Key result
Metabolic syndrome was not associated with a higher prevalence of early cardiovascular complications in patients with familial combined hyperlipoproteinemia.
Why the study?
Does the presence of metabolic syndrome increase the prevalence of early cardiovascular complications in patients with familial combined hyperlipoproteinemia?
Cross-Sectional (n=868)
Yes
Does the presence of metabolic syndrome increase the prevalence of early cardiovascular complications in patients with familial combined hyperlipoproteinemia?
Odds Ratio: 1.87 (95% CI 0.29–11.71)
p-value: p=0.502
Metabolic syndrome does not appear to add to the already elevated cardiovascular risk in patients with familial combined hyperlipoproteinemia, suggesting the risk is primarily driven by FCHL-specific factors like LDL-C and Lp(a).
Metabolic syndrome assessment should not yet change practice in familial combined hyperlipoproteinemia; leaves open primacy of FCHL-specific factors.
INTRODUCTION: Familial combined hyperlipoproteinemia (FCHL) is a very common and aggressive genetic mixed hyperlipoproteinemia, with many features similar to that of the metabolic syndrome (MS). We aimed to evaluate whether the presence of the MS per se could account for a significant part of the elevated cardiovascular disease (CVD) risk associated with FCHL. MATERIAL AND METHODS: A retrospective cross-sectional evaluation of MS features' influence on CVD prevalence in a large sample of adult Italian FCHL affected patients (64 familial clusters; 867 subjects) was carried out. RESULTS: Age is associated with early cardiovascular complications, both in men (OR 1.08, 95% CI: 1.05-1.11, p < 0.0001) and in women (OR 1.09, 95% CI: 1.04-1.13, p = 0.0001). No MS component appears to be related to cardiovascular complications in men, whilst only low plasma high-density lipoprotein cholesterol (HDL-C) shows such a relation in women. Among non-MS parameters, only low-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) (Lp(a)) plasma levels are significantly associated with early cardiovascular complications in male FCHL patients (LDL-C: OR 2.24, 95% CI: 1.02-4.91, p = 0.04; Lp(a): OR 4.64, 95% CI: 1.85-11.62, p = 0.001), but not in women (LDL-C: OR 1.83, 95% CI 0.53-6.34, p = 0.34; Lp(a): OR 3.65, 95% CI: 0.89-14.97, p = 0.07). CONCLUSIONS: Our data support the hypothesis that MS is not associated with a higher prevalence of cardiovascular complications in FCHL affected subjects, probably because of the strongest risk increase associated with the FCHL itself.
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Cicero et al. (2013) conducted a cross-sectional in Familial combined hyperlipoproteinemia (FCHL) (n=868). Metabolic syndrome vs. Absence of metabolic syndrome was evaluated on Early cardiovascular complications associated with metabolic syndrome (in men) (OR 1.87, 95% CI 0.29-11.71, p=0.502). Metabolic syndrome was not associated with a higher prevalence of early cardiovascular complications in patients with familial combined hyperlipoproteinemia.
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