Fig. 4

Lipid target achievements (HDL-C, LDL-C, non HDL-C and Apo B) in patients with metabolic syndrome and high atherosclerotic cardiovascular disease (ASCVD) risk status stratified by gender (N = 575). HDL-C high-density lipoprotein cholesterol, LDL-C low-density lipoprotein cholesterol, Apo B apolipoprotein B. 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 3 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 (1.0 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 factors, LDL-C ≥190 mg/dL (severe hypercholesterolemia). Very high risk group included ASCVD (CHD, PAD, CVD), diabetes mellitus with ≥2 other major ASCVD risk factors. Despite the lack of a recommended HDL-C goal by guidelines, satisfactory HDL-C was defined as <40 mg/dL (1.03 mmol/L) for males or <50 mg/dL (1.29 mmol/L) for females. Therapeutic lipoprotein targets for the high risk patients were LDL-C <2.6 mmol/L, apo B <0.90 g/L and non-HDL-C <3.3 mmol/L