ÙÔ˘ ªÂÙ·‚ÔÏÈÎÔ‡ ™˘Ó‰ÚfiÌÔ˘ Î·È ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘

μ·ıÌfi˜ Â›ÁÓˆÛ˘ Î·È ·ÔÙÂÏÂÛÌ·ÙÈ΋˜ ·ÓÙÈÌÂÙÒÈÛ˘

ÙÔ˘ ªÂÙ·‚ÔÏÈÎÔ‡ ™˘Ó‰ÚfiÌÔ˘ Î·È ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘

ÛÂ ÂÏÏËÓÈÎfi ÁÂÓÈÎfi ÏËı˘ÛÌfi*

¶ÂÚ›ÏË„Ë

∂ÈÛ·ÁˆÁ‹: ¢ÂÓ ˘¿Ú¯Ô˘Ó ÛÙÔȯ›· ÁÈ· ÙÔÓ ‚·ıÌfi Â›ÁÓˆÛ˘, ıÂÚ·›·˜ Î·È ·ÔÙÂÏÂÛÌ·ÙÈÎÔ‡ ÂϤÁ¯Ô˘ ÙÔ˘ ÌÂÙ·‚ÔÏÈÎÔ‡ Û˘Ó‰Úfi- ÌÔ˘ (ª™) Î·È ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘ Ô˘ Û¯ÂÙ›˙ÔÓÙ·È Ì ·˘ÍË̤ÓÔ Î·Ú-

‰È·ÁÁÂÈ·Îfi ΛӉ˘ÓÔ ÛÙÔÓ ÁÂÓÈÎfi ÏËı˘ÛÌfi.ª¤ıÔ‰ÔÈ:∞Ó¿Ï˘ÛË-ÙÔÌ‹

·ÓÙÈÚÔÛˆ¢ÙÈÎÔ‡ ‰Â›ÁÌ·ÙÔ˜ ÙÔ˘ ÂÏÏËÓÈÎÔ‡ ÂÓ‹ÏÈη ÏËı˘ÛÌÔ‡

(n=9.669), ·ÔÙÂÏÔ‡ÌÂÓÔ˘ ·fi ¿Ó‰Ú˜ Î·È Á˘Ó·›Î˜ (49% Î·È 51%

·ÓÙ›ÛÙÔȯ·), Ô˘ ‰È·Ì¤ÓÔ˘Ó Û ·ÛÙÈΤ˜, ËÌÈ·ÛÙÈΤ˜ Î·È ·ÁÚÔÙÈΤ˜ Â- ÚÈÔ¯¤˜ (55%, 23% Î·È 22% ·ÓÙ›ÛÙÔȯ·). ÃÚËÛÈÌÔÔÈ‹ıËÎ·Ó ÔÈ ÔÚÈÛÌÔ›

ÙÔ˘ National Cholesterol Education Program (NCEP-ATP III) Î·È Ù˘

International Diabetes Federation (IDF) ÁÈ· ÙÔ ª™.∞ÔÙÂϤÛÌ·Ù·:∏

‰ÈÔÚıˆÌ¤ÓË ˆ˜ ÚÔ˜ ÙËÓ ËÏÈΛ· Â›ÙˆÛË ÙÔ˘ NCEP ª™ ÛÙÔÓ ÁÂÓÈÎfi

ÏËı˘ÛÌfi ‹Ù·Ó 24,5% [95% ¢∂ 23,4-25,7%] (n=2,369). ∏ Â›ÙˆÛË

‹Ù·Ó ·ÚfiÌÔÈ· Û ¿Ó‰Ú˜ Î·È Á˘Ó·›Î˜ Î·È ·˘Í·ÓfiÙ·Ó Ì ÙËÓ ËÏÈΛ·.

™Ù· ¿ÙÔÌ· Ì NCEP ª™ Ë Â›ÙˆÛË Ù˘ ·ÚÙËÚȷ΋˜ ˘¤ÚÙ·Û˘ ‹Ù·Ó 71%, Ù˘ ·˘ÍË̤Ó˘ ÁÏ˘Îfi˙˘ ÓËÛÙ›·˜ 55%, Ù˘ ÂÏ·Ùو̤Ó˘ ¯·- ÌËÏ‹˜ ˘ÎÓfiÙËÙ·˜ ÏÈÔÚˆÙÂ˚Ó˘ 58%, ÙˆÓ ˘„ËÏÒÓ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ 63% Î·È Ù˘ ÎÔÈÏȷ΋˜ ·¯˘Û·ÚΛ·˜ 82%. ªfiÓÔ ÙÔ ¤Ó· ÙÚ›ÙÔ Â›¯Â Â›- ÁÓˆÛË ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘ ª™, ÏÈÁfiÙÂÚÔ ·fi ÙÔ ¤Ó· ٤ٷÚÙÔ ¤·ÈÚ- Ó ıÂÚ·›· ÁÈ’ ·˘Ù¿ Î·È Ôχ ÌÈÎÚfi ÔÛÔÛÙfi (≤10%) ·ÚÔ˘Û›·˙ ÈηÓÔÔÈËÙÈÎfi ¤ÏÂÁ¯Ô ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘ ª™. ∏ Â›ÁÓˆÛË Û˘ÁÎÂ- ÎÚÈÌ¤ÓˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘ ª™ (.¯. ·ÚÙËÚȷ΋ ˘¤ÚÙ·ÛË) Î·È ÂÔ̤- Óˆ˜ Ô ·ÔÙÂÏÂÛÌ·ÙÈÎfi˜ ¤ÏÂÁ¯fi˜ ÙÔ˘˜ ‹Ù·Ó ÌÈÎÚfiÙÂÚÔ˜ ·fi ·˘Ùfi

Ô˘ ÂÂÙ‡¯ıË Û ¿ÏϘ ÏËı˘ÛÌȷΤ˜ ÔÌ¿‰Â˜ Ô˘ ‰ÂÓ Â›¯·Ó ª™.

ªfiÓÔ ÙÔ 5% ÙˆÓ ·ÙfiÌˆÓ Ì ª™ ›¯·Ó Â›ÁÓˆÛË ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ ˆ˜

Û‡ÓÔÏÔ, ÙÔ 2% ¤·ÈÚÓ ıÂÚ·›· ÁÈ· fiÏ· Ù· Û˘ÛÙ·ÙÈο ÙÔ˘ Î·È ÌfiÓÔ ÙÔ 1% ›¯Â Ï‹ÚË ·ÔÙÂÏÂÛÌ·ÙÈÎfi ¤ÏÂÁ¯Ô. ªÂ ÙÔÓ ÔÚÈÛÌfi IDF Ë Â›-

ÙˆÛË ÙÔ˘ ª™ ‹Ù·Ó ˘„ËÏfiÙÂÚË (43,4%±77% ¤Ó·ÓÙÈ NCEP ª™) Î·È Ë Â›ÁÓˆÛË, Ë ıÂÚ·›· Î·È Ô ·ÔÙÂÏÂÛÌ·ÙÈÎfi˜ ¤ÏÂÁ¯Ô˜ ÙˆÓ Û˘ÛÙ·ÙÈ- ÎÒÓ ÙÔ˘ Ôχ ¯·ÌËÏfiÙÂÚ·. ™˘ÌÂÚ¿ÛÌ·Ù·:∏ Â›ÙˆÛË ÙÔ˘ ª™ ›- Ó·È ˘„ËÏ‹, ·ÏÏ¿ ÙÔ Û‡Ó‰ÚÔÌÔ ‰ÂÓ Â›Ó·È ÁÓˆÛÙfi ÛÙÔÓ ÂÏÏËÓÈÎfi ÁÂÓÈÎfi

ÏËı˘ÛÌfi. ∞˘Ùfi Ô‰ËÁ› Û ÂÍ·ÈÚÂÙÈο ¯·ÌËÏ¿ ÔÛÔÛÙ¿ ıÂÚ·›·˜

EÏÏËÓÈο ¢È·‚ËÙÔÏÔÁÈο XÚÔÓÈο 19, 2: 123 - 129, 2006

¶ÚˆÙfiÙ˘Ë ÂÚÁ·Û›·

μ.°. Õı˘ÚÔ˜

∂.™. °·ÓˆÙ¿Î˘

M. ª·ıÈ·Ó¿ÎË

I. ªÔÓ¤‰·˜

I.A. °Ô˘‰¤‚ÂÓÔ˜

A.A. ¶··ÁˆÚÁ›Ô˘

A. ¶··ı·Ó·Û›Ô˘

A.I. ∫·Î·Ê‹Î·

¢.¶. ªÈ¯·ËÏ›‰Ë˜

M. ∂ÏÈÛ¿Ê

1ªÔÓ¿‰Â˜ ∞ıËÚÔÛÎÏ‹ÚˆÛ˘ Î·È ªÂÙ·‚ÔÏÈÎÔ‡ ™˘Ó‰ÚfiÌÔ˘, μ′¶ÚÔ. ¶·ıÔÏÔÁÈ΋ ∫ÏÈÓÈ΋, πÔÎÚ¿ÙÂÈÔ ¡ÔÛÔÎÔÌ›Ô

2¶·ıÔÏÔÁÈ΋ ∫ÏÈÓÈ΋

¶·ÓÂÈÛÙËÌ›Ô˘ ∫Ú‹Ù˘,

∏Ú¿ÎÏÂÈÔ,

3∫·Ú‰ÈÔÏÔÁÈ΋ ∫ÏÈÓÈ΋ ¶·ÓÂÈÛÙËÌ›Ô˘

πˆ·ÓÓ›ÓˆÓ,

4¶·ıÔÏÔÁÈ΋ ∫ÏÈÓÈ΋ ¶·ÓÂÈÛÙËÌ›Ô˘

πˆ·ÓÓ›ÓˆÓ,

5Department of Clinical Biochemistry, Royal Free Hospital,

Royal Free and University College Medical School, Pond Street, London NW3 2QG,UK,

