Article Figures & Tables
Figures
- Figure 1:
Case-finding algorithm for detecting cases of metabolic syndrome (MetS). All patients within this data set are assessed using the 10 possible combinations based on the case definition outlined in Table 1. Each combination consists of 3 factors. An individual is counted as having MetS only once despite the possibility for meeting the criteria in multiple combinations.
- Figure 2:
Flow of data extraction and cleaning from the NAPCReN-CPCSSN data repository. Note: BMI = body mass index, CPCSSN = Canadian Primary Care Sentinel Surveillance Network, dBP = diastolic blood pressure, NAPCReN = Northern Alberta Primary Care Research Network, sBP = systolic blood pressure.
- Figure 3:
Percentages of participants with and without metabolic syndrome (MetS) who have specific risk factors and diseases. The proportion of participants achieving MetS component cut-off points with and without MetS is numerically represented in parenthesis. Error bars indicate 95% confidence interval. Note: BP = blood pressure, HDL-C = high-density lipoprotein cholesterol.
- Figure 4:
Distributions of missing data in (A) those with metabolic syndrome and (B) those with a BMI ≥ 25. Panel A shows the percent missing of MetS factors among those with MetS. Panel B shows the percent missing of MetS factors among those who are overweight or obese (BMI ≥ 25) regardless of MetS status. The proportion of missing data among those with MetS (panel A) or those who are overweight or obese (panel B) is numerically presented in parentheses. Error bars indicate 95% confidence interval. Note: BMI = body mass index, FBG = fasting blood glucose, HbA1c = hemoglobin A1c, HDL = high-density lipoprotein, MetS = metabolic syndrome, sBP/dBP = systolic/diastolic blood pressure, TG = triglycerides.
- Figure 5:
Degree of missing data on physical examination and laboratory investigations among 0–5 factors for metabolic syndrome. Participants are numerically represented in parenthesis on the x-axis. Error bars indicate 95% confidence intervals. Note: BMI = body mass index, BP = blood pressure, FBG = fasting blood glucose, HbA1c = hemoglobin A1c, HDL = high-density lipoprotein, TG = triglycerides.
Tables
- Table 1:
Harmonized criteria for defining metabolic syndrome: 3 or more factors to make a diagnosis
Metabolic syndrome criteria Cut-off point* Overweight and obese BMI ≥ 25† Elevated BP‡ CPCSSN diagnosis of hypertension
or
systolic BP ≥ 130 mm Hg
or
diastolic BP ≥ 85 mm HgDysglycemia CPCSSN diagnosis of diabetes
or
HbA1c ≥ 6.0%
or
FBG ≥ 5.6 mmol/LHypertriglyceridemia Triglycerides ≥ 1.7 mmol/L Low HDL cholesterol HDL cholesterol ≥ 1.0 mmol/L in men, ≥ 1.3 mmol/L in women Note: BMI = body mass index, BP = blood pressure, CPCSSN = Canadian Primary Care Sentinel Surveillance Network, FBG = fasting blood glucose, HbA1c = hemoglobin A1c, HDL = high-density lipoprotein.
↵* Cut-off points are based on previously established formal criteria for metabolic syndrome, BMI, (25) elevated BP, HbA1c and FBG, (21) HDL cholesterol and triglycerides, (15), (18) and CPCSSN disease diagnosis. (26)
↵† BMI cut-off points for outliers at ≥ 15 and ≥ 50; if BMI is ≥ 30, central obesity can be assumed.
↵‡ BP cut-off points for outliers at 60–300 mm Hg systolic, 30–200 mm Hg diastolic.
