Metabolic syndrome in rural Bangladesh: Comparison of newly proposed IDF, modified ATP III and WHO criteria and their agreements

Abstract

Summary Background The prevalence of metabolic syndrome (MS) differs in different ethnic populations by using different definitions although the applicability of suitable definition for diagnosis of MS yet remains unanswered. Aim The aim the study was to determine the prevalence of metabolic syndrome (MS) in Bangladeshi rural population following the new International Diabetes Federation (IDF), modified ATP III and the World Health Organization (WHO) definition, and the concordance of these three criteria's for identifying metabolic syndrome was assessed. Subjects and methods The study involved 3981 subjects aged ≥20 years from the rural areas of Bangladesh. Fasting blood glucose (FBG) ( n = 3981) and oral glucose tolerance test (OGTT) ( n = 3954) were done. Blood lipids (T-chol, triglyceride, HDL-chol) from ( n = 3921) were assessed and anthropometry blood pressure were measured from all the subjects. Results The prevalence of metabolic syndrome was found to be 20.7%, 11.2% and 8.6% following modified ATP III, IDF and by the WHO definitions, respectively. Using all the three definitions the prevalence was higher in women in all age groups. ATP III and IDF criteria showed good agreement ( κ 0.65) compared to ATP III with WHO ( κ 0.45) and IDF with WHO ( κ 0.20) criteria. Conclusion Metabolic syndrome appeared to be highly prevalent in Bangladeshi population. Highest prevalence was observed following ATP III definition. The foremost rationale explanation for the higher rate of MS following ATP III seems to be predominant focus on the modified waist circumference for the Asian subjects. However, metabolic syndrome prevalence following WHO criteria in those with impaired glucose regulation is comparable with ATP III definition. Follow-up study is needed to examine the significance of MS following all definitions for the assessment of risk for diabetes and or cardiovascular disease (CVD).