The metabolic syndrome in China

Abstract

The metabolic syndrome is a cluster of abnormalities including obesity, dyslipidaemia, abnormal blood glucose and raised blood pressure [1]. Reaven drew attention to this syndrome, which he called syndrome X [2]. Its importance is increasingly recognized in recent years because it predicts cardiovascular disease and the development of diabetes [3–6]. The metabolic syndrome is heterogeneous, so no definition is entirely satisfactory. The World Health Organization (WHO) proposed a definition in 1998 [7]. In 2001, the third report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel) (NCEP-ATPIII) defined it in terms of waist circumference, blood pressure and blood biochemistry [8, 9]. In 2005, the International Diabetes Federation (IDF) made abdominal obesity a prerequisite in the definition [10]. The WHO definition is difficult to embrace because glucose tolerance tests and measurement of insulin sensitivity are seldom performed in clinical practice. In the USA, the revised NCEP and the IDF definitions are quite consistent, with 92.9% agreement [11]. In other ethnic populations, such as Asians, the new ethnic-specific waist circumference criteria may slightly increase the prevalence of the metabolic syndrome [12].