WHO and ATPIII proposals for the definition of the metabolic syndrome in patients with Type 2 diabetes

Abstract

Minimum criteria for the metabolic syndrome are met in most patients with Type 2 diabetes. Correct identification of the syndrome is important for an integrated approach to reduce the high costs and the associated disabilities. The ATPIII proposal more clearly identifies the burden of coronary heart disease associated with the metabolic syndrome.

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

“…Physicians carried out blood pressure measurements using an American Heart Association protocol1. After 5 min of rest in a sitting position, systolic and diastolic pressures were measured from the participant's right arm using a standard mercury sphygmomanometer.…”

“…Since the first official definition of MetS put forward by a working group of the World Health Organization (WHO) in 19991, a number of different definitions have been proposed. The most widely accepted of these definitions is the original WHO definition and alternatives proposed by the European Group for the Study of Insulin Resistance (EGIR)2, and the US National Cholesterol Education Program Adult Treatment Panel III (NCEA‐ATPIII)3.…”

The importance of diagnostic criteria in the association between the metabolic syndrome and cardiovascular disease in obese subjects

“…Notably, HDL cholesterol below the ATPIII cutoff value has been recognized as a predictor of CVD. 22 Therefore, differences in the prevalence in a particular population of a single risk factor included in the definition of the MS may have an important impact on the prevalence of the MS (50% in our study vs 70% in Marchesini's study 8 ) and affect the strength of its association with CVD. The importance of the utilization of a particular set of criteria to assess the CVD risk associated with the MS in obese adults is underscored by the nonsignificant concordance between the WHO and ATPIII diagnosis of the MS among subjects with CVD in our cohort.…”

“…The degree of agreement between the WHO and ATPIII MS definitions among subjects with CVD was not addressed in previous studies comparing the association of the MS and CVD. 2,7,8 Supporting the relationship between the MS and CVD, as the number of altered metabolic markers increased so did the degree of alteration of most of the CVD risk factors included in the MS definition. The metabolic score has previously been associated with the severity of coronary artery disease.…”

“…Therefore, not only the prevalence estimates of the MS but also its degree of association with CVD may vary depending on the definition used. 2,7,8 In the present study, we aimed to examine the association between the MS and CVD in obese adults using the two above-mentioned definitions of the MS. Obesity and the MS frequently coexist. 9,10 Furthermore, it has been suggested that obesity may precede the development of other MS components.…”