Abstract
BackgroundThe reported outcomes of the metabolic syndrome (MetS), containing atherosclerotic cardiovascular disease and diabetes, vary according to the definitions used. This study was designed to compare the performance of the Adult Treatment Panel III/American Heart Association/National Heart, Lung, and Blood Institute (ATP III/AHA/NHLBI) and International Diabetes Federation (IDF) criteria for the risks of atherosclerosis and diabetes.MethodsWe sifted subjects from a self-paid Health examination program from 1999 to 2015 in this cross-sectional population-based study. On the basis of the ATP III/AHA/NHLBI and IDF criteria, the MetS diagnosis and scores were concluded. A brachial-ankle pulse wave velocity (baPWV) more than or equal to 1400 cm/s indicated more severe arterial stiffness, and a high fasting glucose level more than or equal to 6.99 mmol/L or postprandial glucose level more than or equal to 11.10 mmol/L indicated diabetic-level hyperglycemia. Comparisons of the areas under receiver operating characteristic curves (AUC–ROC) for both MetS scores to correlate with a higher baPWV and diabetic-level hyperglycemia were evaluated.ResultsIn the 26,735 enrolled subjects with an average age of 55 (± 12) years, 6633 and 7388 (24.8% vs. 27.6%, p < 0.001) were classified as having MetS on the basis of the ATP III/AHA/NHLBI and IDF criteria, respectively. The AUC–ROC for the ATP III/AHA/NHLBI-MetS score were higher than those for the IDF-MetS score (0.685 vs. 0.595 to correlate with a higher baPWV, p < 0.001; 0.791 vs. 0.665 to correlate with diabetic-level hyperglycemia, p < 0.001).ConclusionsTo the best of our knowledge, this is the first study to demonstrate that through a holistic approach, the performance of the ATP III/AHA/NHLBI-MetS score for the risks of atherosclerosis and diabetes was superior to the IDF-MetS score for Asians.
Highlights
The reported outcomes of the metabolic syndrome (MetS), containing atherosclerotic cardiovascular disease and diabetes, vary according to the definitions used
The number of individual components of both MetS definitions included: (1) 4158 (15.6%) for waist circumference (WC) according to the Adult Treatment Panel III (ATP III)/AHA/NHLBI-MetS and 12,602 (47.1%) according to the International Diabetes Federation (IDF)-MetS; (2) 15,713 (58.8%) for blood pressure (BP); (3) 8223 (30.8%) for fasting glucose; (4) 8408 (31.4%) for triglyceride; and (5) 7751 (29.0%) for high-density lipoprotein cholesterol level (HDL-C)
In all 26,735 subjects, 6633 (24.8%, 95% CI 24.3–25.3) with an average age of 57 (± 12) years and 2695 (41%) female were classified as having the ATP III/AHA/NHLBI-MetS compared to 7388 (27.6%, 95% CI 27.1–28.2) with an average age of 57 (± 12) years and 3107 (42%) female as having the IDFMetS (24.8% vs. 27.6%, p < 0.001)
Summary
The reported outcomes of the metabolic syndrome (MetS), containing atherosclerotic cardiovascular disease and diabetes, vary according to the definitions used. Syndrome X, later termed MetS, is recognized as a multiplex risk factor for type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD) due to high correlations with insulin resistance. MetS is currently described as the grouping of abdominal obesity, insulin resistance, elevated blood pressure (BP), and obesity-related dyslipidemia, while highly correlated with other clinical disorders such as nonalcoholic fatty liver disease, a prothrombotic or proinflammatory state, and reproductive problems [4,5,6]. Previous studies have revealed that MetS is correlated with unfavorable clinical outcomes, including a fivefold increased risk of new diagnosed type
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