Different Definitions Of Metabolic Syndrome Research Articles

Comparison of different definitions of metabolic syndrome and their associations with non-alcoholic fatty liver disease: a retrospective study.

Metabolic syndrome (MetS) is considered an important risk factor for non-alcoholic fatty liver disease (NAFLD). The aim of this study was to measure the prevalence of MetS based on six different MetS definitions and compare the performance of various definitions for identifying diabetes, hypertension, and dyslipidemia among NAFLD patients. The definitions compared were those developed by the World Health Organization (WHO), National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF), American Association of Clinical Endocrinologists (AACE), American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI), and Interim Joint Statement "harmonized" criteria. Receiver operator characteristic (ROC) curves were plotted for the six MetS definitions with NAFLD diagnosis. The diagnosis for NAFLD was established based on liver imaging or biopsy compatible with fatty liver disease. A total of 500 NAFLD patients were analyzed. The mean age was 61.2 (SD 13.2) years, and BMI was 32.7 (SD 8.0) kg/m2. The most prevalent MetS component was dyslipidemia (83%), followed by hypertension (60%), obesity (61%), and diabetes (57%). The prevalence of MetS according to the WHO, NCEP/ATP-III, IDF, AACE, AHA/NHLBI, and harmonized criteria was 69%, 59%, 54%, 64%, 78%, and 79%, respectively. The highest area under the ROC curve for diabetes and hypertension was with the WHO definition (0.7405) and (0.8120), respectively. The prevalence of MetS in NAFLD patients varies according to the definitions of MetS employed. The modified WHO definition appeared to be most useful for the screening of MetS in NAFLD patients.

The clinical value of metabolic syndrome and its components with respect to sudden cardiac death using different definitions: Two decades of follow-up from the Tehran Lipid and Glucose Study

BackgroundTo evaluate the impact of different definitions of metabolic syndrome (MetS) and their components on the risk of sudden cardiac death (SCD) among the Iranian population according to the World Health Organization (WHO), International Diabetes Federation (IDF), Adult Treatment Panel III (ATP III), and Joint Interim Statement (JIS) criteria.MethodsThe study population included a total of 5,079 participants (2,785 women) aged ≥ 40 years, free of cardiovascular disease (CVD) at baseline. Participants were followed for incident SCD annually up to 20 March 2018. Multivariable Cox proportional hazards regression models were applied to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of MetS and its components for incident SCD.ResultsThe prevalence of MetS ranged from 27.16% to 50.81%, depending on the criteria used. Over a median of 17.9 years of follow-up, 182 SCD events occurred. The WHO, IDF, and JIS definitions were strong predictors of SCD with multivariable-adjusted HRs (95% CI) of 1.68 (1.20–2.35), 1.51 (1.12–2.03), and 1.47 (1.08–1.98), respectively; these associations significantly attenuated after further adjustment for MetS components. MetS by the ATP III definition was not associated with the risk of SCD after controlling for antihypertensive, glucose-lowering, and lipid-lowering medication use. Among the components of MetS, high blood pressure (WHO definition), high waist circumference (using the national cutoff of ≥ 95 cm), and high glucose component by the JIS/IDF definitions remained independent predictors of SCD with HRs of 1.79 (1.29–2.48), 1.46 (1.07–2.00), and 1.52 (1.12–2.05), respectively.ConclusionsThe constellation of MetS, except for when defined with ATP III definition, is a marker for identifying individuals at higher risk for SCD; however, not independent of its components. Among MetS components, abdominal obesity using the population-specific cutoff point, high glucose component (JIS/IDF definitions), and high blood pressure (WHO definition) were independent predictors of SCD.

Alternative pediatric metabolic syndrome definitions impact prevalence estimates and socioeconomic gradients.

