Cilj. Utvrditi ucestalost metabolickog sindroma (MS) u dijabeticara tipa 2 i razlike u njegovoj prevalenciji po kriterijima Svjetske zdravstvene organizacije (SZO) i Americkog nacionalnog programa
edukacije o kolesterolu (NCEP-ATP III).
Ispitanici i metode. Ukljuceni su svi dijabeticari tipa 2 stari 18 godina, u skrbi cetiri obiteljska lijecnika (LOM) koji medicinsku dokumentaciju vode elektronskim putem. Prireden je anketni upitnik s pitanjima o sociodemografskim podacima, životnim navikama, komorbiditetu, trajnoj medikamentnoj terapiji, antropometrijskim mjerenjima i cimbenicima kardiovaskularnog rizika. Svi podaci, osim antropometrijskih mjerenja (visina, težina, opseg struka), prikupljeni su retrospektivno.
Rezultati. Analizirana su 243 dijabeticara tipa 2, što cini 3,79% od 6400 osiguranika u skrbi. Od toga je bilo 120 (49,4%) žena i 123 (50,6%) muškarca, prosjecne dobi 66,68 ± 9,23 godine. Prema definiciji SZO metabolicki sindrom ima 62 (25,2%), a po kriterijima NCEP-ATP III 117 (48,1%), ispitanika što je statisticki znacajna razlika (2 = 31,80; P < 0,001). MS je bio znacajno cešci u skupini ispitanika koji prekomjerno piju (2 = 13,56; P = 0,001), kao i tjelesno neaktivnih dijabeticara (2 = 10,52; P = 0,005).
Zakljucak. Rezultati ovog istraživanja pokazuju relevantno vecu ucestalost MS-a u dijabeticara tipa 2 po kriterijima NCEP-ATP III, nego po kriteriju SZO o cemu treba voditi racuna pri usporedivanju razlicitih podataka. Mjerenje opsega struka trebalo bi implementirati u svakodnevni rad LOM-a. Temelj lijecenja MS su nefarmakološke mjere (gubitak težine i tjelovježba). Specificni odnos lijecnik – bolesnik omogucuje utjecaj na mijenjanje navika i ponašanja bolesnika. Zbog slabe percepcije odgodenog rizika to je najteže
provediva, a najucinkovitija mjera lijecenja MS-a.Aim. The aim of this study was to determine the frequency of the metabolic syndrome (MS) in type 2 diabetics and to investigate the possible difference in frequency, calculated according to the World Health Organisation (WHO) and The Third Report of The National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP-ATP III) criteria.
Subjects and methods. Enrolled were all type 2 diabetics aged 18, enlisted in four computorised family physician\u27s offices. The questionnaire created for the purpose of this study included sociodemographic and anthropometric data, data on life habits, comorbidity, medication and cardiovascular risk factors. Data were
collected from medical records retrospectively, while anthropometric data on body height, weight and waist measurement were collected by additional measurements.
Results. Data on 243 type 2 diabetics were collected (3.79% of 6440 patients enlisted), 120 (46.4%) female and 123 (50.6%) male. The average age was 66.68 ± 9.23. According to WHO criteria 62 (25.2%)
examinees in our sample met the metabolic syndrome criteria, while according to NCEP-ATP III criteria that number was significantly higher 117 (48.1%), ( = 31.8, P < 0.001). In our sample MS occurred more often in heavy alcohol drinkers ( = 13.56, P = 0.001) and in diabetics who lacked regular physical activity
( = 10.52, P = 0.005).
Conclusion. There are several MS definitions, those by WHO and NCEP-ATP III are the most often used. In this study a markedly higher prevalence of the metabolic syndrome among type 2 diabetics was observed when assessed according to NCEP-ATP III criteria, which must be kept in mind while comparing different data. Taking waist measurements is an easy and sensitive method of detecting MS and should be implemented in the family physician\u27s daily practice. Nonpharmacological measures (weight loss and exercise) are fundamental for MS treatment. The family physician has an unique opportunity to influence MS patients\u27 lifestyle modifications, which is the most effective and the most difficult measure to carry out because of the patients\u27 inadequate perception of delayed risk
