The metabolic syndrome and incident diabetes: assessment of four suggested definitions of the metabolic syndrome in a Chinese population with high post-prandial glucose.
OBJECTIVE
To assess the sensitivity and specificity of the four definitions of the metabolic syndrome for incident diabetes in both men and women.


METHODS
The screening survey for type 2 diabetes was conducted in 1994. A follow-up study on 627 high-risk non-diabetic individuals at baseline was carried out in 1999 in Beijing area. 70 men and 76 women developed diabetes during the five-year follow-up. Sensitivity and specificity of four definitions of the metabolic syndrome based on the NCEP, WHO, EGIR and AACE recommendations were compared by McNemar's test.


RESULTS
The metabolic syndrome based on all four definitions identified men at a 3.7-4.5-fold and women at a 1.6-2.8-fold risk of developing diabetes during 5-year follow-up. The AACE definition had the highest sensitivity for predicting diabetes (men: 0.61; women: 0.58) and lowest specificity (men: 0.71; women: 0.70). The WHO definition identified 53 % of male and 42 % female incident diabetes. The NCEP definition of adiposity as waist girth > 102 cm was the least sensitive, detecting only 27 % of incident diabetes in men; however, it was the most specific (0.91). The EGIR definition identified the lowest number of female cases (28 %) and fewer male cases (28 %) of incident diabetes, but was specific (women: 0.87; men: 0.91).


CONCLUSIONS
Further studies on definition of the metabolic syndrome should focus on the potential ethnic differences in insulin resistance and anthropometric indicators for obesity.
Wang
J J
JJ
Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, National Public Health Institute, FIN-00300 Helsinki, Finland. jianjun.wang@ktl.fi
Hu
G
G
Miettinen
M E
ME
Tuomilehto
J
J
D001786:Blood Glucose / Q000032:analysis*; D003920:Diabetes Mellitus / Q000208:ethnology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D019518:Postprandial Period / Q000502:physiology*; D011446:Prospective Studies; D012737:Sex Factors
D001786:Blood Glucose