There is no consensus regarding the definition of pediatric metabolic syndrome (MetS). This study assessed the impact of alternative definitions on the prevalence, children identified, and association with socioeconomic status (SES). Data were from the prospective multigenerational Dutch Lifelines Cohort Study. At baseline, 9754 children participated, and 5085 (52.1%) with average follow-up of 3.0 (SD = 0.75) years were included in the longitudinal analyses; median ages were 12 (IQR = 10-14) and 14 years (IQR = 12-15), respectively. We computed MetS prevalence according to five published definitions and measured the observed proportion of positive agreement. We used logistic regression to assess the SES-MetS association, adjusted for age and sex. Longitudinal models were also adjusted for baseline MetS. MetS prevalence and positive agreement varied between definitions, from 0.7 to 3.0% and from 0.34 (95% CI: 0.28; 0.41) to 0.66 (95% CI: 0.58; 0.75) at baseline, respectively. We consistently found a socioeconomic gradient; in the longitudinal analyses, each additional year of parental education reduced the odds of having MetS by 8% (95% CI: 1%; 14%) to 19% (95% CI: 7%; 30%). Alternative MetS definitions had differing prevalence estimates and agreed on 50% of the average number of cases. Additionally, regardless of the definition, low SES was a risk factor for MetS. Little is known about the impact of using different definitions of pediatric metabolic syndrome on study results. Our study showed that the choice of pediatric metabolic syndrome definition produces very different prevalence estimates. We also showed that the choice of definition influences the socioeconomic gradient. However, low socioeconomic status was consistently a risk factor for having pediatric metabolic syndrome. In conclusion, studies using different definitions of metabolic syndrome could be reasonably compared when investigating the association with socioeconomic status but not always validly when comparing prevalence studies.

Pediatric metabolic syndrome definitions impact prevalence and socioeconomic gradients

Abstract Background The choice of pediatric metabolic syndrome (MetS) definition influences prevalence estimates, but further implications, especially on the association with socioeconomic status (SES), are not well-known. This hampers a synthesis of the evidence to help guide the relevant stakeholders. For this reason, we aim to assess the impact of alternative definitions on the prevalence of MetS, the children that are identified, and the association between SES and MetS. Methods Data were used from the Lifelines Cohort Study, a prospective multigenerational cohort in the Netherlands. At baseline 9,754 children participated, of which 5,085 (52.1%) were included in the longitudinal analyses. We computed the prevalence of MetS according to five published definitions and measured the observed positive agreement between pairs of definitions, indicating the proportion of agreement across the average number of MetS cases. Logistic regression was used to assess the association between SES and MetS. All models were adjusted for age and sex; the longitudinal models were also adjusted for baseline MetS status. Results The prevalence rates of MetS varied between definitions (0.7-3.0% at baseline), but positive agreement between MetS definitions was generally fair to good ranging from 0.34 (95% confidence interval (CI) 0.28; 0.41) to 0.66 (95%CI 0.58; 0.75) at baseline. At both assessments, we found an inverse association between baseline SES and MetS, which ranged from 0.81 (95%CI 0.70; 0.93) to 0.92 (95%CI 0.86; 0.98) per definition in the longitudinal analyses with a mean follow-up (SD) of 3.0 (0.75) years. Conclusions Alternative definitions of MetS lead to differing prevalence estimates, and they agreed on 50% of the average number of cases of MetS. The alternative definitions also lead to similar socioeconomic gradients; regardless of which definition was used we concluded low SES was a risk factor for developing MetS. Key messages Evidence regarding different definitions of metabolic syndrome in children can be combined because the agreement among definitions is generally fair to good. As low socioeconomic status is a consistent risk factor for developing metabolic syndrome, preventive interventions should preferentially target children from low socioeconomic backgrounds.

