Metabolic Syndrome and Risk of Coronary, Cerebral, and Peripheral Vascular Disease in a Large Dutch Population With Familial Hypercholesterolemia
- Jamal S. Rana, MD, PHD12,
- Angelique C. Jansen, MD, PHD1,
- Aeilko H. Zwinderman, PHD3,
- Max Nieuwdorp, MD1,
- Emily S. van Aalst-Cohen, MD, PHD1,
- J. Wouter Jukema, MD, PHD4,
- Mieke D. Trip, MD, PHD1 and
- John J.P. Kastelein, MD, PHD1
- 1Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
- 2Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- 3Department of Medical Statistics, Academic Medical Center, Amsterdam, the Netherlands
- 4Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
- Address correspondence and reprint requests to John J.P. Kastelein, MD, PhD, Professor of Medicine, Chairman, Department of Vascular Medicine, Academic Medical Center, Meibergdreef 9, Room F4–159.2, 1105 AZ Amsterdam, Netherlands. E-mail: j.j.kastelein{at}amc.uva.nl
- CeVD, cerebrovascular disease
- CHD, coronary heart disease
- CVD, cardiovascular disease
- FH, familial hypercholesterolemia
- PVD, peripheral vascualar disease
Various studies (1–16) in recent years have reported that the metabolic syndrome is associated with an increase in cardiovascular disease (CVD). However, there is still an uncertainty about the clinical importance and consequences of the metabolic syndrome (17). There is paucity of data looking at the effect of metabolic syndrome, specifically on cerebrovascular (CeVD) (9,12,18,19) and peripheral vascular (PVD) disease. Heterozygous familial hypercholesterolemia (FH) is a common hereditary disorder of lipoprotein metabolism (prevalence 1:400). The disorder is caused by mutations in the LDL receptor gene. The objective of our study was to assess if there was an additional risk associated with the presence of metabolic syndrome for coronary disease, CeVD, and PVD in this high-risk population, which included patients inducted from 27 clinics around the Netherlands.
RESEARCH DESIGN AND METHODS
The database for the current study is the molecular diagnostic center for nationwide FH screening in the Netherlands, located at the Academic Medical Centre, University of Amsterdam. A total of 2,400 patients fulfilled the diagnostic criteria for FH and were included in the study. The inclusion and exclusion criteria for participation in the study and details of the data collection are outlined and previously discussed in detail (20–22). The ethics institutional review board of each participating hospital approved …
