Fig. 1

Number of metabolic syndrome (MetS) risk factors (increased abdominal obesity, elevated triglycerides, reduced HDL-C, elevated blood pressure, and elevated blood glucose) in atherosclerotic cardiovascular disease (ASCVD) risk patients (N = 4171). As per recent unified definition by the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) using the modified National Cholesterol Education Program–Adult Treatment Panel III (NCEP ATP III) guidelines, MetS was defined as having three or more of the following criteria: (1) increased abdominal obesity (waist circumference of ≥94 cm for men and ≥80 cm for women for Middle Eastern (Mediterranean/European) populations), (2) elevated triglycerides of ≥150 mg/dL (1.7 mmol/L), (3) reduced HDL-C of <40 mg/dL (1.04 mmol/L) for males and <50 mg/dL (1.3 mmol/L) for females, (4) elevated BP ≥130 mmHg for systolic and/or ≥85 mmHg for diastolic, and (5) elevated fasting blood glucose of ≥100 mg/dL (5.6 mmol/L). Criteria for ASCVD risk status was adapted from the National Lipid Association criteria for atherosclerotic cardiovascular disease. High risk group included patients with ≥3 major ASCVD risk factors, diabetes mellitus (type 1 or 2) with 0/1 major ASCVD risk factor and LDL-C ≥190 mg/dL (5.02 mmol/L) (severe hypercholesterolemia). Very high risk group included ASCVD (CHD, PAD, CVD), diabetes mellitus with ≥2 other major ASCVD risk factors