Familial Combined Hyperlipidemia, Metabolic Syndrome and Cardiovascular Disease

Our aim was to investigate the relationship between metabolic syndrome and cardiovascular disease (i.e., survivors of myocardial infarction) in patients with familial combined hyperlipidemia (FCH). We compared a group of 20 male patients with FCH who had survived a myocardial infarction with two other groups matched for age and body mass index, comprising 20 individuals with FCH who had not had a myocardial infraction and 20 control subjects. Plasma lipid, glucose, and insulin levels were determined. Metabolic syndrome was judged to present on the basis of World Health Organization (WHO) and National Cholesterol Education Program-Adult treatment panel (NCEP-ATPIII) criteria. Differences between the groups were evaluated using non-parametric tests and the association between ischemic coronary disease and other parameters was assessed by logistic regression analysis. According to WHO criteria, the metabolic syndrome was present in 19 FCH patients who had survived a myocardial infarction, in 11 individuals with FCH who had not had a myocardial infraction, and in six control subject (P<.001); the difference between FCH patients with and without myocardial infarction was significant (P<.01). Presence of the metabolic syndrome, as defined by WHO criteria, is a marker of cardiovascular risk in individuals with FCH.

Se estudia la relación entre síndrome metabólico (SM) e infarto agudo de miocardio (IAM) en la hiperlipidemia familiar combinada (HFC). Se comparan 20 sujetos varo-nes con HFC supervivientes a IAM con otras 2 series de sujetos emparejados por edad e índice de masa corporal (IMC): 20 individuos con HFC que no han presentado IAM y 20 controles sanos. Se determinaron los lípidos, la glucosa y la insulina en plasma y la presencia de SM de-finido por criterios de la Organización Mundial de la Salud (OMS) y National Cholesterol Education Program-Adults Treatment Panel (NCEP-ATP-III). El SM definido por cri-terios OMS se encontró en 19 sujetos con HFC e IAM, en 11 sujetos con HFC sin IAM y en 6 controles (p < 0,001); hubo diferencias significativas (p < 0,01) al comparar los sujetos con HFC con y sin IAM. No hubo diferencias sig-nificativas entre grupos de HFC al estudiar el SM por cri-terios ATP-III. La HFC es una dislipidemia primaria fre-cuentemente asociada con resistencia a la insulina y elevado riesgo cardiovascular. En los sujetos con HFC, la presencia de SM según criterios de la OMS es un marca-dor de riesgo cardiovascular.