Prevalence of Metabolic Syndrome among Students of Faculty of Health Science and Technology in Ebonyi State University,

Metabolic impairments could be seen at any point in human development. Although emphasis has been placed on older adults but it could be encountered in any age brackets. The aim of this study was to compare prevalence rates using different definitions of Metabolic syndrome (MetS) among students of Faculty of Health Sciences and Technology (FHST) in Ebonyi State University (EBSU), Abakaliki.  This was a cross-sectional study involving 80 students (28 male students and 52 female students) recruited from among students of FHST in EBSU, Abakaliki, Ebonyi State, Nigeria. MetS was defined in three different ways [by International Diabetes Federation (IDF), National Cholesterol Education Program—Adult Treatment Panel III (NCEP-ATPIII), or World Health Organization (WHO) criteria]. Prevalence was found to be 6.3%, 2.5% and 7.5% using NCEP-ATP III, WHO, and IDF definitions respectively. The most common MetS components among female students using the NCEP-ATP III criteria were high blood pressure (5.8%) and abdominal obesity (5.8%), whilst low HDL-C concentrations, high blood pressure and abdominal obesity were most common among male students (7.1 % for each component mentioned). According to WHO, abdominal obesity (7.1%) and hyperglycaemia (7.1%) were the most common MetS components among male students. The most common MetS components among participants using the IDF criteria were abdominal obesity and high blood pressure. While some participants did not meet the MetS criteria of the NCEP-ATP III, WHO and IDF criteria (50%), many had one (30%) or two (13.8%) components and may be at risk of developing the syndrome in the future. The mean values of the risk factors used as criteria for the diagnosis of MetS were relatively normal in the study population thereby masking the presence of MetS, thus showing that the prevalence of MetS may gradually increase undetected unless individual members of the study population are subjected to laboratory investigation using different criteria for diagnosis of MetS. Therefore, traditional risk factors might be late markers for diagnosis of MetS since findings from this study showed that MetS was only detected in participants that already had it.

A Comparative Prevalence Of Metabolic Syndrome Among Type 2 Diabetes Mellitus Patients In Hawassa University Comprehensive Specialized Hospital Using Four Different Diagnostic Criteria.

BackgroundRecognition of MetS in type two diabetic patients is important in starting the appropriate preventive and therapeutic measures. The commonly used definitions of MetS have similarities and discrepancies. Different definitions defined metabolic syndrome differently. IDF, WHO, NCEP-ATP III, and the harmonized definitions were used frequently to determine the prevalence of metabolic syndrome.ObjectivesThis study was aimed to investigate the prevalence of MetS and its associated factors among patients with type 2 Diabetes Mellitus using four definitions and to identify the concordance and the difference of these four definitions.MethodsA cross-sectional study was conducted from February 28 to May 30/2017 at Hawassa university comprehensive specialized hospital. The study involved 314 study participants selected by simple random sampling technique. Logistic regression was used to determine associated factors of metabolic syndrome, and kappa statistics was used to determine the concordance between different definitions of metabolic syndrome. In any cases, a p-value of <0.05 was considered to be statistically significant.ResultThe prevalence of metabolic syndrome according to IDF, WHO, harmonized, and NCEP-ATP III diagnostic criteria was 59.9%, 31.2%, 65.6%, and 70.1%, respectively. Our study found the maximum agreement between IDF and NCEP criteria (K=0.54, P<0.001) and IDF and Harmonized(K=0.65, P<0.001). Uric acid level was associated factor of metabolic syndrome by all the four definitions, and total cholesterol was associated factors by the three definitions.ConclusionThe prevalence of metabolic syndrome varies based on the definition used and the highest prevalence of MetS was observed with NCEP-ATP III and the different types of criteria do not always diagnose the same group of individuals.