6OÌ¿‰· ∂ÚÁ·Û›·˜ ∞Ó›¯Ó¢Û˘ ηÈ

£ÂÚ·›·˜ ÙÔ˘ ªÂÙ·‚ÔÏÈÎÔ‡

™˘Ó‰ÚfiÌÔ˘ Ù˘ ∂ÏÏËÓÈ΋˜ ∂Ù·ÈÚ›·˜

∞ıËÚÔÛÎÏ‹ÚˆÛ˘, ∞ı‹Ó·,

7OÌ¿‰· ∂ÚÁ·Û›·˜ ∞Ó›¯Ó¢Û˘ ηÈ

£ÂÚ·›·˜ ÙÔ˘ ªÂÙ·‚ÔÏÈÎÔ‡

™˘Ó‰ÚfiÌÔ˘ Ù˘ ∂ÏÏËÓÈ΋˜ ∂Ù·ÈÚ›·˜

°ÂÓÈ΋˜ π·ÙÚÈ΋˜, £ÂÛÛ·ÏÔÓ›ÎË,

8OÌ¿‰· ∂ÚÁ·Û›·˜ ¶ÚfiÏ˄˘ ηÈ

∂ȉËÌÈÔÏÔÁ›·˜ Ù˘ ∂ÏÏËÓÈ΋˜

∂Ù·ÈÚ›·˜ ∫·Ú‰ÈÔÏÔÁ›·˜, ∞ı‹Ó·

* ∏ ÌÂϤÙË ·˘Ù‹ ¤ÁÈÓ ¯ˆÚ›˜ ÙËÓ ÔÈÎÔÓÔÌÈ΋ ˘ÔÛÙ‹ÚÈÍË ·fi Ê·Ú̷΢ÙÈ΋

ÂÙ·ÈÚ›· ‹ ›‰Ú˘Ì·. ªÂÚÈÎÔ› ·fi ÙÔ˘˜ Û˘ÁÁÚ·Ê›˜ ¤¯Ô˘Ó ‰ÒÛÂÈ ‰È·Ï¤ÍÂȘ,

¤¯Ô˘Ó ·Ú·ÎÔÏÔ˘ı‹ÛÂÈ È·ÙÚÈο Û˘Ó¤‰ÚÈ· Î·È Û˘ÌÌÂÙ›¯·Ó Û ÌÂϤÙ˜ ‹ Û˘Ì‚Ô˘Ï¢ÙÈο ÛÒÌ·Ù· Ô˘ ¯ÚËÌ·ÙÔ‰ÔÙ‹ıËÎ·Ó ·fi ‰È¿ÊÔÚ˜ Ê·Ú̷΢- ÙÈΤ˜ ÂÙ·ÈÚ›˜.

Î·È ·ÔÙÂÏÂÛÌ·ÙÈÎÔ‡ ÂϤÁ¯Ô˘ ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ Î·È ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘. ∂¿Ó Ë Î·Ù¿ÛÙ·ÛË ·˘Ù‹ ‰ÂÓ ‚ÂÏ- ÙȈı› Û‡ÓÙÔÌ·, ÙÔ ª™ ı· ÚÔηϤÛÂÈ ÌÈ· Ó¤· ÂȉË- Ì›· ηډȷÁÁÂÈ·ÎÒÓ ÓÔÛËÌ¿ÙˆÓ Ù· ÂfiÌÂÓ· ¯ÚfiÓÈ·.

∞˘Ùfi ηÏ› ÁÈ· Â›ÁÔ˘Û· ÂÈÌfiÚʈÛË ÙÔ˘ ÎÔÈÓÔ‡

Î·È Ù˘ È·ÙÚÈ΋˜ ÎÔÈÓfiÙËÙ·˜.

1. EÈÛ·ÁˆÁ‹

ŒÓ· ·fi Ù· ÛËÌ·ÓÙÈο ÂÈÙ‡ÁÌ·Ù· Ù˘ Û‡Á-

¯ÚÔÓ˘ È·ÙÚÈ΋˜ Â›Ó·È Ë ÂÏ¿ÙÙˆÛË Ù˘ ηډȷÁÁÂÈ-

·Î‹˜ (∫∞) ıÓËÙfiÙËÙ·˜ Î·È ÓÔÛËÚfiÙËÙ·˜ Ì ÙÔÓ

·ÔÙÂÏÂÛÌ·ÙÈÎfi ¤ÏÂÁ¯Ô ÙˆÓ ÙÚÔÔÔÈ‹ÛÈÌˆÓ ·- Ú·ÁfiÓÙˆÓ ÎÈÓ‰‡ÓÔ˘. ∏ Û˘Ó‡·ÚÍË ·Ú·ÁfiÓÙˆÓ ÎÈÓ‰‡ÓÔ˘ Ô˘ ÔÓÔÌ¿˙ÂÙ·È ÌÂÙ·‚ÔÏÈÎfi Û‡Ó‰ÚÔÌÔ (ª™) ·˘Í¿ÓÂÈ ÙÔÓ Î›Ó‰˘ÓÔ Ù˘ ∫∞ ıÓËÙfiÙËÙ·˜ Î·È ÓÔÛËÚfiÙËÙ·˜^1-7 Î·È Ù˘ ÔÏÈ΋˜ ıÓËÙfiÙËÙ·˜,²·ÎfiÌË Î·È ÛÙËÓ ·Ô˘Û›· ÎÏÈÓÈÎÒ˜ ÂÌÊ·ÓÔ‡˜ ∫∞ ÓfiÛÔ˘

‹/Î·È Û·Î¯·ÚÒ‰Ë ‰È·‚‹ÙË (™¢).^2,3 O ÔÚÈÛÌfi˜ ÙÔ˘

ª™ ÙÔ˘ National Cholesterol Educational Program (NCEP) Adult Treatment Panel III (ATP III)⁸›- Ó·È Û¯ÂÙÈο ÚfiÛÊ·ÙÔ˜ (2001). °È· ÙÔÓ ÏfiÁÔ ·˘Ùfi

‰ÂÓ ˘¿Ú¯Ô˘Ó ·ÚÎÂÙ¿ ÛÙÔȯ›· ÁÈ· ÙÔÓ ‚·ıÌfi Â›- ÁÓˆÛ˘, ıÂÚ·›·˜ Î·È ·ÔÙÂÏÂÛÌ·ÙÈÎÔ‡ ÂϤÁ¯Ô˘

ÙÔ˘ ª™ Î·È ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘ ÛÙÔÓ ÁÂÓÈÎfi ÏË- ı˘ÛÌfi. ∂›Ó·È Ôχ ¯Ú‹ÛÈÌÔ ÁÈ· ÙÔ˘˜ ÁÈ·ÙÚÔ‡˜ Î·È ÙÔ˘˜ ˘Ô„‹ÊÈÔ˘˜ ·ÛıÂÓ›˜ Ó· ¤¯Ô˘Ó ÁÓÒÛË ÙÔ˘

ª™, Ô‡Ùˆ˜ ÒÛÙ ӷ ÙÔ ·Ó·ÁÓˆÚ›˙Ô˘Ó Î·È Ó· ÙÔ ıÂ- Ú·Â‡Ô˘Ó ·ÔÙÂÏÂÛÌ·ÙÈο.

™ÙËÓ ·ÚÔ‡Û· ÏËı˘ÛÌȷ΋ ÌÂϤÙË-ÙÔÌ‹ ‰ÈÂ- ÚÂ˘Ó‹Û·Ì ÙËÓ Â›ÙˆÛË, ÙËÓ Â›ÁÓˆÛË, ÙË ıÂÚ·-

›· Î·È ÙÔÓ ·ÔÙÂÏÂÛÌ·ÙÈÎfi ¤ÏÂÁ¯Ô ÙÔ˘ ª™ Î·È ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘ ÛÙËÓ ∂ÏÏ¿‰·, ÌÈ· ÌÂÛÔÁÂȷ΋

¯ÒÚ·.

2. ™¯Â‰È·ÛÌfi˜ ÌÂϤÙ˘ Î·È Ì¤ıÔ‰ÔÈ

∏ ÌÂϤÙË ‰ÈÂÍ‹¯ıË Î·Ù¿ ÙË ‰È¿ÚÎÂÈ· ÙÔ˘ 2003 Î·È 2004 ÛÙËÓ ∂ÏÏ¿‰·. ™˘ÌÌÂÙ›¯·Ó 57 ÂÚ¢ÓËÙ¤˜,

·fi 6 ¡ÔÛÔÎÔÌ›·, 39 ∫¤ÓÙÚ· ÀÁ›·˜ Î·È ÙȘ OÌ¿-

‰Â˜ ∂ÚÁ·Û›·˜ ∞Ó›¯Ó¢Û˘ Î·È £ÂÚ·›·˜ ÙÔ˘ ªÂ- Ù·‚ÔÏÈÎÔ‡ ™˘Ó‰ÚfiÌÔ˘ Ù˘ ∂ÏÏËÓÈ΋˜ ∂Ù·ÈÚ›·˜

∞ıËÚÔÛÎÏ‹ÚˆÛ˘ Î·È Ù˘ ∂ÏÏËÓÈ΋˜ ∂Ù·ÈÚ›·˜ °Â- ÓÈ΋˜ π·ÙÚÈ΋˜. ∏ ÌÂϤÙË ÂÁÎÚ›ıËΠ·fi ∂ÈÛÙË- ÌÔÓÈ΋ ∂ÈÙÚÔ‹ Î·È Ë Û˘ÁηٿıÂÛË ÙˆÓ Û˘ÌÌÂÙÂ-

¯fiÓÙˆÓ ÂÏ‹ÊıË ÚÈÓ ÙËÓ Â›ÛÔ‰fi ÙÔ˘˜ ÛÙË ÌÂϤÙË.

