The aim of study was to evaluate in a group of obese women the prevalence of the metabolic syndrome, defined accordingly to the International Diabetes Federation, of single factors of the syndrome and the correlations with endocrine factors. We evaluated 351 women, 262 overweight-obese and 89 normal weight controls, which underwent physical, biochemical and hormonal evaluation. The prevalence of MS in obese and overweight subjects was 62.3%; the prevalence increased significantly by increasing body mass index, ranging from 20.6% for overweight to 71.6% for class III obesity. The analysis of prevalence of single factors of MS showed that the prevalence of low HDL levels and high fasting glycaemia had an inverse trend, by increasing values from overweight to class II obesity but decreasing levels in class III obesity. In the normal-weight controls there is 12.5% prevalence of increased waist circumference and 14.8% prevalence of hypertension. The analysis of the prevalence of single factors showed that in overweight subjects the commonest association was between waist circumference, high fasting glycaemia and hypertension. In class I and II obesity, the most frequent association was between metabolic parameters whereas in class III obesity, hypertension was the main element. Urinary free cortisol and testosterone levels were significantly higher in subjects with MS.
In conclusion, the lower prevalence of metabolic alterations in massive obesity might be related to genetic factors or to a protective role of the large amount of subcutaneous fat of these individuals. The presence of some elements of the MS also in normal weight controls indicate that even this group had a risk of development of MS. Hormonal differences detected in women with MS might be due to the already described different hypothalamic-pituitary-adrenal axis activity and/or to the effect of insulin resistance.