A comparison of different definitions of metabolic syndrome for the risks of atherosclerosis and diabetes

BackgroundThe reported outcomes of the metabolic syndrome (MetS), containing atherosclerotic cardiovascular disease and diabetes, vary according to the definitions used. This study was designed to compare the performance of the Adult Treatment Panel III/American Heart Association/National Heart, Lung, and Blood Institute (ATP III/AHA/NHLBI) and International Diabetes Federation (IDF) criteria for the risks of atherosclerosis and diabetes.MethodsWe sifted subjects from a self-paid Health examination program from 1999 to 2015 in this cross-sectional population-based study. On the basis of the ATP III/AHA/NHLBI and IDF criteria, the MetS diagnosis and scores were concluded. A brachial-ankle pulse wave velocity (baPWV) more than or equal to 1400 cm/s indicated more severe arterial stiffness, and a high fasting glucose level more than or equal to 6.99 mmol/L or postprandial glucose level more than or equal to 11.10 mmol/L indicated diabetic-level hyperglycemia. Comparisons of the areas under receiver operating characteristic curves (AUC–ROC) for both MetS scores to correlate with a higher baPWV and diabetic-level hyperglycemia were evaluated.ResultsIn the 26,735 enrolled subjects with an average age of 55 (± 12) years, 6633 and 7388 (24.8% vs. 27.6%, p < 0.001) were classified as having MetS on the basis of the ATP III/AHA/NHLBI and IDF criteria, respectively. The AUC–ROC for the ATP III/AHA/NHLBI-MetS score were higher than those for the IDF-MetS score (0.685 vs. 0.595 to correlate with a higher baPWV, p < 0.001; 0.791 vs. 0.665 to correlate with diabetic-level hyperglycemia, p < 0.001).ConclusionsTo the best of our knowledge, this is the first study to demonstrate that through a holistic approach, the performance of the ATP III/AHA/NHLBI-MetS score for the risks of atherosclerosis and diabetes was superior to the IDF-MetS score for Asians.

Comparing associations of different metabolic syndrome definitions with ischemic stroke in Chinese elderly population

ObjectivesStudies have showed the associations between different definitions of metabolic syndrome (MetS) and risk of ischemic stroke were inconsistent. In this study, we compared associations of different MetS definitions with ischemic stroke in Chinese elderly population. MethodsA total of 1713 individuals aged 70–84years from Rugao Longevity and Ageing Study were analyzed. The MetS was defined by four different criteria: Chinese Adult Dyslipidemia Prevention Guide, International Diabetes Federation (IDF), Updated ATPIII (Updated ATPIII) by American heart association/American heart, lung and blood institute (AHA/NHLBI), and Joint Interim Statement(JIS) recommended by IDF and the American heart association/American national institutes of health/American heart, lung and blood institute (AHA/NIH/NHLBI). ResultsPrevalence of MetS in the whole population was 24.0% (Chinese guide), 32.5% (IDF), 38.8% (Updated ATPIII) and 24.0% (JIS) and in stroke population was 27.1% (Chinese guide), 41.1% (IDF), 48.8% (Updated ATPIII) and 27.1% (JIS), respectively. The agreement between definitions was highest in Updated ATPIII vs. IDF (kappa=0.863). It showed that only definitions of IDF (OR 1.55, 95%CI 1.04–2.31, p=0.031) and Updated ATPIII (OR 1.64, 95%CI 1.11–2.42, p=0.013) were independently associated with risk of ischemic stroke in multivariable logistic regression analysis. The risk of ischemic stroke increased with the increasing of numbers of Mets components in Updated ATPIII (p<0.05). ConclusionIn this population, Updated ATPIII criteria was a more suitable definition of Mets than definitions of Chinese guide, IDF and JIS for screening high-risk individuals of ischemic stroke, and the additive effects of Mets components might play a greater role than its composition alone in ischemic stroke.

Optimal cut-off levels of obesity indices by different definitions of metabolic syndrome in a southeast rural Chinese population.

