Erhöhter blutdruck und abdominale adipositas sind die häufigsten faktoren des metabolischen syndroms in einer kohorte von 35.869 patienten in der primärärztlichen versorgung

Introduction: The metabolic syndrome is a heterogenous complex clinically interpreted as an indicator of an increased risk of diabetes mellitus as well as cardiovascular morbidity and mortality. The metabolic syndrome is present if at least three out of five factors - hyperglycemia, visceral obesity, increased triglycerides, decreased HDL cholesterol, increased arterial blood pressure - are present. Aim of the analysis at hand was to quantify the single components and their relative importance for the prevalence of the metabolic syndrome in primary care in Germany. Methods: 1511 general practitioners were recruited for this study. Included were all patients aged 18 and above on a pre-defined study day irrespective of their reason for attendance. Data recorded included body height and weight, waist circumference, blood pressure, blood glucose, and serum lipids as well as life style, pre-existing disease, medication, and socio-demographic data. Results: Between October 10 and 15, 2005, a total of 35,869 patients (age range 18-99, 61 % women) were included. Increased arterial blood pressure was most frequent in men (67 %; 95%-confidence interval [CI]: 65.5-67.6) and women (53 %; 95%-CI: 51.9-53.9), followed by abdominal obesity (36 %; 95%-CI: 35.4-37.4 and 42 %; 95%-CI: 40.6-42.4, respectively). Increased triglycerides and reduced HDL cholesterol were frequent single criteria in younger patients while hyperglycemia increased with age. Abdominal obesity (84 % men, 93 % women) and increased blood pressure (93 % and 92 %, respectively) were however most frequent in all age groups. Conclusion: The frequency and relative importance of abdominal obesity and arterial hypertension for the metabolic syndrome suggest a screening for further risk factors. These data emphasize the importance of abdominal obesity for a "visual" screening in primary care.