Int J Obes (Lond). 2006 Jul 25; [Epub ahead of print]
Yoon YS, Lee ES, Park C et al.
'The new definition of metabolic syndrome by the international diabetes federation (IDF) is less likely to identify metabolically abnormal but non-obese individuals than the definition by the revised national cholesterol education program (NCEP)'. This is the title of a report from Korea. Metabolic syndrome is an asymptomatic cluster of risk factors which leads to heart disease and diabetes, both of which can be prevented if identified in time.
The new definitions for metabolic syndrome (MS) proposed by the IDF and revised NCEP have caused some confusion because patients have emerged that have satisfied the revised NCEP but not the IDF criteria. The study was performed to compare the prevalence of these criteria and to investigate the characteristics of discrepant cases.
A total of 7962 individuals aged >/= 20 years (3597 men; 4365 women) who participated in the 1998 Korean NHANES were included. The agreement between the revised NCEP and IDF criteria was assessed and the characteristics of cases satisfying the revised NCEP criteria but not the IDF criteria were investigated.
Results:
The prevalence of MS by the revised NCEP (25.7% of men and 31.9% of women) was higher than that according to the IDF (14.2% of men and 26.6% of women). The IDF criteria failed to identify 44.9% of men and 16.6% of women identified as having MS according to the revised NCEP criteria. The discrepant group showed more adverse metabolic profiles and unfavorable lifestyles despite lower waist circumference as compared with those having MS by both the IDF and revised NCEP criteria.
Conclusions:
The IDF criteria were inferior to the revised NCEP criteria in identifying 'metabolic obesity' known to predisposed to type 2 diabetes and cardiovascular disease. Further research regarding the appropriateness of central obesity as an obligatory criterion proposed by the IDF seems to be warranted.
The new NCEP criteria require any three of the following:
1.) Waist circumference >108cm for men and >88cm for women
2.) Raised blood fats
3.) Reduced 'good' (HDL) cholesterol
4.) Raised blood pressure (above 130/85)
5.) High blood sugar
Healthier weight centres screen each patient for metabolic syndrome and the above investigatations are done at the initial medical examination. The syndrome is important to pick up as it is symptomless and treatment reduces risk of future heart disease and the development of type 2 diabetes. - Dr D Rallan
