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Table 1 Demographic and clinical characteristics stratified by metabolic syndrome

From: Impact of metabolic syndrome on lipid target achievements in the Arabian Gulf: findings from the CEPHEUS study

Characteristic, n (%) unless specified otherwise All (N = 4171) No MetS (n = 1223) 29 % Mets (n = 2948) 71 % P value
Gulf citizen 3215 (77 %) 874 (71 %) 2341 (79 %) <0.001
Female gender 1711 (41 %) 366 (30 %) 1345 (46 %) <0.001
Age, mean ± SD, years 57 ± 11 57 ± 12 57 ± 11 0.620
Weight, mean ± SD, kg 82 ± 17 78 ± 17 84 ± 17 <0.001
Waist circumference, mean ± SD, cm 104 ± 14 99 ± 14 106 ± 13 <0.001
BMI, mean ± SD, kg/m2 31 ± 7 29 ± 6 32 ± 7 <0.001
BMI >30 kg/m2 2219 (53 %) 484 (40 %) 1735 (59 %) <0.001
Current smoker 517 (12 %) 168 (14 %) 349 (12 %) 0.090
Hypertension 2906 (70 %) 750 (61 %) 2156 (73 %) <0.001
Coronary heart disease 1511 (36 %) 554 (45 %) 957 (32 %) <0.001
Peripheral vascular disease 142 (3.4 %) 52 (4.3 %) 90 (3.1 %) 0.052
Cerebrovascular disease 183 (4.4 %) 53 (4.3 %) 130 (4.4 %) 0.913
Diabetes mellitus 3205 (77 %) 768 (63 %) 2437 (83 %) <0.001
HbA1c, mean ± SD,  % 8.62 ± 3.79 7.84 ± 2.61 8.88 ± 4.06 <0.001
HbA1c <7 % 820 (26 %) 320 (42 %) 500 (21 %) <0.001
ASCVD risk status
High risk 910 (22 %) 335 (27 %) 575 (20 %) <0.001
Very high risk 3261 (78 %) 888 (73 %) 2373 (81 %) <0.001
Dyslipidaemic therapy
Statin monotherapy 3928 (94 %) 1146 (94 %) 2782 (94 %) 0.218
Statin combination 202 (4.8 %) 67 (5.5 %) 135 (4.6 %) 0.486
Others 41 (1.0 %) 10 (0.8 %) 31 (1.1 %) 0.404
Lipid levels on treatment, mean ± SD, mmol/L, unless specified otherwise
TC 4.31 ± 1.11 4.15 ± 1.08 4.38 ± 1.12 <0.001
LDL-C 2.54 ± 0.94 2.43 ± 0.95 2.58 ± 0.93 <0.001
HDL-C 1.15 ± 0.31 1.30 ± 0.32 1.10 ± 0.28 <0.001
Apo B, g/L 0.92 ± 0.27 0.84 ± 0.26 0.95 ± 0.27 <0.001
Non-HDL-C 3.16 ± 1.09 2.85 ± 1.01 3.28 ± 1.09 <0.001
TG 1.75 ± 1.27 1.19 ± 0.46 1.98 ± 1.42 <0.001
Lipid goal attainments, n (%)
HDL-C goal 1952 (47 %) 963 (79 %) 989 (34 %) <0.001
LDL-C goal 1258 (30 %) 449 (37 %) 809 (27 %) <0.001
Apo B goal 1676 (40 %) 658 (54 %) 1018 (35 %) <0.001
Non-HDL-C goal 1715 (41 %) 673 (55 %) 1042 (35 %) <0.001
Blood pressure (BP), mean ± SD unless specified otherwise
Systolic BP, mmHg 133 ± 19 125 ± 17 136 ± 18 <0.001
Diastolic BP, mmHg 79 ± 10 75 ± 10 80 ± 10 <0.001
BP control, n (%) 2497 (60 %) 957 (78 %) 1540 (52 %) <0.001
  1. 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 (1.04 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)
  2. 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
  3. Despite the lack of a recommended HDL-C goal by guidelines, satisfactory HDL-C was defined as <40 mg/dL (1.04 mmol/L) for males or <50 mg/dL (1.3 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. For the highest risk group therapeutic lipoprotein targets were LDL-C <1.8 mmol/L, apo B <0.80 g/L and non-HDL-C <2.6 mmol/L
  4. BP goals were adapted from the new JNC-8 2014 Hypertension Guideline Management Algorithm. BP goals for those without diabetes mellitus (DM) and ≥60 years and those <60 years were <150/90 mmHg and <140/90 mmHg, respectively. For those with DM irrespective of age, the BP goal was <140/90 mmHg
  5. MetS metabolic syndrome, SD standard deviation, BMI body mass index, CHD coronary heart disease, PAD peripheral arterial disease, CVD cardiovascular disease, ASCVD atherosclerotic cardiovascular disease, TC total cholesterol, LDL-C low-density lipoprotein cholesterol, HDL-C high-density lipoprotein cholesterol, Apo B apolipoprotein B, TG triglyceride