2.1 OÚÈÛÌfi˜ ÙÔ˘ ª™. ™˘ÌÌÂÙ¤¯ÔÓÙ˜ Ô˘ ›-

¯·Ó 3 ‹ ÂÚÈÛÛfiÙÂÚ· ·fi Ù· ·Ú·Î¿Ùˆ ÎÚÈÙ‹ÚÈ·

(Û‡Ìʈӷ Ì ÙÔ NCEP ATP III⁸) ¯·Ú·ÎÙËÚ›ÛÙË- Î·Ó fiÙÈ ¤¯Ô˘Ó ª™:

1. ∫ÔÈÏȷ΋ ·¯˘Û·ÚΛ·: ÂÚ›ÌÂÙÚÔ˜ ̤Û˘

(¶ª) >102 cm ÁÈ· ¿Ó‰Ú˜ Î·È >88 cm ÁÈ· Á˘Ó·›Î˜

2. ÀÂÚÙÚÈÁÏ˘ÎÂÚȉ·ÈÌ›·: ÙÚÈÁÏ˘ÎÂÚ›‰È· ÓË-

ÛÙ›·˜ ≥1,7 mmol/l (150 mg/dl) ‹ ıÂÚ·›·

3. ÷ÌËÏ‹ ˘„ËÏ‹˜ ˘ÎÓfiÙËÙ·˜ ÏÈÔÚˆÙÂ˚ÓÈ- ΋ ¯ÔÏËÛÙÂÚfiÏË (HDL-Ã): <1,0 mmol/l (40 mg/dl) ÛÙÔ˘˜ ¿Ó‰Ú˜ Î·È <1,3 mmol/l (50 mg/dl) ÛÙȘ Á˘- Ó·›Î˜ ‹ ˘fi ıÂÚ·›·

4. ∞˘ÍË̤ÓË ·ÚÙËÚȷ΋ ›ÂÛË: ≥130/85 mm Hg ‹ ˘fi ·ÓÙÈ˘ÂÚÙ·ÛÈ΋ ıÂÚ·›·

5. ∞˘ÍË̤ÓË ÁÏ˘Îfi˙Ë ÓËÛÙ›·˜: ≥6,1 mmol/l (110 mg/dl) ‹ ÚÔËÁËı›۷ ıÂÚ·›·.

ŒÓ·˜ Ó¤Ô˜ ÔÚÈÛÌfi˜ ÁÈ· ÙÔ ª™ ÚÔÙ¿ıËΠ·fi ÙËÓ International Diabetes Federation (IDF)⁹Î·È ˘È- ÔıÂÙ‹ıËΠ·fi ÙËÓ European Association for the Study of Diabetes (EASD) Î·È ÙËÓ European Athe- rosclerosis Society (EAS). O ÔÚÈÛÌfi˜ IDF ‰È·Ù‹ÚËÛ 3 ·fi Ù· 5 ÎÚÈÙ‹ÚÈ· ÙÔ˘ NCEP ATP III (·˘Ù¿ ÁÈ· ÙËÓ

˘¤ÚÙ·ÛË, ÙËÓ ˘ÂÚÙÚÈÁÏ˘ÎÂÚȉ·ÈÌ›· Î·È ÙË ¯·ÌËÏ‹

HDL-Ã), ¤‚·Ï fï˜ Ó¤· ÎÚÈÙ‹ÚÈ· ÁÈ· Ù· ÂÓ·ÔÌ›- Ó·ÓÙ· 2 ÎÚÈÙ‹ÚÈ·. ∞˘Ùfi ‹Ù·Ó ÁÈ· ÙËÓ ÎÔÈÏȷ΋ ·¯˘- Û·ÚΛ· (¶ª >94 cm ÁÈ· ∂˘Úˆ·›Ô˘˜ ¿Ó‰Ú˜ ηÈ

>80 cm ∂˘Úˆ·›Â˜ Á˘Ó·›Î˜) Î·È ÁÈ· Ù· Â›‰·

ÁÏ˘Îfi˙˘ ÓËÛÙ›·˜ [>5,6 mmol/l (100 mg/dl)] ‹

ÚÔËÁÔ˘Ì¤Óˆ˜ ‰È·ÁÓˆÛı›˜ ™¢Δ2, fiˆ˜ ›¯Â ‹‰Ë

ÚÔÙ›ÓÂÈ Ë American Diabetes Association.¹⁰∏ ‰È¿- ÁÓˆÛË ÙÔ˘ ª™ Û‡Ìʈӷ Ì ÙÔÓ ÔÚÈÛÌfi IDF ··ÈÙ›

ÎÔÈÏȷ΋ ·¯˘Û·ÚΛ· + 2 ·fi Ù· 4 ¿ÏÏ· ÎÚÈÙ‹ÚÈ·.

2.2 ™¯Â‰È·ÛÌfi˜ ÌÂϤÙ˘ – ÏËı˘ÛÌfi˜. ΔÔ

ÚˆÙfiÎÔÏÏÔ Ù˘ Û˘Ó¯È˙fiÌÂÓ˘ ·˘Ù‹˜ ÌÂϤÙ˘ ¤¯ÂÈ

‹‰Ë ÂÚÈÁÚ·Ê›.^11,12∂Ó Û˘ÓÙÔÌ›·, ‹Ù·Ó ÌÈ· ·Ó¿Ï˘- ÛË-ÙÔÌ‹ ÂÓfi˜ ·ÓÙÈÚÔÛˆ¢ÙÈÎÔ‡ ‰Â›ÁÌ·ÙÔ˜ ∂ÏÏ‹- ÓˆÓ ÂÓËÏ›ÎˆÓ (9.669 Û˘ÌÌÂÙ¤¯ÔÓÙ˜ ¿Óˆ ÙˆÓ 18 ÂÙÒÓ). ŸÏÔÈ ‹Ù·Ó Ï¢ÎÔ› ¿Ó‰Ú˜ ‹ Á˘Ó·›Î˜ Ô˘

ηÙÔÈÎÔ‡Û·Ó ÌfiÓÈÌ· Û ·ÛÙÈΤ˜, ËÌÈ·ÛÙÈΤ˜ Î·È ÁˆÚÁÈΤ˜ ÂÚÈÔ¯¤˜.

2.3 ∂ÚÁ·ÛÙËÚȷΤ˜ ÂÍÂÙ¿ÛÂȘ. ªÂÙ¿ ·fi 12ˆÚË ÓËÛÙ›· ÚÔÛ‰ÈÔÚÈ˙fiÙ·Ó Ë ÔÏÈ΋ ¯ÔÏËÛÙÂ- ÚfiÏË, Ë HDL-Ã, Ù· ÙÚÈÁÏ˘ÎÂÚ›‰È·, ÔÈ ÙÚ·ÓÛ·ÌÈÓ¿- Û˜ Î·È Ë ÁÏ˘Îfi˙Ë ÓËÛÙ›·˜ fiˆ˜ ‹‰Ë ¤¯ÂÈ ÂÚÈ- ÁÚ·Ê›.^11,12

2.4 ™Ù·ÙÈÛÙÈ΋ ·Ó¿Ï˘ÛË. ∞˘Ù‹ ¤ÁÈÓ Ì ÙÔ

ÚfiÁÚ·ÌÌ· SPSS 11.01 (SPSS, Inc., Chicago, IL).

∏ Â›ÙˆÛË ÙÔ˘ ª™ Î·È Ù· ‰È·ÛÙ‹Ì·Ù· ÂÌÈÛÙÔÛ‡- Ó˘ (¢∂) 95% ¤ÁÈÓ·Ó Ì SPSS frequency Î·È explo- re procedures. ∏ ÔÌ·Ï‹ ηٷÓÔÌ‹ ÙˆÓ ÙÈÌÒÓ ‰ÔÎÈ- Ì¿ÛÙËΠ̠ÙË Ì¤ıÔ‰Ô Kolmogorov-Smirnov. ∏ ηٷÓÔÌ‹ ÙˆÓ ÙÈÌÒÓ ‹Ù·Ó ÔÌ·Ï‹ Î·È ¯ÚËÛÈÌÔÔÈ‹- ıËÎ·Ó Ù· unpaired Student’s t-tests Î·È Chi Square test ÁÈ· ÙȘ Û˘ÁÎÚ›ÛÂȘ. ∞ӷʤÚÂÙ·È Ë Ì¤ÛË ÙÈÌ‹

Î·È Ë ÛÙ·ıÂÚ‹ ·fiÎÏÈÛË ÙˆÓ ·ÚÈıÌËÙÈÎÒÓ ·Ú·Ì¤- ÙÚˆÓ. ª›· ÙÈÌ‹ Ì two tailed p<0,05 ıˆÚ›ÙÔ ÛÙ·- ÙÈÛÙÈο ÛËÌ·ÓÙÈ΋.

3. ∞ÔÙÂϤÛÌ·Ù·

3.1 ∂›ÙˆÛË ÙÔ˘ ª™ Î·È ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘. ™˘ÓÔÏÈο ÂÚÈÏ‹ÊıËÎ·Ó 9.669 ¿ÙÔÌ·, ̤Û˘

ËÏÈΛ·˜ 46 ± 18 ÂÙÒÓ. Δ· ¯·Ú·ÎÙËÚÈÛÙÈο ÙÔ˘˜ Â- ÚÈÁÚ¿ÊÔÓÙ·È ÛÙÔ ›Ó·Î· 1. ∞fi ·˘ÙÔ‡˜ 49% ‹Ù·Ó

¿Ó‰Ú˜ Î·È 51% Á˘Ó·›Î˜, Ô˘ ‰È¤ÌÂÓ·Ó Û ·ÛÙÈ- Τ˜ (55%), ËÌÈ·ÛÙÈΤ˜ (23%) Î·È ·ÁÚÔÙÈΤ˜ (22%)

ÂÚÈÔ¯¤˜. OÈ Î·Ù·ÓÔ̤˜ ·˘Ù¤˜ (‰È·ÌÔÓ‹˜, ËÏÈΛ·˜

Î·È Ê‡ÏÔ˘) Â›Ó·È ·ÓÙÈÚÔÛˆ¢ÙÈΤ˜ Û‡Ìʈӷ Ì ÙËÓ ∂ıÓÈ΋ ∞ÔÁÚ·Ê‹ ÙÔ˘ 2001. ∏ ‰ÈÔÚıˆÌ¤ÓË ˆ˜

ÚÔ˜ ÙËÓ ËÏÈΛ· Â›ÙˆÛË ÙÔ˘ ª™ ‹Ù·Ó 24,5%

[95% (¢∂) 23,4%-25,7%] (n=2.369). ∏ Â›ÙˆÛË

‹Ù·Ó ·ÚfiÌÔÈ· ÛÙÔ˘˜ ¿Ó‰Ú˜ Î·È ÛÙȘ Á˘Ó·›Î˜

(24,8% ¤Ó·ÓÙÈ 24,2%, p=0,8). ∏ Â›ÙˆÛË ÙÔ˘ ª™

·‡Í·Ó Ì ÙËÓ ËÏÈΛ· Î·È ÛÙ· ‰‡Ô ʇϷ. ™ÙËÓ ËÏÈ- Îȷ΋ ÔÌ¿‰· >70 Ô Î›Ó‰˘ÓÔ˜ ÂÌÊ¿ÓÈÛ˘ ª™ ‹Ù·Ó 15Ï¿ÛÈÔ˜ ·fi ·˘Ùfi Ù˘ ÔÌ¿‰·˜ 19-29 ÂÙÒÓ (p<

0,0001). ∏ ̤ÛË ËÏÈΛ· ÙˆÓ ·ÙfiÌˆÓ Ì ª™ ‹Ù·Ó

˘„ËÏfiÙÂÚË ·fi ·˘Ù‹ ÙÔ˘ ÁÂÓÈÎÔ‡ ÏËı˘ÛÌÔ‡ (57 ± 13 ¤Ó·ÓÙÈ 46 ± 18 ¤ÙË, p<0,0001, ›Ó·Î·˜ 1).

