Abstract
Objective: extensive effort has been made to better define metabolic syndrome (MetS). Whether current definitions accurately diagnose MetS and predict risk of cardiovascular disease (CVD) or diabetes in diverse ethnic groups remains largely unknown. The objective of this study was to compare the prevalence of MetS and risk of CVD and diabetes among Asian American adults using two MetS definitions, one proposed by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) and one by the International Diabetes Federation (IDF). Methods: we obtained a nationally representative sample of 2121 Asian American adults in the noninstitutionalized civilian population of the United States from the National Health and Nutrition Examination Survey (2011–2016). We computed age-adjusted, gender-specific MetS prevalence and each MetS component using ATP III and IDF definitions. Results: based on the IDF definition, MetS prevalence was 39.26% among Asian American men and 39.66% among Asian American women included in the study sample. Based on the ATP III definition, MetS prevalence in our sample was 39.38% among men and 36.11% among women. We found good concordance between the IDF and the ATP III definitions in identifying MetS in Asian American adults. Those with MetS defined only by the IDF definition had significantly higher body mass index (BMI) and waist circumference than those with MetS defined only by the ATP III definition. The IDF definition also better predicted elevated fasting insulin. Conclusions: the IDF definition is more pertinent than the ATP III definition for screening and estimating risk of CVD and diabetes in Asian American adults. Future studies should examine differences in MetS prevalence across Asian ethnic groups to facilitate the development of culturally tailored strategies improve MetS prevention and detection in Asian Americans.
Highlights
Metabolic syndrome (MetS) is a disease entity characterized by a complex constellation of physiological, biochemical, and metabolic factors [1,2,3,4]—including abdominal obesity, insulin resistance, elevated arterial blood pressure, and dyslipidemia [1,2,3,5]
We found that MetS by the Adult Treatment Panel III (ATP III) definition (OR = 4.27, 95% confidence intervals (CIs): 3.14–5.80) and International Diabetes Federation (IDF) definition (OR = 4.59, 95% CI: 3.35–6.28) were both independently and significantly associated with elevated fasting insulin, but not with elevated uric acid
IDF-defined MetS prevalence in this study population was similar in men (39.26% vs. 39.38%) and slightly higher in women (39.66% vs. 36.11%), when compared to prevalence by the ATP III definition
Summary
Metabolic syndrome (MetS) is a disease entity characterized by a complex constellation of physiological, biochemical, and metabolic factors [1,2,3,4]—including abdominal obesity, insulin resistance, elevated arterial blood pressure, and dyslipidemia (elevated triglycerides, decreased high-density lipoproteins) [1,2,3,5]. The modified National Cholesterol Education Program Adult Treatment Panel III (ATP III) [2] and the International Diabetes Federation (IDF) [12] have become the most widely utilized and compared [13,14,15,16,17,18,19] While criteria for both ATP III and IDF consider central obesity (defined by waist circumference, with ethnicity- and gender-specific cutoff values), the IDF uses central obesity as a prerequisite for diagnosis, while the ATP III considers central obesity as one component out of several that could be present. It is still controversial which definition is more accurate in detecting CVD risk [20] and for which ethnic groups
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