Comparison of IDF criteria and NCEP ATP-III criteria for the diagnosis of metabolic syndrome in lean and non-lean NAFLD patients and its correlation with carotid intima media thickness

Abstract

Background and Aims: The International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) define different criteria for the diagnosis of metabolic syndrome (MetS). This study compares the proportion of patients diagnosed with MetS by IDF and NCEP-ATP III definitions among Lean and non-Lean Non-alcoholic fatty liver disease(NAFLD) patients and assesses correlation with Carotid Intima Media thickness(CIMT) values in these subsets. Methods: Cross-sectional observational study of 120 patients with lean NAFLD (BMI< 23kg/m2) and 120 non-lean NAFLD patients (BMI‰¥ 23kg/m2). Prevalence of MetS was estimated using the IDF and NCEP-ATP III definitions. CIMT was measured using carotid doppler ultrasound. Results: Among lean NAFLD subjects, MetS was diagnosed in 44(36.67%) by IDF criteria and 67(55.83%) by NCEP-ATP III criteria (p=0.003). There was a trend towards higher values of CIMT in lean NAFLD with MetS diagnosed by NCEP-ATP III criteria (mean CIMT- 0.58±0.04) than by IDF criteria (mean CIMT-0.57±0.07) although the difference was not statistically significant(p=0.641). In the non-lean NAFLD group, 91(75.83%) and 97(80.83%) patients were diagnosed with MetS according to the IDF and NCEP-ATP III criteria (p=0.348) respectively. There was no difference in the mean CIMT (0.58±0.08) of patients of MetS diagnosed by either IDF or NCEP-ATP III criteria in the non-lean NAFLD group. Conclusions: A higher proportion of patients were diagnosed with MetS by NCEP-ATP III criteria than by IDF criteria in the lean NAFLD group. This is probably because waist circumference is an essential criterion in IDF. No significant difference was observed in the proportion of MetS diagnosed by either criterion in the non-lean NAFLD group. Mean CIMT remains the same irrespective of the criteria used for MetS definition.