Aims/IntroductionThe aim of the present study was to compare the cut‐off values and prediction effect of different obesity indices by different definitions of metabolic syndrome (MetS) in Zhejiang Province of China.Materials and MethodsWe carried out a cross‐sectional survey of 10,100 individuals (age 40 years and older) in Jiashan, Zhejiang Province. Receiver operating characteristic analysis was used to examine discrimination and find optimal cut off values of waist circumference (WC), body mass index (BMI), waist‐to‐hip ratio (WHR) and waist‐to‐height ratio (WHtR) to predict two or more non‐adipose components of MetS by The National Cholesterol Education Program Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III) definition modified by the Asia–Pacific region criteria, International Diabetes Federation definition for the Chinese population and Chinese Diabetes Society definitions of MetS.ResultsThe age‐standardized prevalence of MetS was 23.78% vs 28.76% vs 19.37% by The National Cholesterol Education Program Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III), International Diabetes Federation and Chinese Diabetes Society definitions, respectively. Cut‐off values of BMI were approximately 24 kg/m2 both in men and women by three definitions; the average cut‐off values of WC, WHR and WHtR were 83 cm in men vs 81 cm in women, 0.89 in men vs 0.86 in women and 0.50 in men vs 0.51 in women, respectively. The area under receiver operating characteristic curve of BMI was larger than WC both in men and women (P < 0.05); in women, the area under receiver operating characteristic curve of WHtR was larger than WC, and WHR was smaller.ConclusionsMetS is prevalent in Zhejiang Province of China, especially in the female population. BMI and WHtR might be more useful than WC and WHR for predicting two or more non‐adipose components of MetS.

Metabolic predispositions and increased risk of colorectal adenocarcinoma by anatomical location: a large population-based cohort study in Norway.

Whether different definitions of metabolic syndrome (MetS) are differently associated with colorectal adenocarcinoma (CA) by anatomical location is unclear. A population-based cohort study, the Cohort of Norway (CONOR) Study, was conducted in Norway from 1995 to 2010. Anthropometric measurements, blood samples, and lifestyle data were collected at recruitment. CAs were identified through linkage to the Norwegian Cancer Register. A composite index of MetS as defined by the International Diabetes Federation (IDF) or/and the National Cholesterol Education Program's Adult Treatment Panel III (ATP III) and single components of MetS, including anthropometric factors, blood pressure, lipids, triglycerides, and glucose, were analyzed. Cox proportional hazards regression was performed to estimate hazard ratios and 95% confidence intervals. Significant associations between single MetS components and CA, except for reduced high-density lipoprotein cholesterol and nonfasting glucose levels, were observed. MetS defined by 2 criteria separately showed a similar association with CA in general, and MetS defined by both the IDF and ATP III showed consistent results. Stronger associations were observed in the proximal colon among men (IDF: hazard ratio (HR) = 1.51, 95% confidence interval (CI): 1.24, 1.84; ATP III: HR = 1.40, 95% CI: 1.15, 1.70) and in the rectum among women (IDF: HR = 1.42, 95% CI: 1.07, 1.89; ATP III: HR = 1.43, 95% CI: 1.08, 1.90).

The association of metabolic syndrome and urolithiasis.

There has been an increasing prevalence of kidney stones over the last 2 decades worldwide. Many studies have indicated a possible association between metabolic syndrome and kidney stone disease, particularly in overweight and obese patients. Many different definitions of metabolic syndrome have been suggested by various organizations, although the definition by the International Diabetes Federation (IDF) is universally considered as the most acceptable definition. The IDF definition revolves around 4 core components: obesity, dyslipidemia, hypertension, and diabetes mellitus. Several hypotheses have been proposed to explain the pathophysiology of urolithiasis resulting from metabolic syndrome, amongst which are the insulin resistance and Randall's plaque hypothesis. Similarly the pathophysiology of calcium and uric acid stone formation has been investigated to determine a connection between the two conditions. Studies have found many factors contributing to urolithiasis in patients suffering from metabolic syndrome, out of which obesity, overweight, and sedentary lifestyles have been identified as major etiological factors. Primary and secondary prevention methods therefore tend to revolve mainly around lifestyle improvements, including dietary and other preventive measures.

