatment Program-III definition of metabolic syndrome (Genetic Epidemiology of Metabolic Syndrome Project): Am J Cardiol 2005; 95(2): 194-8.Schillaci G, Pirro M, Vaudo G, еt al. Prognostic value of the metabolic syndrome in essential hypertension. JACC 2004; 43(10): 1817-22.Schillaci G, Pirro M, Vaudo G, еt al. Prognostic value of the metabolic syndrome in essential hypertension. JACC 2004; 43(10): 1817-22.Vazquez Vigoa A, Vazquez Cruz A, Calderin RO, et al. Metabolic syndrome in patients with essential hypertension. Nefrologia 2003; 23(5): 423-31.Vazquez Vigoa A, Vazquez Cruz A, Calderin RO, et al. Metabolic syndrome in patients with essential hypertension. Nefrologia 2003; 23(5): 423-31.Vidal J, Morinigo R, Codoceo VH, et al. The importance of diagnostic criteria in the association between the metabolic syndrome and cardiovascular disease in obese subjects. Int J Obes Relat Metab Disord 2005; 29(6): 668-74.Vidal J, Morinigo R, Codoceo VH, et al. The importance of diagnostic criteria in the association between the metabolic syndrome and cardiovascular disease in obese subjects. Int J Obes Relat Metab Disord 2005; 29(6): 668-74.Athyros VG, Mikhailidis DP, Papageorgiou AA, et al. Prevalence of atherosclerotic vascular disease among subjects with the metabolic syndrome with or without diabetes mellitus: the METS-GREECE Multicentre Study. Curr Med Res Opin 2004; 20(11): 1691-701.Athyros VG, Mikhailidis DP, Papageorgiou AA, et al. Prevalence of atherosclerotic vascular disease among subjects with the metabolic syndrome with or without diabetes mellitus: the METS-GREECE Multicentre Study. Curr Med Res Opin 2004; 20(11): 1691-701.Scuteri A, Najjar SS, Morrell CH, et al. The metabolic syndrome in older individuals: prevalence and prediction of cardiovascular events: the cardiovascular health study. Diabetes Care 2005; 28(4): 882-7.Scuteri A, Najjar SS, Morrell CH, et al. The metabolic syndrome in older individuals: prevalence and prediction of cardiovascular events: the cardiovascular health study. Diabetes Care 2005; 28(4): 882-7.Muxfeldt ES. Demographic and clinical characteristics of hypertensive patients in the internal medicine outpatient clinic of a university hospital in Rio de Janeiro. Sao Paulo Med J 2004; 122(3): 87-93.Muxfeldt ES. Demographic and clinical characteristics of hypertensive patients in the internal medicine outpatient clinic of a university hospital in Rio de Janeiro. Sao Paulo Med J 2004; 122(3): 87-93.Abdul-Rahim HF, Husseini A, Bjertness E, et al. The metabolic syndrome in the West Bank population: an urban-rural comparison. Diabetes Care 2001; 24: 275-9.Abdul-Rahim HF, Husseini A, Bjertness E, et al. The metabolic syndrome in the West Bank population: an urban-rural comparison. Diabetes Care 2001; 24: 275-9.Al-Lawati JA, Mohammed AJ, Al-Hinai HQ, Jousilahti PJ. Prevalence of the metabolic syndrome among Omani adults. Diabetes Care 2003; 26: 1781-5.Al-Lawati JA, Mohammed AJ, Al-Hinai HQ, Jousilahti PJ. Prevalence of the metabolic syndrome among Omani adults. Diabetes Care 2003; 26: 1781-5.Ozsahin AK, Gokcel A, Sezgin N, et al. Prevalence of the metabolic syndrome in a Turkish adult population. Diabetes Nutr Metab 2004; 17(4): 230-4.Ozsahin AK, Gokcel A, Sezgin N, et al. Prevalence of the metabolic syndrome in a Turkish adult population. Diabetes Nutr Metab 2004; 17(4): 230-4.Jaber LA, Brown MB, Hammad A, et al. The prevalence of the metabolic syndrome among arab americans. Diabetes Care 2004; 27(1): 234-8.Jaber LA, Brown MB, Hammad A, et al. The prevalence of the metabolic syndrome among arab americans. Diabetes Care 2004; 27(1): 234-8.Horky K. The hypertensive metabolic syndrome. Vnitr Lek 1993; 39(9): 836-43.Horky K. The hypertensive metabolic syndrome. Vnitr Lek 1993; 39(9): 836-43.

The authors declare that there are no conflicts of interest present.