Abstract 096: Comparison of Different Metabolic Syndrome Definitions for the Risks of Arterial Stiffness and Diabetes

Abstract

Context: The reported clinical outcomes of the metabolic syndrome (MetS), including cardiovascular disease and diabetes, vary according to the definitions used. Objective: 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 arterial stiffness and diabetes. Design, Setting, Participants, and Outcome Measures: In this Chinese population-based cross-sectional study, we screened subjects from a Health Examination Program from 1999-2015. The MetS scores were determined according to the ATP III/AHA/NHLBI and IDF criteria. A brachial-ankle pulse wave velocity (baPWV) ≧1400 cm/s indicated more severe arterial stiffness, and a high fasting glucose level ≧6.99 mmol/L or postprandial glucose level ≧11.10 mmol/L indicated diabetic-level hyperglycemia. Comparisons of the areas under receiver operating characteristic curves (AUC-ROC) for both MetS scores to predict a higher baPWV and diabetic-level hyperglycemia were evaluated. Results: Among the 26735 enrolled subjects (mean age 55 ± 12 years), 6633 (24.8%) and 7388 (27.6%) were classified as having MetS according to 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 predict a higher baPWV, P < 0.001; 0.791 vs. 0.665 to predict diabetic-level hyperglycemia, P < 0.001). Conclusions: To the best of our knowledge, this is the first study to show that through a holistic approach, the predictive performance of the ATP III/AHA/NHLBI-MetS score for the risks of arterial stiffness and diabetes was superior to the IDF-MetS score.