Hypercholesterolemia secondary targets

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Associate Editor(s)-In-Chief: Kashish Goel, M.D.

The Metabolic Syndrome

The metabolic syndrome is identified as a secondary target of therapy in the NCEP ATP III guidelines, beyond LDL cholesterol. The metabolic syndrome is a constellation of multiple risk factors which are lipid and non-lipid in origin. The basic metabolic abnormality associated with the metabolic syndrome is insulin resistance. Two main factors are responsible for the development of insulin resistance which include abdominal obesity and physical inactivity. The definition of the metabolic syndrome includes:

Clinical Identification of the Metabolic Syndrome

Risk Factor	Defining level
Abdominal Obesity: Men Women	Waist Circumference: >102 cm (>40 in) >88 cm (>35 in)
Triglycerides	≥ 150 mg/dL
HDL cholesterol Men Women	<40 mg/dL <50 mg/dL
Blood pressure	≥ 130/≥ 85 mmHg
Fasting glucose	≥ 110 mg/dL