Δ· ÂÚÈÛÛfiÙÂÚ· ¿ÙÔÌ· Ì ª™ ÏËÚÔ‡Û·Ó 3 ÎÚÈÙ‹ÚÈ· (63%), ÙÔ 22% ÏËÚÔ‡Û 4 Î·È ÙÔ 15% ›-

¯Â Î·È Ù· 5. ∏ ÎÔÈÏȷ΋ ·¯˘Û·ÚΛ· (82%) Î·È Ë

·ÚÙËÚȷ΋ ˘¤ÚÙ·ÛË (∞À) (71%) ‹Ù·Ó ÔÈ ÈÔ Û˘-

¯Ó¤˜ ‰È·Ù·Ú·¯¤˜ Î·È ÛÙ· ‰‡Ô ʇϷ (¶›Ó. 1). ΔÔ 55% ›¯Â ·˘ÍË̤ÓË ÁÏ˘Îfi˙Ë ÓËÛÙ›·˜ [31% ›¯Â

™¢ Î·È ÙÔ 24% ‰È·Ù·Ú·¯‹ ·ÓÔ¯‹˜ ÁÏ˘Îfi˙˘ ÓË- ÛÙ›·˜ (¢∞°¡)] (¶›Ó. 1). ŸÙ·Ó ¯ÚËÛÈÌÔÔÈ‹ıËÎ·Ó Ù· Ó¤· ÎÚÈÙ‹ÚÈ· ÁÈ· ÙË ¢∞°¡ Ù˘ IDF Î·È ADA¹⁰ [>5,6 mmol/l (100 mg/dl)] ‰È·ÈÛÙÒıËΠfiÙÈ ÙÔ 32% ÙˆÓ ·ÙfiÌˆÓ Ì ª™ ›¯Â ¢∞°¡ Î·È fiÙÈ Û˘ÓÔ-

ÏÈο ÙÔ 63% ›¯Â ·˘ÍË̤ӷ Â›‰· ÁÏ˘Îfi˙˘ ÓË- ÛÙ›·˜. ∏ Â›ÙˆÛË Ù˘ ˘ÂÚÙÚÈÁÏ˘ÎÂÚȉ·ÈÌ›·˜

ÛÙ· ¿ÙÔÌ· Ì ª™ ‹Ù·Ó 63% Î·È Ù˘ ¯·ÌËÏ‹˜ HDL-

× 58% (¶›Ó. 1). ∏ Â›ÁÓˆÛË Û˘ÁÎÂÎÚÈÌ¤ÓˆÓ Û˘- ÛÙ·ÙÈÎÒÓ ÙÔ˘ ª™ (.¯. ·ÚÙËÚȷ΋ ˘¤ÚÙ·ÛË) Î·È ÂÔ̤ӈ˜ Ô ·ÔÙÂÏÂÛÌ·ÙÈÎfi˜ ¤ÏÂÁ¯fi˜ ÙÔ˘˜ ‹Ù·Ó ÌÈÎÚfiÙÂÚÔ˜ ·fi ·˘Ùfi Ô˘ ÂÂÙ‡¯ıË Û ¿ÏϘ ÏË- ı˘ÛÌȷΤ˜ ÔÌ¿‰Â˜ Ô˘ ‰ÂÓ Â›¯·Ó ª™.

¢ÂÓ ˘‹Ú¯·Ó ÛËÌ·ÓÙÈΤ˜ ‰È·ÊÔÚ¤˜ ÛÙÔ ÔÛÔ- ÛÙfi ÙˆÓ Î·ÓÈÛÙÒÓ ÌÂٷ͇ ÙˆÓ ÔÌ¿‰ˆÓ Ù˘ ÌÂϤ- Ù˘. ÀÔÏÔÁ›ÛÙËÎÂ, Ï·Ì‚¿ÓÔÓÙ·˜ ˘fi„Ë ÙÔÓ ÏË- ı˘ÛÌfi Ù˘ ¯ÒÚ·˜ Û‡Ìʈӷ Ì ٷ ÛÙÔȯ›· Ù˘ ∂- ıÓÈ΋˜ ∞ÔÁÚ·Ê‹˜ ÙÔ˘ 2001, fiÙÈ ÂÚ›Ô˘ 2,5 Âη- ÙÔÌ̇ÚÈ· ŒÏÏËÓ˜ ¿Û¯Ô˘Ó ·fi ª™.

3.2 μ·ıÌfi˜ Â›ÁÓˆÛ˘ Î·È ·ÔÙÂÏÂÛÌ·ÙÈÎÔ‡

ÂϤÁ¯Ô˘ ÙÔ˘ ª™ Î·È ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘. ∞fi Ù·

¿ÙÔÌ· Ì NCEP ª™ (n=2.369) ÌfiÓÔ ÙÔ ¤Ó· ÙÚ›ÙÔ Â›¯Â Â›ÁÓˆÛË ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘ ª™, ÏÈÁfiÙÂÚÔ

·fi ÙÔ ¤Ó· ٤ٷÚÙÔ ¤·ÈÚÓ ıÂÚ·›· (·ÏÏ·Á‹ ÙÚfi-

Ô˘ ˙ˆ‹˜ ‹/Î·È Ê·Ú̷΢ÙÈ΋ ·ÁˆÁ‹) ÁÈ’ ·˘Ù¿ ηÈ

Ôχ ÌÈÎÚfi ÔÛÔÛÙfi (≤10%) ·ÚÔ˘Û›·˙ ÈηÓÔ-

ÔÈËÙÈÎfi ¤ÏÂÁ¯Ô ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘ ª™ (∂ÈÎ. 1A).

ªfiÓÔ ÙÔ 5% ÙˆÓ ·ÙfiÌˆÓ Ì ª™ ›¯·Ó Â›ÁÓˆÛË ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ ˆ˜ Û‡ÓÔÏÔ, ÙÔ 2% ¤·ÈÚÓ ıÂÚ·-

›· ÁÈ· fiÏ· Ù· Û˘ÛÙ·ÙÈο ÙÔ˘ Î·È ÌfiÓÔ ÙÔ 1% ›¯Â

Ï‹ÚË ·ÔÙÂÏÂÛÌ·ÙÈÎfi ¤ÏÂÁ¯Ô (∂ÈÎ. 1∞). ∞fi Ù·

¿ÙÔÌ· Ì IDF ª™ (n=4.169) ÌfiÓÔ ÙÔ ¤Ó· ٤ٷÚÙÔ Â›¯Â Â›ÁÓˆÛË ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘ ª™, ÏÈÁfiÙÂÚÔ

·fi ÙÔ ¤Ó· ¤ÌÙÔ ¤·ÈÚÓ ıÂÚ·›· (·ÏÏ·Á‹ ÙÚfi-

Ô˘ ˙ˆ‹˜ ‹/Î·È Ê·Ú̷΢ÙÈ΋ ·ÁˆÁ‹) ÁÈ’ ·˘Ù¿ ηÈ

Ôχ ÌÈÎÚfi ÔÛÔÛÙfi (≤7%) ·ÚÔ˘Û›·˙ ÈηÓÔÔÈ- ËÙÈÎfi ¤ÏÂÁ¯Ô ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘ ª™ (∂ÈÎ. 1B).

EÏÏËÓÈο ¢È·‚ËÙÔÏÔÁÈο XÚÔÓÈο 19, 2

¶›Ó·Î·˜ 1.÷ڷÎÙËÚÈÛÙÈο ÙÔ˘ ÁÂÓÈÎÔ‡ ÏËı˘ÛÌÔ‡, ·ÙfiÌˆÓ Ì NCEP ÌÂÙ·‚ÔÏÈÎfi Û‡Ó‰ÚÔÌÔ Î·È ·˘ÙÒÓ Ì IDF ÌÂÙ·‚Ô- ÏÈÎfi Û‡Ó‰ÚÔÌÔ

°ÂÓÈÎfi˜ ÏËı˘ÛÌfi˜ Û˘ÓÔÏÈο ÕÙÔÌ· Ì NCEP ª™ ÕÙÔÌ· Ì DF ª™

n=9.669 n=2.369 n=4.169

∏ÏÈΛ· (¤Ù˱1 ™∞) 46±18 57±13¹ 54±16^1,2

ÕÚÚÂÓ Ê‡ÏÔ % 49 51 50

∂Î·›‰Â˘ÛË (¤Ù˱1 ™∞) 11±6 10±8 11±6

∫·ıÈÛÙÈ΋ ˙ˆ‹ % 78 88¹ 85¹

À„ËÏ‹ LDL-C % 46 (5029) 35¹ (829) 30^1,2 (1.250)

™. ¢È·‚‹Ù˘ % 10 (968) 31¹ (734) 19^1,2 (772)

∫ÔÈÏȷ΋ ·¯˘Û·ÚΛ· (NCEP-IDF) % 37 (3.578)-48 (4.643) 82¹ (1.942) 100^1,2 (4.169)

∞˘ÍË̤ÓË ÁÏ˘Îfi˙Ë (NCEP-IDF) % 16 (1.547)-28 (2.708) 55¹ (1.303) 59^1,2 (2.460)

∞ÚÙËÚȷ΋ ˘¤ÚÙ·ÛË % 32 (3.094) 71¹ (1.682) 59^1,2 (2.460)

∞˘ÍË̤ӷ ÙÚÈÁÏ˘ÎÂÚ›‰È· % 27 (2.610) 63¹(1.492) 56^1,2 (2.334)

÷ÌËÏ‹ HDL-C % 26 (2.514) 61¹(1.445) 57^1,2 (2.376)

¶ÔÛÔÛÙfi ·ÙfiÌˆÓ – ÂÎÙfi˜ Â¿Ó ÚÔÛ‰ÈÔÚ›˙ÂÙ·È ‰È·ÊÔÚÂÙÈο – Î·È ·fiÏ˘ÙÔ˜ ÔÚÈÛÌfi˜ ·ÛıÂÓÒÓ Û ·Ú¤ÓıÂÛË. ª™= ÌÂÙ·-

‚ÔÏÈÎfi Û‡Ó‰ÚÔÌÔ, NCEP= National Cholesterol Education Program, IDF= International Diabetes Federation, ™∞= ÛÙ·- ıÂÚ‹ ·fiÎÏÈÛË, LDL-à = low-density lipoprotein ¯ÔÏËÛÙÂÚfiÏË, HDL-C = high-density lipoprotein ¯ÔÏËÛÙÂÚfiÏË.

