Key result
The IDF definition of metabolic syndrome identified a higher prevalence (25.8% in men, 19.5% in women) than NCEP or WHO definitions, but excess subjects had less insulin resistance and atherosclerosis.
Why the study?
Does the IDF definition of metabolic syndrome identify subjects with similar insulin resistance and carotid atherosclerosis compared to the NCEP and WHO definitions?
Cross-Sectional (n=1,518)
Does the IDF definition of metabolic syndrome identify subjects with similar insulin resistance and carotid atherosclerosis compared to the NCEP and WHO definitions?
The IDF definition of metabolic syndrome identifies more individuals than NCEP or WHO criteria, but these additional subjects have less insulin resistance and carotid atherosclerosis, potentially blurring the distinction between health and disease.
Answers are grounded in this paper and cite their sources.
IDF criteria may overidentify lower-risk subjects; leaves open optimal metabolic syndrome definition for insulin resistance and atherosclerosis.
BACKGROUND: The International Diabetes Federation (IDF) published a new definition of the metabolic syndrome (MetS). For this definition we compared frequency, concordance, clinical and laboratory stigmata and carotid atherosclerosis with those of the established definitions by the National Cholesterol Education Program (NCEP) and World Health Organization (WHO). MATERIALS AND METHODS: A total of 1518 subjects (943 men, 575 women) from the Salzburg Atherosclerosis Prevention Program in Subjects at High Individual Risk (SAPHIR), free of clinical atherosclerosis, were included in this study. To estimate insulin sensitivity two methods, i.e. homeostasis model assessment of insulin resistance (HOMA-IR) and the short insulin tolerance test, were employed. Carotid intima media thickness (IMT) and plaque extent were quantified for all subjects using high-resolution ultrasound. RESULTS: Prevalence of the MetS was 18.7% for men and 16.2% for women for the WHO definition, 18.9% and 17.0%, respectively, for the NCEP definition, and 25.8% and 19.5%, respectively, for the IDF definition. Concordance was lower between the definitions of WHO and IDF (< 50%) than between NCEP and IDF (> 67%). Compared to subjects identified by NCEP definition, subjects identified in excess by IDF (3.1-11.7%) showed less insulin resistance and lower IMT and plaque extent indistinguishable from MetS-free subjects. CONCLUSIONS: Our data suggest that the IDF definition includes subjects as MetS sufferers above these detected by NCEP or WHO, who exhibit considerably less insulin resistance and carotid atherosclerosis blurring the distinction between health and disease.
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Sandhofer et al. (2007) conducted a cross-sectional in Metabolic syndrome (n=1,518). IDF definition of metabolic syndrome vs. NCEP and WHO definitions of metabolic syndrome was evaluated on Prevalence of metabolic syndrome. The IDF definition of metabolic syndrome identified a higher prevalence (25.8% in men, 19.5% in women) than NCEP or WHO definitions, but excess subjects had less insulin resistance and atherosclerosis.
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