Identifying people with metabolic syndrome in primary care by screening with a mailed tape measure: A survey of 14,000 people in the Netherlands

ObjectivesTo determine the feasibility of population-based screening for metabolic syndrome (MetS) in primary care with self-measurement of waist circumference (WC) as first step, and the prevalence of MetS in a Dutch city.MethodsA survey of 14,000 people on the list of primary care physicians in the city of IJsselstein. All adults between 20 and 70 years on July 1st, 2006 were asked to measure their WC using a mailed tape measure. Participants with a high WC (> 88/102 cm for women/men) were invited for assessment of other factors defining MetS. For patients already known with cardiovascular risk factors, these data were collected from medical records.Results11,862 subjects were invited, of whom 6843 (58%) measured their WC. 2004 had a WC > 88/102 cm and 1721 participated in all examinations. In 473 MetS was detected. The sensitivity of the screening was 77%, the negative predictive value 96%. The prevalence of MetS, including patients known with cardiovascular risk factors, was 15.5%.ConclusionsA primary care physician-driven population screening with self-measurement of WC can identify adults with MetS. The estimated prevalence of MetS is 15.5%. This procedure creates possibilities for targeted screening, prevention and treatment of people who are at increased cardiovascular risk.