1=p<0,05 ¤Ó·ÓÙÈ ÙÔ˘ ÁÂÓÈÎÔ‡ ÏËı˘ÛÌÔ‡, ²=p<0,05 ¤Ó·ÓÙÈ NCEP ª™

ªfiÓÔ ÙÔ 3% ÙˆÓ ·ÙfiÌˆÓ Ì ª™ ›¯·Ó Â›ÁÓˆÛË ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ ˆ˜ Û‡ÓÔÏÔ, ÙÔ 1% ¤·ÈÚÓ ıÂÚ·-

›· ÁÈ· fiÏ· Ù· Û˘ÛÙ·ÙÈο ÙÔ˘ Î·È ÌfiÓÔ ÙÔ 0,5% ›-

¯Â Ï‹ÚË ·ÔÙÂÏÂÛÌ·ÙÈÎfi ¤ÏÂÁ¯Ô (∂ÈÎ. 1B).

4. ™˘˙‹ÙËÛË

∏ Â›ÙˆÛË ÙÔ˘ ª™ ÛÙËÓ ∂ÏÏ¿‰· Â›Ó·È ˘„ËÏ‹

Î·È ÙÔ Û‡Ó‰ÚÔÌÔ ‰ÂÓ Â›Ó·È ÁÓˆÛÙfi ÛÙÔÓ ÁÂÓÈÎfi

ÏËı˘ÛÌfi. ø˜ ÂÎ ÙÔ‡ÙÔ˘, Ù· ÔÛÔÛÙ¿ ıÂÚ·›·˜

Î·È ·ÔÙÂÏÂÛÌ·ÙÈÎÔ‡ ÂϤÁ¯Ô˘ ÙÔ˘ ª™ Î·È ÙˆÓ Û˘- ÛÙ·ÙÈÎÒÓ ÙÔ˘ Â›Ó·È ÂÍ·ÈÚÂÙÈο ¯·ÌËÏ¿ Ì Ôχ ÛË- Ì·ÓÙÈ΋ ‰˘Ó·ÙfiÙËÙ· ‚ÂÏÙ›ˆÛ˘. ∂¿Ó Ë Î·Ù¿ÛÙ·ÛË

·˘Ù‹ ‰ÂÓ ‚ÂÏÙȈı› Û‡ÓÙÔÌ·, ÙÔ ª™ ı· ÚÔηϤ- ÛÂÈ ÌÈ· Ó¤· ÂȉËÌ›· ηډȷÁÁÂÈ·ÎÒÓ ÓÔÛËÌ¿ÙˆÓ Ù· ÂfiÌÂÓ· ¯ÚfiÓÈ·.

Δ· ÛÙÔȯ›· ÁÈ· ÙËÓ Â›ÙˆÛË ÙÔ˘ ª™ ÛÙË ·- ÚÔ‡Û· ÌÂϤÙË (·ÊÔÚÔ‡Ó ÙÔ 2003 Î·È 2004, n=

9.669) ÚÔ¤Ú¯ÔÓÙ·È ·fi fiÏË ÙËÓ ∂ÏÏ¿‰·. ∞˘Ù¿ ›- Ó·È ·ÚfiÌÔÈ· Ì ٷ ÛÙÔȯ›· Ô˘ ÚÔ¤Ú¯ÔÓÙ·È ·fi ÙË μfiÚÂÈ· ∂ÏÏ¿‰· (2003, n=4.153) Î·È ¤¯Ô˘Ó ·Ó·- ÎÔÈÓˆı› ÛÙÔ ·ÚÂÏıfiÓ¹¹.

Δ· ·ÔÙÂϤÛÌ·Ù· Ù˘ ÌÂϤÙ˘ ‰Â›¯ÓÔ˘Ó ·Ô- ÙÂÏÂÛÌ·ÙÈÎfi ¤ÏÂÁ¯Ô Ù˘ ·ÚÙËÚȷ΋˜ ˘¤ÚÙ·Û˘

ÛÙÔ 9% ÙˆÓ ·ÙfiÌˆÓ Ì ª™. ΔÔ ÔÛÔÛÙfi ·˘Ùfi ›ӷÈ

¯·ÌËÏfiÙÂÚÔ ·fi ÙÔ ÂıÓÈÎfi ÔÛÔÛÙfi ÁÈ· ˘ÂÚÙ·ÛÈ- ÎÔ‡˜ ·ÛıÂÓ›˜, Èı·ÓÒ˜ ÏfiÁˆ ÙˆÓ ¯·ÌËÏfiÙÂÚˆÓ ÂÈ¤‰ˆÓ ·ÚÙËÚȷ΋˜ ›ÂÛ˘ Ô˘ ¤¯ÂÈ Ô ÔÚÈÛÌfi˜

ÙÔ˘ ª™ (130/85 mmHg).⁸ ∏ ·ÚÙËÚȷ΋ ˘¤ÚÙ·ÛË Â›Ó·È ÙÔ Û˘ÛÙ·ÙÈÎfi ÙÔ˘ ª™ Ô˘ ¤¯ÂÈ ÌÂÏÂÙËı› Â- ÚÈÛÛfiÙÂÚÔ ·fi Ù· ˘fiÏÔÈ·, ΢ڛˆ˜ Û ¿ÙÔÌ· ¯ˆ- Ú›˜ ª™. ÃÚËÛÈÌÔÔÈÒÓÙ·˜ ˆ˜ fiÚÈÔ ÙÔ 140/90 mmHg, ÛÙȘ ∏¶∞ ÂϤÁ¯ÂÙ·È ·ÔÙÂÏÂÛÌ·ÙÈο ÙÔ 24% ¤ˆ˜ 29%^13,14ÙˆÓ ˘ÂÚÙ·ÛÈÎÒÓ, ÛÙÔÓ ∫·Ó·‰¿

ÙÔ 17% Î·È ÛÙËÓ ∂˘ÚÒË (5 Â˘Úˆ·˚Τ˜ ¯ÒÚ˜) ÙÔ

≤10%.¹⁴∞˘Ù¿ Ù· Â˘Ú‹Ì·Ù· Â›Ó·È Û˘Ì‚·Ù¿ Ì ÂΛ- Ó· Ù˘ ÌÂÙ·-·Ó¿Ï˘Û˘ ÛÙÔȯ›ˆÓ ·fi 6 Â˘Úˆ·˚- Τ˜ ¯ÒÚ˜ fiÙÈ Î·Ù¿ ̤ÛÔ fiÚÔ ÌfiÓÔ ÙÔ 8% ÙˆÓ

˘ÂÚÙ·ÛÈÎÒÓ ÂϤÁ¯ÔÓÙ·È ·ÔÙÂÏÂÛÌ·ÙÈο.¹⁵ΔÚÂȘ

ÌÂϤÙ˜ ÛÙË ∂ÏÏ¿‰· ·Û¯ÔÏ‹ıËÎ·Ó Ì ÙÔ ı¤Ì· ·˘- Ùfi, ¯ÚËÛÈÌÔÔÈÒÓÙ·˜ ˆ˜ fiÚÈÔ ÙÔ 140/90 mmHg. ∏ ÌÂϤÙË EPIC (Greek component of the European Prospective Investigation into Cancer and nutrition Study)¹⁶Ô˘ ÂÚȤϷ‚ 26.913 ¿ÙÔÌ· ‚ڋΠfiÙÈ Ë Â›ÙˆÛË Ù˘ ·ÚÙËÚȷ΋˜ ˘¤ÚÙ·Û˘ Â›Ó·È 44%, 23% ÙˆÓ ·ÙfiÌˆÓ ¤¯Ô˘Ó Â›ÁÓˆÛË Î·È fiÙÈ ÙÔ 15,2%

ÂϤÁ¯ÂÙ·È ·ÔÙÂÏÂÛÌ·ÙÈο. OÌÔ›ˆ˜ Ë ÌÂϤÙË

∞ΔΔπC∞ (n=2.282)¹⁷‚ڋΠfiÙÈ ÙÔ 15% ÙˆÓ ˘ÂÚ- Ù·ÛÈÎÒÓ ÂϤÁ¯ÂÙ·È ·ÔÙÂÏÂÛÌ·ÙÈο. ΔÂÏÈο Ë ÌÂ- ϤÙË DIDIMA (n=694),¹⁸·fi Ì›· ÂÍÂȉÈÎÂ˘Ì¤ÓË

˘ÂÚÙ·ÛÈÔÏÔÁÈ΋ ÎÏÈÓÈ΋ Ú‡ıÌÈÛ ÙËÓ ·ÚÙËÚȷ΋

˘¤ÚÙ·ÛË ÛÙÔ 27% ÙˆÓ ·ÛıÂÓÒÓ. ŸÏ· Ù· ·Ú·¿- Óˆ ‰Â›¯ÓÔ˘Ó fiÙÈ Ë ÂÚÈÔÚÈṲ̂ÓË Â›ÁÓˆÛË, ıÂÚ·-

›· Î·È ¤ÏÂÁ¯Ô˜ Ù˘ ·ÚÙËÚȷ΋˜ ˘¤ÚÙ·Û˘ ›ӷÈ

·ÁÎfiÛÌÈÔ Ê·ÈÓfiÌÂÓÔ. ¶·ÚfiÏ· ·˘Ù¿, Ù· ¯·ÌËÏfiÙÂ- Ú· Â›‰· ÙfiÛÔ Ù˘ Û˘ÛÙÔÏÈ΋˜ fiÛÔ Î·È Ù˘ ‰È·- ÛÙÔÏÈ΋ ›ÂÛ˘ Ô˘ ¯ÚËÛÈÌÔÔÈÔ‡ÓÙ·È ÛÙÔ˘˜ ÔÚÈ- ÛÌÔ‡˜ ÙÔ˘ ª™, Ú·ÎÙÈο ¿ÁÓˆÛÙ· ÛÙÔÓ ÁÂÓÈÎfi ÏË- ı˘ÛÌfi, Û˘Ì‚¿ÏÏÔ˘Ó ÛËÌ·ÓÙÈο ÛÙË ÌÈÎÚfiÙÂÚË Â›- ÁÓˆÛË, ıÂÚ·›· Î·È ·ÔÙÂÏÂÛÌ·ÙÈÎfiÙËÙ· Ù˘ ıÂ- Ú·¢ÙÈ΋˜ ·ÁˆÁ‹˜ ÁÈ· ÙËÓ ·ÚÙËÚȷ΋ ˘¤ÚÙ·ÛË.

