Metabolic syndrome and atherosclerotic cardiovascular disease in non-diabetic adult patients with familial hypercholesterolemia: Data from the Hellas-FH registry

Background and Aims: We investigated the association of Familial Hypercholesterolemia (FH) with the Metabolic Syndrome (MetSyn) in a population of adult non-diabetic patients with heterozygous FH. Methods: Adult non-diabetic patients from the HELLAS FH registry were evaluated. The NCEP ATPIII criteria were used for the definition of the MetSyn. Patients were classified into 2 groups: with and without MetSyn. Demographic data, lipid profile and cardiovascular profile of the 2 groups were compared. Results: A total of 748 patients were evaluated, 41.1% of of whom had MetSyn. These patients were older (54±13 vs 46±14 years,p<0.001), had more often hypertension (34.8% vs 6.3%,p<0.001), abdominal obesity (70.8% vs 21.6%,p<0.001), impaired fasting glucose (39.8% vs 10.4%,p<0.001), and increased body mass index (77.6% vs 54.8%,p<0.001) as compared with patients without MetSyn. Lipid profile before hypolipidemic therapy was characterized by higher TG and lower HDL-C levels (150 vs 112 mg/dL; p<0.001 and 52 vs 57 mg/dL, p<0.001, respectively). Patients with MetSyn had more frequently established ASCVD (20.8% vs 11.7%; p<0.001), association that remained significant after adjustment for major ASCVD risk factors. Lipid profile on hypolipidemic therapy was characterized by higher TG and lower HDL-C levels (142 vs 93 mg/dL,p<0.001 and 50 vs 56 mg/dL,p<0.001, respectively). Hypolipidemic treatment did not differ between the 2 groups. The LDL-C goal achievement was numerically lower in the MetSyn group (2.1% vs 3.8%,p=NS). Conclusions: A total of 4 out of 10 non-diabetic patients with FH have the MetSyn. These patients have a more atherogenic lipid profile and an increased prevalence of ASCVD compared with non-MetSyn FH patients.