Abstract B28: Racial/ethnic differences in prostate-specific antigen levels among U.S. men with metabolic syndrome: Results from NHANES 2001-2006

Abstract Objective: Effect of the interplay between metabolic syndrome and race/ethnicity on prostate specific antigen (PSA) remains unclear. Different definitions of metabolic syndrome (National Cholesterol Education Program [ATP III], International Diabetes Federation [IDF] and World Health Organization [WHO]) may influence PSA disparities. Prevalence of these definitions varies by race/ethnicity. Little is known whether the degree to which serum PSA levels differ is dependent upon the metabolic syndrome definition used, and whether these associations vary by race and ethnicity. Methods: We measured serum PSA (ng/mL) in 3528 adult men &amp;gt;40 years from the National Health and Nutrition Examination Survey (NHANES) 2001-2006. Metabolic syndrome was defined with ATP III, IDF, and WHO criteria. Racial/ethnic groups included non-Hispanic blacks (NHB's), non-Hispanic whites (NHW's) and Mexican-Americans (MA's). We computed adjusted geometric mean PSA by definition of metabolic syndrome and race/ethnicity. Univariate and multivariate regression analysis were performed. Results: Univariate analysis was used to calculate age adjusted geometric mean PSA. Multivariable analysis were adjusted for age, smoking, moderate and vigorous physical activity and plasma-volume. Multivariable analyses showed men classified with ATP III and WHO metabolic syndrome had lower PSA concentrations than those without it (P=0.01 and P=0.03, respectively). Stratifying these associations by race and ethnicity showed that NHW's classified with ATP III and WHO definitions had lower PSA concentrations than those without it (P&amp;lt;0.01 and P=0.04, respectively). Similarly, MA's classified with WHO metabolic syndrome had lower PSA concentration than those without it (P=0.02). No significant differences were detected in PSA levels among NHB's with and without metabolic syndrome. Conclusion: Different criteria for defining metabolic syndrome and its stratification by race and ethnicity had an inverse effect on PSA concentrations among MA and NHW. Our findings highlight the implications when investigating the interplay of different anthropometric measurements and metabolic factors with PSA levels by race and ethnicity. Citation Format: Shailesh M. Advani, David S. Lopez. Racial/ethnic differences in prostate-specific antigen levels among U.S. men with metabolic syndrome: Results from NHANES 2001-2006. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B28. doi:10.1158/1538-7755.DISP13-B28

Added value of different metabolic syndrome definitions for predicting cardiovascular disease and mortality events among elderly population: Tehran Lipid and Glucose Study.

To examine the association between the different definitions of metabolic syndrome (MetS) and the prediction of incident cardiovascular disease (CVD) and mortality events and to determine whether the concept of MetS adds to traditional risk factors among elderly Iranians. The association between MetS and outcomes wasexamined in 922 adultsaged ⩾65 years, free of CVD at baseline, using multivariate Cox proportional hazards models. To examine whether MetS could enhance prediction of outcomes beyond that achieved by risk factors; the net reclassification improvement index was used. During a median follow-up of 9.9 years, 207 CVD events and 193 deaths (82 CVD deaths) occurred. World health organization (WHO) and the joint interim statement (JIS) definitions were shown to be the strongest predictors of CVD events. The WHO definition predicted CVD and all-cause mortality events (hazard ratio (HR)=1.55 (95% confidence interval (CI)=1.15-2.09) and 2.08 (95% CI=1.23-3.51), respectively) and the JIS definition showed a risk for CVD mortality (HR=1.65 (95% CI=1.03-2.65)). Different definitions of MetS did not add to traditional risk factors in the prediction of different outcomes. The WHO definition was the strongest predictor of CVD and mortality outcomes;however, none of the MetS definitions provided added value to traditional risk factors.