™ÙË ·ÚÔ‡Û· ÌÂϤÙË ÙÔ ÔÛÔÛÙfi ÙˆÓ ·ÙfïÓ

Ô˘ ›¯·Ó ª™ Î·È ·ÔÙÂÏÂÛÌ·ÙÈÎfi ¤ÏÂÁ¯Ô Ù˘ ¯·- ÌËÏ‹˜ HDL-à ‹ ˘„ËÏÒÓ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ ‹Ù·Ó 5%

Î·È 8% ·ÓÙ›ÛÙÔȯ·. ∞˘Ù¿ Ù· Ùˆ¯¿ ·ÔÙÂϤÛÌ·Ù·

ı· ÌÔÚÔ‡Û·Ó Ó· ·Ô‰ÔıÔ‡Ó ÛÙÔ fiÙÈ ÂÈÎÂÓÙÚˆ- ÓfiÌ·ÛÙ ΢ڛˆ˜ ÛÙËÓ ·ÓÙÈÌÂÙÒÈÛË Ù˘ ˘„ËÏ‹˜

100 80 60 40 20

0

AY AΓΝ X-HDL ΥΤΡ ΚΠ ΜΣ AY AΓΝ X-HDL ΥΤΡ ΚΠ ΜΣ

100 80 60 40 20 0

Επίπτωση Επίγνωση Θεραπεία Έλεγχος Επίπτωση Επίγνωση Θεραπεία Έλεγχος

Ορισμός NCEP Ορισμός IDF

A B

EÈÎ. 1(∞,μ). ∂›ÙˆÛË, Â›ÁÓˆÛË, ıÂÚ·›· Î·È ¤ÏÂÁ¯Ô˜ ÙÔ˘ ÌÂÙ·‚ÔÏÈÎÔ‡ Û˘Ó‰ÚfiÌÔ˘ (ª™) Î·È ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘

Û‡Ìʈӷ Ì ÙÔ˘˜ ÔÚÈÛÌÔ‡˜ NCEP (A) Î·È IDF (B). NCEP= National Cholesterol Education Program, IDF=

International Diabetes Federation, ∞À= ·ÚÙËÚȷ΋ ˘¤ÚÙ·ÛË, ∞°¡= ·˘ÍË̤ÓË ÁÏ˘Îfi˙Ë ÓËÛÙ›·˜, Ã-HDL= ¯·- ÌËÏ‹ high-density lipoprotein ¯ÔÏËÛÙÂÚfiÏË, ÀΔƒ= ˘ÂÚÙÚÈÁÏ˘ÎÂÚȉ·ÈÌ›·, ∫¶= ÎÔÈÏȷ΋ ·¯˘Û·ÚΛ·.

LDL-Ã,¹⁹ÂÓÒ Ù· ÙÚÈÁÏ˘ÎÂÚ›‰È· ‹ Ë ¯·ÌËÏ‹ HDL- à (·ÌÊfiÙÂÚ· ‰È·ÁÓˆÛÙÈο ÎÚÈÙ‹ÚÈ· ÙÔ˘ ª™) Û˘-

¯Ó¿ ·Ú·ÌÂÏÔ‡ÓÙ·È ˆ˜ ÛÙfi¯Ô˜ ıÂÚ·›·˜. ¢Â‰Ô̤- ÓÔ˘ fiÙÈ ÛÙËÓ ∂ÏÏ¿‰· ·ÎfiÌË Î·È Ù· ·ÔÙÂϤÛÌ·Ù·

Ù˘ ıÂÚ·›·˜ Ì ·ÚÈÔ ÛÙfi¯Ô ÙËÓ LDL-à ›ӷÈ

Ùˆ¯¿¹⁹, ‰ÂÓ ·ÔÙÂÏ› ¤ÎÏËÍË fiÙÈ Ù· ·ÔÙÂϤÛÌ·- Ù· Ù˘ ıÂÚ·›·˜ ÙˆÓ ˘„ËÏÒÓ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ ‹ Ù˘ ¯·ÌËÏ‹˜ HDL-Ã Â›Ó·È Ùˆ¯fiÙÂÚ·.

Δ· ·ÔÙÂϤÛÌ·Ù· Ù˘ ÌÂϤÙ˘ ‰Â›¯ÓÔ˘Ó fiÙÈ Ë Â›ÙˆÛË Ù˘ ¢∞°¡ ÛÙ· ¿ÙÔÌ· Ì ª™ Â›Ó·È ÂÚ›-

Ô˘ ÙfiÛÔ ˘„ËÏ‹ fiÛÔ Î·È ÙÔ˘ Ù‡Ô˘ 2 ™¢ (¶›Ó. 1) ‹

·ÎfiÌË ˘„ËÏfiÙÂÚ· Û‡Ìʈӷ Ì ÙÔÓ ÔÚÈÛÌfi IDF Î·È ADA¹⁰ (¶›Ó. 1). ™Â ·Ó·ÊÔÚ¿ ·fi ÙȘ ∏¶∞²⁰Ë Â›-

ÙˆÛË ÙÔ˘ ÌË ÁÓˆÛÙÔ‡ ™¢ Ù‡Ô˘ 2 ‹Ù·Ó 4,5% ÛÙÔÓ ÁÂÓÈÎfi ÏËı˘ÛÌÔ‡ Î·È ÙÔ 61% ÙˆÓ ÌË ÁÓˆÛÙÒÓ Â- ÚÈÙÒÛÂˆÓ ™¢ Ù‡Ô˘ 2 Â›Ó·È ·ÚÚ‡ıÌÈÛÙ˜.^20,21 ∏ Â›ÙˆÛË Ù˘ ¢∞°¡ Û 13 Â˘Úˆ·˚Τ˜ ¯ÒÚ˜ Â›Ó·È 10%^22,23Î·È Ë ¢∞°¡ Â›Ó·È ÙÚÔÔÔÈ‹ÛÈÌÔ˜ ·Ú¿- ÁÔÓÙ·˜ ∫∞ ÎÈÓ‰‡ÓÔ˘.^22,23O ∫∞ ΛӉ˘ÓÔ˜ Â›Ó·È ·Îfi- ÌË ˘„ËÏfiÙÂÚÔ˜ fiÙ·Ó Û˘Ó˘¿Ú¯Ô˘Ó Î·È ¿ÏÏ· Û˘ÛÙ·- ÙÈο ÙÔ˘ ª™.²⁴ ∂¿Ó ÏÔÈfiÓ ÏËÊı› ˘fi„Ë fiÙÈ Ë

¢∞°¡ Â›Ó·È Ú·ÎÙÈο ¿ÁÓˆÛÙË ÛÙÔÓ ÁÂÓÈÎfi ÏËı˘- ÛÌfi Î·È fiÙÈ Ô ™¢ ˘ԉȷÁÈÁÓÒÛÎÂÙ·È Î·È ˘ÔıÂÚ·-

‡ÂÙ·È Û ÛËÌ·ÓÙÈÎfi ‚·ıÌfi²⁰, ÙfiÙ ٷ ¯·ÌËÏ¿ Â›-

‰· Â›ÁÓˆÛ˘, ıÂÚ·›·˜ Î·È ÂϤÁ¯Ô˘ Ù˘ ‰È·Ù·- Ú·¯‹˜ ÌÂÙ·‚ÔÏÈÛÌÔ‡ Ù˘ ÁÏ˘Îfi˙˘ ‰ÂÓ ÚÔηÏÔ‡Ó

¤ÎÏËÍË. ∏ ¢∞°¡ Î·È Ô ™¢ Ù‡Ô˘ 2 Ê·›ÓÂÙ·È Ó·

Û¯ÂÙ›˙ÔÓÙ·È Ì ÙËÓ ˘„ËÏ‹ Â›ÙˆÛË Ù˘ ·¯˘Û·Ú- Λ·˜ ÛÙ· ¿ÙÔÌ· Ì ª™ (82%) Î·È Ë ·¯˘Û·ÚΛ·

Ê·›ÓÂÙ·È Ó· Û¯ÂÙ›˙ÂÙ·È Ì ÙËÓ ·ÏÏ·Á‹ ÙÔ˘ ÙÚfiÔ˘

˙ˆ‹˜ ÛÙËÓ ∂ÏÏ¿‰· ÙȘ ÙÂÏÂ˘Ù·›Â˜ ‰ÂηÂٛ˜.¹⁶ Δ· Û˘ÓÔÏÈο ·ÔÙÂϤÛÌ·Ù· Ù˘ ÌÂϤÙ˘ ÚÔη- ÏÔ‡Ó ÙÂÏÈο ¤ÎÏËÍË, ÁÈ·Ù› ̤¯ÚÈ ÚfiÛÊ·Ù· (Ï›Á˜

