Is mild hyperhomocysteinemia an additional risk factor of the metabolic syndrome?; [L'hyperhomocystéinémie est-elle un facteur de risque supplémentaire du syndrome métabolique?]

Introduction. - Metabolic syndrome is a cardiovascular risk factors cluster and hyperhomocysteinemia an obvious independant risk factor. Objective. - To ascertain if hyperhomocysteinemia is associated with the metabolic syndrome. Methods. - "Epimil" is a prospective epidemiologic survey, which began by a cross-sectionnal study of cardiovascular risk factors in a French population, which then will be followed for ten years for supervision and intervention. Initial data collection, blood pressure measurement, ECG and blood samples (biology and DNA) have been performed. For the metabolic syndrome, we used the criterias of the third report of the national cholesterol education program expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (NCEP ATP III). Results. - Out of 2045 men aged from 20 to 58 years (37.7 ± 8.7 years), 185 (9%) have metabolic syndrome (at least three criterias), 587 (29%) a blood homocysteine ≥ 12 μmol/L and 202 (10%)≥ 15 μmol/L. Homocysteinemia is 10.97 ± 5.01 μmol/L for the whole population and doesn't differ with (11.4 ± 6 μmol/L) or without (10.9 ± 5μmol/L) the metabolic syndrome, as does its values distribution. It's not correlate with the body mass index, waist and hip measurements, nor with glycemia, HbA1c, insulin resistance and cardiovascular risk markers (CRPus, microalbuminuria). It weakly correlates with systolic and diastolic blood pressure, creatinine clearance, tobacco use, cholesterolemia, triglycerides and free fatty acids but not with HDL and LDL fractions, nor lipoprotein (a). Among this population, it slightly contributes to the ten years vascular risk evaluated according to Framingham equations or Score system. Conclusions. - Homocysteinemia and the prevalence of hyperhomocysteinemia don't differ with or without the metabolic syndrome and doesn't correlate its main criterias. © 2005 Elsevier SAS. Tous droits réservés.