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Identifying metabolic syndrome without blood tests in young adults: The Terneuzen Birth Cohort

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Author: Kroon, M.L.A. de · Renders, C.M. · Kuipers, E.C.C. · Wouwe, J.P. van · Buuren, S. van · Jonge, G.A. de · Hirasing, R.A.
Type:article
Date:2008
Institution: TNO Kwaliteit van Leven
Source:European Journal of Public Health, 6, 18, 656-660
Identifier: 280012
doi: doi:10.1093/eurpub/ckn056
Keywords: Health · Metabolic syndrome · Tree regression · Blood examination · Blood pressure measurement · Body mass · Cardiovascular disease · Vohort analysis · Major clinical study · Non insulin dependent diabetes mellitus · Patient identification · Physical examination · Prevalence · Risk assessment · Statistical analysis · Technique · Tree regression · Waist circumference · Adolescent · Adult · Age Factors · Blood Pressure · Body Mass Index · Cohort Studies · Diagnosis, Differential · Female · Health Behavior · Humans · Lipids · Male · Metabolic Syndrome X · Netherlands · Physical Examination · Prevalence · Waist Circumference · Young Adult

Abstract

Background: Within the context of the obesity epidemic identifying young adults at risk for type 2 diabetes and cardiovascular disease is important. A practical approach is based on the identification of metabolic syndrome (MetS). Our objective was to develop a simple and efficient stepwise strategy to identify MetS in young adults. Methods: Subjects were part of a birth cohort (n = 2599) in Terneuzen, The Netherlands, born in 1977-86. In 2004-05: 642 of these young adults participated in a physical examination and blood tests. Tree regression was used to determine the optimal decision strategy to identify MetS. Results: Overall prevalence of MetS, defined according to the NCEP ATPIII, was 7.5%. The tree regression yielded an optimal stepwise strategy that eliminated the need for blood tests for the diagnosis of MetS in 50-90% of the cases, depending on the accepted level of error. A large group (52% of the total) with BMI <35 had a normal waist circumference (WC) and normal blood pressure (BP). None of them had MetS. Subjects with BMI ≥35 all had MetS. If BMI <30, 38% had an increased WC or increased BP with a risk of MetS of only 6%. So for them the omission of blood tests could also be considered. Conclusion: In most young adults MetS can be identified or excluded without blood tests by a simple and stepwise strategy, based on the measurement of BMI, WC and BP. This makes it possible to develop simple prevention strategies for young adults at risk for type 2 diabetes and cardiovascular disease. © The Author 2008. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. Chemicals/CAS: Lipids