‰ÂηÂٛ˜) Ë ÏÂÈÔÓfiÙËÙ· ÙÔ˘ ÂÏÏËÓÈÎÔ‡ ÏËı˘ÛÌÔ‡

›¯Â ·˘ÍË̤ÓË Ê˘ÛÈ΋ ‰Ú·ÛÙËÚÈfiÙËÙ· Î·È ¯ÚËÛÈÌÔ-

ÔÈÔ‡Û ÙË ÌÂÛÔÁÂȷ΋ ‰È·ÙÚÔÊ‹, Ë ÔÔ›· ÂÏ·ÙÙÒÓÂÈ ÙËÓ Èı·ÓfiÙËÙ· ÂÌÊ¿ÓÈÛ˘ ª™ Î·È ÙÔÓ Î›Ó‰˘ÓÔ ∫∞

ÂÂÈÛÔ‰›ˆÓ.^25-27 Œ¯ÂÈ ‰È·ÈÛÙˆı› fiÙÈ Ë Â›ÙˆÛË ÙfiÛÔ ÙˆÓ ÎÏ·ÛÈÎÒÓ ·Ú·ÁfiÓÙˆÓ ∫∞ ÎÈÓ‰‡ÓÔ˘ fiÛÔ Î·È ÙÔ˘ ª™ Â›Ó·È ÛËÌ·ÓÙÈο ¯·ÌËÏfiÙÂÚË Û ¿ÙÔÌ·

Ô˘ ¤¯Ô˘Ó ˘ÈÔıÂÙ‹ÛÂÈ ÙË ÌÂÛÔÁÂȷ΋ ‰È·ÙÚÔÊ‹ Û ۇÁÎÚÈÛË Ì ·˘ÙÔ‡˜ Ô˘ ‰ÂÓ ÙËÓ ˘ÈÔı¤ÙËÛ·Ó.²⁵™˘- ÁÎÂÎÚÈ̤ӷ Ë ÌÂÛÔÁÂȷ΋ ‰È·ÙÚÔÊ‹ ¤¯ÂÈ Û˘Û¯ÂÙÈ- ÛÙ› Ì ÌÈ· ηٿ 30% ÂÏ¿ÙÙˆÛË ÙˆÓ ÔͤˆÓ ÛÙÂÊ·ÓÈ-

·›ˆÓ ÂÂÈÛÔ‰›ˆÓ.²⁵ ∏ ‰È·ÙÚÔÊ‹ ·˘Ù‹, Ôχ Û˘¯Ó‹

ÛÙË ∫Ú‹ÙË, ¤¯ÂÈ ‰Â›ÍÂÈ ÛËÌ·ÓÙÈο ÔʤÏË.²⁸

¶ÚfiÛÊ·Ù· ÛÙÔȯ›·, ÌÂÙ¿ ÙËÓ ˘ÈÔı¤ÙËÛË ÙÔ˘

‰˘ÙÈÎÔ‡ ÙÚfiÔ˘ ˙ˆ‹˜ ÛÙËÓ ∂ÏÏ¿‰·, ‰Â›¯ÓÔ˘Ó fiÙÈ Ë Î·Ù·Ó¿ÏˆÛË ÔÏÈÎÔ‡ Ï›Ô˘˜ Â›Ó·È ˘„ËÏ‹ (40% ÙÔ˘

Û˘ÓfiÏÔ˘ ÙˆÓ ÚÔÛÏ·Ì‚·ÓÔÌ¤ÓˆÓ ıÂÚÌ›‰ˆÓ²⁹), ·- ÚfiÏÔ Ô˘ Ô ÏfiÁÔ˜ ÌÔÓÔ·ÎfiÚÂÛÙˆÓ (ÂÏ·ÈfiÏ·‰Ô)

ÚÔ˜ ÎÔÚÂṲ̂ӷ Ï›Ë (˙ˆÈ΋˜ ÚÔ¤Ï¢Û˘) ›ӷÈ

˘„ËÏfiÙÂÚÔ˜ ·fi ¿ÏϘ ¯ÒÚ˜ (ÂÚÈÏ·Ì‚·ÓÔ̤ӈÓ

·˘ÙÒÓ ÛÙË μfiÚÂÈ· ∂˘ÚÒË ‹ μfiÚÂÈ· ∞ÌÂÚÈ΋).²⁹

∂Ô̤ӈ˜, ˘Ôı¤ÙÔ˘Ì fiÙÈ Ë ÚÔÛٷ٢ÙÈ΋ ‰Ú¿ÛË Ù˘ ÌÂÛÔÁÂȷ΋˜ ‰›·ÈÙ·˜ ÛÙËÓ ÚfiÏË„Ë ÙÔ˘ ª™

Î·È ÙˆÓ ∫∞ ÓÔÛËÌ¿ÙˆÓ ‰ÂÓ ÚÔ¤Ú¯ÂÙ·È ·fi ÂÈ̤- ÚÔ˘˜ ÙÚÔʤ˜ (.¯. ‰È·ÈÙËÙÈÎfi Ï›Ô˜ ‹ Ê˘ÙÈΤ˜ ›Ó˜),

·ÏÏ¿ ı· Ú¤ÂÈ Ó· ·Ô‰Ôı› ÛÙÔ Û‡ÓÔÏfi Ù˘.^29-32

∂ÈϤÔÓ, Ù· ÛÙÔȯ›· Ù˘ ÌÂϤÙ˘ ‰Â›¯ÓÔ˘Ó fiÙÈ Ë Ê˘ÛÈ΋ ‰Ú·ÛÙËÚÈfiÙËÙ· ηٿ ÙËÓ ÂÚÁ·Û›· ‹ ÙÔÓ ÂχıÂÚÔ ¯ÚfiÓÔ ¤¯ÂÈ ‰Ú·Ì·ÙÈο ÂÏ·ÙÙˆı› ÙȘ ÙÂ- ÏÂ˘Ù·›Â˜ Ï›Á˜ ‰ÂηÂٛ˜ (>80% ÙˆÓ ·ÙfiÌˆÓ Ô˘

ÂÚÈÏ‹ÊıËÎ·Ó ÛÙË ÌÂϤÙË Â›¯·Ó ÂÏ·Ùو̤ÓË Ê˘ÛÈ- ΋ ‰Ú·ÛÙËÚÈfiÙËÙ·). ŸÏ· ·˘Ù¿ Û˘Ó‰˘·˙fiÌÂÓ· ·›-

˙Ô˘Ó ÛËÌ·ÓÙÈÎfi ÚfiÏÔ ÛÙË ‰È·ÌfiÚʈÛË Ù˘ Â›Ùˆ- Û˘ ÙÔ˘ ª™ ÛÙËÓ ∂ÏÏ¿‰·, ÁÈ·Ù› Ë ˘ÈÔı¤ÙËÛË Ù˘

ÌÂÛÔÁÂȷ΋˜ ‰È·ÙÚÔÊ‹˜ ·fi ¿ÙÔÌ· Ì ·˘ÍË̤ÓË Ê˘ÛÈ΋ ‰Ú·ÛÙËÚÈfiÙËÙ· Û¯ÂÙ›˙ÂÙ·È Ì ¯·ÌËÏfiÙÂÚÔ Î›Ó‰˘ÓÔ ÂÌÊ¿ÓÈÛ˘ ª™ ‹ ∫∞ ÂÂÈÛÔ‰›ˆÓ, Û ۯ¤- ÛË Ì ÙÔÓ Î›Ó‰˘ÓÔ Ô˘ ‰È·ÙÚ¤¯Ô˘Ó Ù· ¿ÙÔÌ· ÌfiÓÔ Ì ÙÔ ¤Ó· ·fi Ù· ‰‡Ô.³³∏ ˘ÈÔı¤ÙËÛË ÙÔ˘ ‰˘ÙÈÎÔ‡

ÙÚfiÔ˘ ˙ˆ‹˜ ÛÙËÓ ∂ÏÏ¿‰· ‰ÂÓ ·ÎÔÏÔ˘ı‹ıËΠ·fi ÂÈÌfiÚʈÛË ÙÔ˘ ÎÔÈÓÔ‡ ‹ Ù˘ È·ÙÚÈ΋˜ ÎÔÈÓfiÙËÙ·˜

ÁÈ· ÙÔ˘˜ ÎÈÓ‰‡ÓÔ˘˜ Ô˘ ÎÚ‡‚ÂÈ. ∞˘Ùfi ¤·ÈÍ ÛËÌ·- ÓÙÈÎfi ÚfiÏÔ ÛÙËÓ ·‰˘Ó·Ì›· ·Ó·ÁÓÒÚÈÛ˘, ıÂÚ·›-

·˜ Î·È ·ÔÙÂÏÂÛÌ·ÙÈÎÔ‡ ÂϤÁ¯Ô˘ ÙÔ˘ ª™.

¶ÚfiÛÊ·Ù· ·Ó·ÎÔÈÓÒ۷̳⁴ fiÙÈ Ô ·ÔÙÂÏÂ- ÛÌ·ÙÈÎfi˜ ¤ÏÂÁ¯Ô˜ ÙÔ˘ ª™ Î·È ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘, Ì ·ÏÏ·Á‹ ÙÚfiÔ˘ ˙ˆ‹˜ Î·È ÔÏ˘ÛÙfi¯Â˘ÛË Ù˘

Ê·Ú̷΢ÙÈ΋˜ ·ÁˆÁ‹˜ Â›Ó·È ÂÊÈÎÙfi˜ Î·È ÂÏ·ÙÙÒ- ÓÂÈ ÙÔÓ ∫∞ ΛӉ˘ÓÔ Ì¤¯ÚÈ Î·È 76%, Û Â›‰Ô

·Ó¿ÏÔÁÔ Ì ·˘Ùfi ÙÔ˘ ÁÂÓÈÎÔ‡ ÏËı˘ÛÌÔ‡.³⁴ŒÙÛÈ Ù· ̤۷ ÁÈ· ÙËÓ ÂÏ¿ÙÙˆÛË ÙÔ˘ ∫∞ ÎÈÓ‰‡ÓÔ˘ Û ¿ÙÔ- Ì· Ì ª™ Â›Ó·È ‰È·ı¤ÛÈÌ· Î·È Ë ÂÏ¿ÙÙˆÛË ÙÔ˘ ÎÈÓ-

‰‡ÓÔ˘ ·fiÏ˘Ù· ÂÊÈÎÙ‹. ∂Ô̤ӈ˜ Ú¤ÂÈ Ó· ÛÙÔ-

¯Â‡ÛÔ˘Ì ÛÙËÓ ·Ó›¯Ó¢ÛË Î·È ·ÓÙÈÌÂÙÒÈÛË ÙÔ˘

ª™, Ú¿ÁÌ· Ô˘ ··ÈÙ› ÙËÓ ÂÈÌfiÚʈÛË ÙÔ˘ ÁÂ- ÓÈÎÔ‡ ÏËı˘ÛÌÔ‡ Î·È ÙˆÓ ÁÈ·ÙÚÒÓ.