Diagnostic values of different definitions of metabolic syndrome to detect poor health status in Iranian adults without diabetes

This study aimed to compare the diagnostic impact of four definitions of the metabolic syndrome for detection of poor health status in adults without diabetes living in Tehran. A representative sample of 950 individuals (64% women), aged ≥20years, participants of the Tehran Lipid and Glucose Study in 2005-2007, were recruited for the study. Health status was assessed using the Iranian version of the 36-item Short Form Health Survey. We assessed the detectability of poor health status by definitions of the National Cholesterol Education Program Adult Treatment PanelIII, the International Diabetes Federation, the American Heart Association/National Heart, Lung, and the Blood Institute and the Joint Interim Statement. Compared with other definitions, the Joint Interim Statement identified more participants (46.9%) having the metabolic syndrome. Using the National Cholesterol Education Program Adult Treatment Panel III, the International Diabetes Federation and the Joint Interim Statement, the metabolic syndrome was significantly related to poor physical health status, even after adjustment for confounding variables, in women, but not in men. None of the four definitions of the metabolic syndrome was related to the mental health status in either gender. The receiver operating characteristic curves showed no significant difference in the discriminative power of the metabolic syndrome definitions in detecting poor health status in either gender. However, women showed a higher area under the curve for all definitions, in comparison with men. There was no difference in the four different definitions of the metabolic syndrome in detecting poor health status among Iranian adults.

Metabolic Syndrome (MetS)

The clinical cluster of hypertension, cardiovascular disease, hyperlipemia, hyperuricemia and type 2 Diabetes had been recognized by physicians for many decades, described as syndrome X and finally metabolic syndrome (MetS). A few decades ago, investigators noted this syndrome in the alarming pandemic of obesity and type 2 diabetes. Different definitions of metabolic syndrome had been developed by the World Health Organization (WHO), the National Cholesterol Education Program me Adult Treatment Panel 111 (NCEP-ATP111) and by the International Diabetes Federation (IDF). High Triglycerides, low HDL-C, hypertension, raised fasting plasma glucose, and central obesity are essential factors. Obligatory factors such as obesity (BMI ≥ 30) and high waist circumference with ethnic specificity were required by WHO and IDF criteria respectively. Cutoff points of systolic and diastolic blood pressures, HDL-C and fasting plasma glucose of WHO criteria were required to be adjusted; and cutoff points of waist circumference for males and females of IDF were required to be standardized with European and non-European populations, South Asians and South-East Asians of WHO and IDF criteria. Later, three out of five criteria was introduced by NCEP ATP111 instead of obligatory requirements plus two out of four criteria used by WHO and IDF. To be practical for application to public health sectors, MetS has been defined by at least two criteria such as hypertriglyceridemia-waist and hypertensive-waist by validation to IDF criteria definition. Some elements of MetS are noted to be clustered more frequently in some ethnic populations. Individuals without type 2 DM, obesity or MetS are noted to have low HDL-C regardless of age in some populations, probably based on genetic susceptibility. Gender also has an impact on HDL-C level, lower in females than males in general. Then, triglycerides and total cholesterol levels increase with age.

Prognostic impact of different definitions of metabolic syndrome in predicting cardiovascular events in a cohort of non-diabetic Tehranian adults

