The 6th Annual World Congress on the Insulin Resistance Syndrome

Abstract

This is the third of a series of articles based on presentations at the 6th Annual World Congress on the Insulin Resistance Syndrome held 25–27 September 2008 in Los Angeles, California. ### Insulin resistance epidemiology In an update on the metabolic syndrome, Earl Ford (Atlanta, GA) discussed epidemiological relationships between metabolic syndrome and incident diabetes and compared the syndrome with risk prediction models. Over the past 3 years, more than 3,000 articles have been written about the syndrome. The 1998 World Health Organization (WHO) definition focused on glucose intolerance or insulin resistance, the 1999 European Group for the Study of Insulin Resistance required either insulin resistance or fasting hyperinsulinemia, and the NCEP/ATP III (National Cholesterol Education Program/Adult Treatment Panel III) definition in 2001 did not focus on glycemia or insulin resistance, simply requiring three of five abnormalities (abdominal obesity, low HDL cholesterol, high triglyceride levels, hypertension, and hyperglycemia), in 2002 and 2005 changing the glycemic criteria. The 2005 International Diabetes Federation (IDF) definition focused on central adiposity, giving ethnic-specific limits. The American College of Endocrinology also proposed a definition, giving a large number of possible conditions associated with insulin resistance. Using the 1999–2004 National Health and Nutrition Examination Survey data, the age-adjusted prevalence of metabolic syndrome in adults is ∼35% with ATP III and 38% with IDF definitions. Based on the projected U.S. population of 218,000,000 adults in 2007, then, there are ∼80,000,000 individuals with metabolic syndrome. There is heterogeneity by ethnicity and sex, with prevalence lowest in African American men and higher in Hispanic women. With the IDF definition, prevalence of the syndrome is greater in men than women. A number of studies have analyzed the association of metabolic syndrome with cardiovascular disease (CVD) and diabetes, with meta-analysis showing a relative CVD risk of 1.5–1.8 and a threefold increase in likelihood of diabetes …