™˘ÌÂÚ¿ÛÌ·Ù·

ÃÚËÛÈÌÔÔÈÒÓÙ·˜ ÙˆÓ ÔÚÈÛÌfi NCEP ÁÈ· ÙÔ ª™, Ë Â›ÁÓˆÛË, Ë ıÂÚ·›· Î·È Ô ·ÔÙÂÏÂÛÌ·ÙÈ- Îfi˜ ¤ÏÂÁ¯Ô˜ ‹Ù·Ó Ôχ ¯·ÌËÏ¿, ·ÚfiÙÈ Ë Â›ÙˆÛ‹

ÙÔ˘ Â›Ó·È ˘„ËÏ‹. ªÂ ÙÔÓ ÔÚÈÛÌfi IDF fiÏ· Ù· ·Ú·-

¿Óˆ Â›Ó·È Ôχ ¯ÂÈÚfiÙÂÚ·, Èı·ÓÒ˜ ÁÈ·Ù› Ôχ

ÂÚÈÛÛfiÙÂÚÔÈ ıˆÚÔ‡ÓÙ·È fiÙÈ ¤¯Ô˘Ó ª™ Û‡Ìʈӷ

Ì ÙÔÓ ÔÚÈÛÌfi ·˘Ùfi.³⁵∏ ıÂÚ·›· Î·È Ô ·ÔÙÂÏÂ- ÛÌ·ÙÈÎfi˜ ¤ÏÂÁ¯Ô˜ ÙÔ˘ ª™ Î·È ÙˆÓ Û˘ÛÙ·ÙÈÎÒÓ ÙÔ˘

Ú¤ÂÈ Ó· ·ÔÙÂÏÔ‡Ó ˘„ËÏ‹ ÚÔÙÂÚ·ÈfiÙËÙ· ÁÈ· Ó·

·ÔÊ¢¯ı› ÌÈ· ÂȉËÌ›· ∫∞ ÓÔÛËÌ¿ÙˆÓ Ù· Âfi- ÌÂÓ· ¯ÚfiÓÈ·. ∏ ÂÈÌfiÚʈÛË ÙÔ˘ ÁÂÓÈÎÔ‡ ÏËı˘- ÛÌÔ‡ Î·È ÙˆÓ ÁÈ·ÙÚÒÓ ¤¯ÂÈ ‹‰Ë ·ÚÁ‹ÛÂÈ. ∏ ·ÏÏ·Á‹

EÏÏËÓÈο ¢È·‚ËÙÔÏÔÁÈο XÚÔÓÈο 19, 2

ÙÔ˘ ÙÚfiÔ˘ ˙ˆ‹˜ Î·È (ÂÊfiÛÔÓ ··ÈÙËı›) Ë Ê·Ú- ̷΢ÙÈ΋ ·ÁˆÁ‹ ı· ÂÏ·ÙÙÒÛÔ˘Ó ÛËÌ·ÓÙÈο ÙËÓ ÂÈ‚¿Ú˘ÓÛË ·fi ÙÔ Û‡Ó‰ÚÔÌÔ ·˘Ùfi.

∂˘¯·ÚÈÛٛ˜

∂˘¯·ÚÈÛÙԇ̠ÙËÓ ∂ÏÏËÓÈ΋ ∂Ù·ÈÚ›· ∞ıËÚÔ- ÛÎÏ‹ÚˆÛ˘, ÙËÓ ∂ÏÏËÓÈ΋ ∂Ù·ÈÚ›· °ÂÓÈ΋˜ π·ÙÚÈ- ΋˜ Î·È ÙÔ˘˜ ·Ú·Î¿Ùˆ ÁÈ· ÙË Û˘ÏÏÔÁ‹ ÙˆÓ ÛÙÔÈ-

¯Â›ˆÓ: ∞¯Ï·‰¿˜ H (∫À), ∞ÎÚÈÙfiÔ˘ÏÔ˜ ¶ (°°),

∞Ô˘Û›‰Ô˘ μ¶ (°¡), ∞ÚÛÂÓ›Ô˘ A (∫À), ∞ı·Ó·Û›- Ô˘ ¶π (∫À), μ·ÛÈÏÔÔ‡ÏÔ˘ ¢ (∫À), μ·ÙÔ‡ N¢

(∫À), ¢ËÌÔÔ‡ÏÔ˘ ™¶ (∫À), ¢ÈÔÓ˘ÛÔÔ‡ÏÔ˘ ™ (°¡), °ÂˆÚÁ¿ÎË AN (∫À), °·˙‹˜ E (¶¡), °È·- ÁÎÔ˘ÛÙ›‰Ë˜ μ (°°), °ÎÈÔ˘ÏÂ̤ O (¶¡), ∫·Ï·˚Ù˙›-

‰Ô˘ E§ (°°), ∫·Î·ÁÈ¿ μ (°°), ∫·Ú·Ï¢ı¤ÚË ª¶

(∫À), ∫·ÚfiÙÛ˘ A (°°), ∫·Ô˘ÛÔ‡˙Ë MI (∫À),

∫ÂÛ›‰Ô˘ NI (∫À), ∫ÈÔ˘ÚÛ›‰Ô˘ B§ (∫À), ∫Ô˘ÚÔ˘- ÓÙ› AI (∫À), §·˙·Ú›‰Ô˘ ¶° (∫À), §È¿ÎÔ˘ K (∫À), ª¿ÙÛÔ˘ AT (∫À), ª¤ÛÛÈÔ˜ ƒ (∫À), ªÔ˘- ÏÔ‡ÎÔ˜ μI (¶¡), ªÔ˘Ú‰Ô‡‚·Ï˘ IA (∫À), ¡ÔÙ·- Ú›‰Ë˜ ° (∫À), ¶·ÙÚfiÎÏÔ˘ ™ (∫À), ¶·˘Ï›‰Ô˘ H (∫À), ¶Â¯ÏÈ‚·Ó·Ó›‰Ë˜ ∞N (¶¡), ¶ÂÙÚ›‰Ë˜ ¢I (∫À), ¶ÔÏ˘¯ÚfiÓȉ˘ E (∫À), ¶ÔÛÓ·¯›‰Ô˘ ¢N (∫À), ¶ÚÔÎÔÈ¿‰Ô˘ ¢ (°°), ¶ÚÔÎÔ›‰Ë˜ ¢ (°°),

¶ÚˆÙfi··˜ N (∫À), ™·ÚÈÁÈ¿ÓÓË M (°¡), ™¿ÙÛÔ- ÁÏÔ˘ EA (°¡), ™¤ÎÂÚË Z¶ (∫À), ™Ê·ÎÈ·Ó¿Î˘ M (∫À), ™˘Ìˆӛ‰Ë˜ A (∫À), Δ۷ΛÚ˘ K (∫À), ΔÛ·ÎÔ˘ÓÙ¿ÎÈÛ N (°°), ΔÚÔ˘Ï¿ÎË Z (∫À), ΔÛÈÎÓ¿- ÎË ™ (∫À), ÷ÚÙ·Ì¿ μ (∫À), æ¿ÏÙÔÁÏÔ˘ I (∫À).

¶¡ = ¶·ÓÂÈÛÙËÌÈ·Îfi ¡ÔÛÔÎÔÌ›Ô, °¡ = °ÂÓÈÎfi ¡ÔÛÔ- ÎÔÌ›Ô, °° = °ÂÓÈÎfi˜ °È·ÙÚfi˜, ∫À =∫¤ÓÙÚÔ ÀÁ›·˜.

Abstract

Athiros VG, Ganotakis ES, Bathianaki M, Monedas J, Goudevenos IA, Papageorgiou AA, Papathanasiou A, Kakafika AI, Mixailidis DP, Elisaf M. Degree of awareness and effective treatment of metabolic syndrome and its substitutes in Hellenic general population.Hellen Nephrol 2006; 2: 123-129.

Purpose:To estimate the prevalence, awareness, treatment and control of the metabolic syndrome (MetS) and its components in the general population of a Mediterranean country (Greece). Subjects and methods: A cross-sectional analysis of a representative sample of Greek adults (n=9,669), men and women (49% and 51%, respectively), living in urban, semi- urban and rural areas (55%, 23% and 22%, re- spectively). The National Cholesterol Education Pro- gram (NCEP-ATP III) and the Inernational Diabetes Federation (IDF) definitions of the MetS were used.

Results:The age-standardized prevalence of the MetS

in the general population was 24.5% [95% CI 23.4- 25.7%] (n=2.369). This was similar in men and women (24.8% vs 24.2%, p=0.8) and increased with age.

Among subjects with the NCEP MetS the prevalence of hypertension was 71%, elevated blood glucose 55%, low high density lipoprotein cholesterol 58%, high triglycerides 63% and abdominal obesity 82%. Only one third of subjects were aware of the MetS compo- nent conditions, less than one quarter was on treat- ment, and very few (≤10%) were controlled. Aware- ness of MetS individual component conditions (e.g. ar- terial hypertension), and consequently effective con- trol, was lower than that reported in other cohorts, in- cluding subjects without MetS. Only 5% of subjects a- ware of MetS as an entity, 2% were treated for all com- ponent conditions, and only 1% was controlled. With the IDF definition the prevalence of MetS is higher (43.4%) and awareness, treatment and control of MetS and its components are significantly lower. Conclu- sions:The prevalence of MetS is high in Greece but is not recognised among the general population. There- fore, treatment and control of MetS and component conditions are extremely low. If the situation does not improve soon, MetS will cause a further increase in the vascular disease epidemic in the years to come.

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Key words:

Metabolic syndrome Constituents

Awareness

Therapy and Control