Comparación de diferentes definiciones de síndrome metabólico y su relación con la estimación del riesgo cardiovascular

Introduction: Multiple definitions of metabolic syndrome (MS) are used in Peru; however, currently there is no consensus on which definition should be used in clinical practice. Objectives: To compare the estimations of cardiovascular disease (CVD) risk, obtained by means of the ACC/AHA ASCVD Risk Calculator, and to assess their level of agreement with different definitions of MS in patients treated in Lima, Peru. Materials and methods: Analytical cross-sectional study. The medical records, obtained through consecutive sampling, of 233 patients treated between October and December 2019 at the Hospital Nacional Hipolito Unanue (HNHU), Lima, Peru were reviewed. CVD risk was calculated using the virtual ACC/AHA ASCVD Risk Calculator, and the MS definitions of the WHO, NCEP-ATP III, IDF, AHA / NHLBI, JIS and ALAD were considered to compare CVD risk according to each definition. The agreement between the different MS definitions was calculated using the kappa coefficient based on the six levels of strength of agreement described by Landis and Koch. Results: The median CVD risk in patients with SM according to the definitions of the WHO, NCEP-ATP III, IDF, AHA / NHLBI, ALAD and JIS was 9.6 (3.9-20.35), 7.9 (3.1-18.6), 7.3 (3- 16.5), 7.8 (3-17.6), 7.1 (2.9-16.5), and 7.1 (3.1-16.5), respectively. The prevalence of MS according to JIS, IDF, ALAD, AHA / NHLBI, NCEP-ATP III and WHO definitions was 81.97%, 80.26%, 74.68%, 67.81%, 65.67%, and 51.14%, respectively. The concordance between the JIS criteria and those of IDF, ALAD, NCEP-ATP III and AHA / NHLBI was 0.944, 0.787, 0.592, and 0.567, respectively, but between those of JIS and WHO it was 0.286. Conclusions: There are differences between CVD risk estimations according to the different MS definitions used in Peru and considered in the present study, which may have an impact on the intensity of the therapeutic and preventive interventions performed in these patients.