Self-measurement screening for metabolic syndrome

Researchers at the University Medical Center (UMC) Utrecht have shown that apparently healthy people measuring their own waist circumference can be a reliable and feasible first step in screening for the metabolic syndrome. This finding could form the basis of a focused screening program for risk factors for diabetes and cardiovascular disease to be implemented nationally.

In IJsselstein, in the Netherlands, a total of 11,862 apparently healthy men and women between the ages of 20 and 70 years were invited by their general practitioner to take part in the study. Of the 5,558 people who responded, 2,004 proved to have a large waist circumference. The participants measured their waist with a tape measure. If this was above 102 cm in men or 88 cm in women, they were invited to take part in further research to check for additional risk factors. The measurement of the waist circumference proved to be reliable. Of the 1,721 people with a large waist circumference who underwent further examinations, 473 met the criteria for metabolic syndrome. Nearly half of them were under the age of 50.

The metabolic syndrome is a cluster of risk factors for diabetes and cardiovascular disease, and involves having at least three of the following five risk factors: large waist circumference, elevated blood pressure, raised triglyceride level, raised glucose level and lowered HDL cholesterol level. People with the metabolic syndrome have an increased risk of developing diabetes and cardiovascular disease.

Encouraging results
Patients with the metabolic syndrome received an extensive explanation of the findings and advice on lifestyle from their own general practice. After one year it appeared that many of them had followed the health advice: half of them said they were exercising more, 17 percent of the smokers had stopped and there was an average weight loss of 2.1 kilograms. It is encouraging to see that after three years, most of the patients were still showing clear improvement and that more than half of them (53 percent) were no longer classified as having metabolic syndrome.

Screening proves reliable and feasible
Dr. Corine den Engelsen of the Julius Center for Health Sciences and Primary Health Care at UMC Utrecht, who recently received her doctorate for this study explains: “We have shown that a large proportion of an apparently healthy population has an elevated risk of developing diabetes and cardiovascular disease. This unique and relatively simple screening method, where patients measure their waist circumference and which is run by general practice, has proved to be reliable and feasible. It enables us to trace this major health problem. Moreover, we have been able to design a screening program for diabetes and cardiovascular disease in the overweight as recommended by the Dutch Health Council in 2004.

Dr. Corine den Engelsen was awarded her doctorate on February 12, 2013 at UMC Utrecht (Supervisor: Prof. Guy Rutten). She is currently training to be a general practitioner.

 

Reference:

Den Engelsen C (2012). Screening for metabolic syndrome in primary care. Thesis. Utrecht University, Utrecht, The Netherlands.