BackgroundThe applicability of different definitions of metabolic syndrome (MetS) in predicting cardiovascular diseases (CVD) remains questionable. The aim of this study was to compare predictive ability of different definitions of MetS for CVD in non‐diabetic subjects. MethodsIn this community-based study, 5198 non‐diabetic subjects aged≥30years (mean age 45.6years, 45% men) free of CVD at baseline were followed for a median of 9.3years to assess risk for CVD. We assessed the predictability of definitions of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), the International Diabetes Federation (IDF), the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI), and the joint interim statement (JIS) on development of CVD. Hazard ratios (HRs) were calculated using Cox proportional‐hazards models. The receiver operating characteristic (ROC) curve was also used to compare discriminative power of these MetS definitions in predicting CVD events. ResultsCompared to other definitions, the JIS identified more participants (41.8%) having MetS. First CVD events occurred in 311 subjects. After adjustment for potential confounders, the HRs of the NCEP-ATP III, AHA/NHLBI, IDF and JIS definitions for incident CVD were 1.55 (1.21–2.00), 1.73 (1.35–2.20), 1.54 (1.22–1.94) and 1.70 (1.34–2.17), respectively. All definitions showed higher HRs for females in comparison to males (P<0.05). ROC analysis showed no significant difference in the discriminative power of different MetS definitions in predicting CVD events (P>0.05). ConclusionsIn the current study, compared to each other none of the definitions showed a superior discriminative power in predicting CVD; although, all definitions were more predictive in females than in males.

Diagnostic values of metabolic syndrome definitions for detection of insulin resistance: Tehran Lipid and Glucose Study (TLGS).

This study examines the characteristics and agreement between different definitions of metabolic syndrome (MetS) and insulin resistance (IR). A total of 347 non-diabetic individuals who were ≥ 20 years of age were selected from the Tehran Lipid and Glucose Study (TLGS). Subjects were categorized as having MetS by the Adult Treatment Panel III (ATP III) and the Joint Interim Statement (JIS). IR was estimated by using the homeostasis model assessment (HOMA-IR). According to ATP III and JIS criteria 38.9% and 38.2% of subjects had MetS respectively. The sensitivity of ATP III was 52.3% and specificity was 65%; for JIS the sensitivity was 52.3%, with a specificity of 66.5%. Kappa between ATP III or JIS and HOMA-IR was 0.14 and 0.16, respectively. Based on receiver operating characteristic (ROC) analysis, the use of waist circumference (WC) and fasting plasma glucose (FPG) for the diagnosis of IR in women showed a diagnostic accuracy equal to or instead of counting MetS components using modified ATP III or JIS. WC optimal cut points for prediction of IR were 93.5 cm for men and 92.5 cm for women. ATP III and JIS definitions have low sensitivities and specificities for detecting IR. There is poor agreement between these criteria and IR.

All-cause and cardiovascular mortality risk estimation using different definitions of metabolic syndrome in Lithuanian urban population

ObjectiveThe objective of the study was to assess mortality risk in the subjects with diagnosed metabolic syndrome (MS) using National Cholesterol Educational Program (NCEP-ATPIII), American Heart Association and National Heart Lung and Blood Institute (AHA/NHLBI) International Diabetes Federation (IDF) and Joint Interim Societies (JIS) definitions. MethodsTwo random samples aged 35–64years were examined in 1992–2002 in the framework within the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study (N=2455). The follow-up was carried out in terms of the end points reached from the baseline health examinations until December 31, 2009. ResultsCox regressions demonstrated that MS defined by IDF and JIS definitions remained the only significant determinants for all-cause mortality (RR=1.48 and RR=1.41; p<0.05) and cardiovascular disease (CVD) mortality in men (RR=1.81 and RR=1.66; p<0.05). In men (without previous CVD) the NCEP-ATPIII definition had increased mortality risk from CVD (RR=1.98; p=0.012), than in men with identified MS by the IDF and the new JIS definition. In women the MS was not associated with risk of mortality from CVD. ConclusionThe MS definitions according to the IDF and JIS criteria appear to be a slightly better predictor of all-cause mortality and mortality from CVD; MS according to the NCEP-ATPIII criteria appears to be a better predictor of mortality from CVD in men.

Impact of Different Definitions of Metabolic Syndrome on Clinical Outcome

Impact of Different Definitions of Metabolic Syndrome on Clinical Outcome

Impact of Different Definitions of Metabolic Syndrome on Clinical Outcome

Impact of Different Definitions of Metabolic Syndrome on Clinical Outcome