- Table 2:
Baseline characteristics of study sample stratified by presence of metabolic syndrome*
Characteristic Total
n = 15 766Metabolic syndrome
n = 700No metabolic syndrome
n = 15 066No. (%)† Mean ± SD‡ No. (%) Mean ± SD‡ No. (%) Mean ± SD‡ Age, yr 15 766 (100.0) 30.9 ± 5.9 700 (100.0) 34.3 ± 4.8 15 066 (100.0) 30.8 ± 5.9 Sex, female 10 002 (63.4) – 346 (49.4) – 9656 (64.1) – BMI 11 835 (75.0) 27.9 ± 7.5 657 (93.8) 35.8 ± 10.6 11 178 (74.2) 27.4 ± 7.0 Systolic BP, mm Hg 14 185 (90.0) 119.2 ± 13.0 678 (96.8) 130.1 ± 13.3 13 507 (89.6) 118.7 ± 12.7 Diastolic BP, mm Hg 14 185 (90.0) 75.9 ± 9.9 678 (96.8) 84.1 ± 9.3 13 507 (89.6) 75.5 ± 9.7 FBG, mmol/L 2007 (12.7) 5.1 ± 1.3 343 (49.0) 5.7 ± 1.7 1664 (11.0) 5.0 ± 1.1 HbA1c, % 3846 (24.4) 5.4 ± 0.9 548 (78.3) 5.9 ± 1.4 3298 (21.9) 5.3 ± 0.7 Triglycerides, mmol/L, median (IQR) 2568 (16.3) 1.3 (0.2–2.4) 633 (90.4) 2.1 (1.0–3.2) 1935 (12.8) 1.1 (0.4–1.8) HDL cholesterol, mmol/L 2403 (15.2) 1.4 ± 0.4 608 (86.8) 1.1 ± 0.2 1795 (11.9) 1.4 ± 0.4 Note: BMI = body mass index, BP = blood pressure, FBG = fasting blood glucose, HbA1c = hemoglobin A1c, HDL = high-density lipoprotein, IQR = interquartile range, SD = standard deviation.
↵* For metabolic syndrome cases: overweight includes BMI ≥ 25; systolic BP ≥ 130 mm Hg and diastolic BP ≥ 85 mm Hg; FBG ≥ 5.6 mmol/L; HbA1c ≥ 6.0%; triglycerides ≥ 1.7 mmol/L; reduced HDL cholesterol < 1.0 (men), < 1.3 (women). Exclusion of outliers was based on expert clinical judgment for BMI < 15 and > 55, and BP outside the range of 60–300 mm Hg for systolic BP and 30–200 mm Hg for diastolic BP.
↵† Represents no. (%) of participants for whom these data were available, except for sex, which represents proportion of female participants.
↵‡ Unless stated otherwise.
- Table 3:
Prevalence of combinations meeting the minimum 3 factors for metabolic syndrome
Combination of metabolic syndrome factors* No. (%) of patients Metabolic syndrome
n = 700Overweight + elevated BP + hypertriglyceridemia 291 (41.6) Overweight + reduced HDL cholesterol + hypertriglyceridemia 247 (35.3) Overweight + elevated BP + reduced HDL cholesterol 226 (32.3) Overweight + elevated BP + dysglycemia 171 (24.4) Elevated BP + reduced HDL cholesterol + hypertriglyceridemia 159 (22.7) Overweight + dysglycemia + hypertriglyceridemia 115 (16.4) Overweight + dysglycemia + reduced HDL cholesterol 100 (14.3) Elevated BP + dysglycemia + hypertriglyceridemia 79 (11.3) Dysglycemia + reduced HDL cholesterol + hypertriglyceridemia 73 (10.4) Elevated BP + dysglycemia + reduced HDL cholesterol 67 (9.5) Note: BP = blood pressure, HDL = high-density lipoprotein.
↵* Elevated BP includes a Canadian Primary Care Sentinel Surveillance Network (CPCSSN) diagnosis of hypertension or BP ≥ 130/85 mm Hg. Dysglycemia includes validated CPCSSN diagnosis of diabetes or fasting blood glucose (FBG) ≥ 5.6 mmol/L or hemoglobin A1c (HbA1c) ≥ 6.0%. Overweight includes body mass index (BMI) ≥ 25. Hypertriglyceridemia includes triglycerides ≥ 1.7 mmol/L and reduced HDL cholesterol < 1.0 mmol/L (men), < 1.3 mmol/L (women).
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