title: Relationship to insulin resistance of the adult treatment panel III diagnostic criteria for identification of the metabolic syndrome.
abstract: The Adult Treatment Panel III (ATP III) has published criteria for diagnosing the metabolic syndrome, a cluster of closely related abnormalities related to insulin resistance that increase cardiovascular disease risk. The present analysis was performed to evaluate the ability of these criteria to identify insulin-resistant individuals. The population consisted of 443 healthy volunteers, with measurements of BMI, blood pressure, fasting plasma glucose, triglycerides, HDL cholesterol concentrations, and steady-state plasma glucose (SSPG) concentration. Insulin resistance was defined as being in the top tertile of SSPG concentrations. Of the population, 20% satisfied ATP III criteria for the metabolic syndrome. Although insulin resistance and the presence of the metabolic syndrome were significantly associated (P < 0.001), the sensitivity and positive predictive value equaled 46% (69 of 149) and 76% (69 of 91), respectively. Being overweight, with high triglycerides, low HDL cholesterol, or elevated blood pressure, most often resulted in a diagnosis of the metabolic syndrome. Thus, the ATP III criteria do not provide a sensitive approach to identifying insulin-resistant individuals. The individual components vary both in terms of their utility in making a diagnosis of the metabolic syndrome and their relationship to insulin resistance, with the obesity and lipid criteria being most useful.
authors.affiliation: Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Cheal
authors.forename: Fahim
authors.initials: F
authors.lastname: Abbasi
authors.forename: Cindy
authors.initials: C
authors.lastname: Lamendola
authors.forename: Tracey
authors.initials: T
authors.lastname: McLaughlin
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Reaven
authors.forename: Earl S
authors.initials: ES
authors.lastname: Ford
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001835:Body Weight; D008076:Cholesterol, HDL / Q000097:blood; D003955:Diagnostic Tests, Routine / Q000592:standards*; D005260:Female; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D008875:Middle Aged; D009994:Osmolar Concentration; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides