An evaluation of candidate definitions of the metabolic syndrome in adult Asian Indians.
OBJECTIVE
We aimed to evaluate eight candidate definitions of the metabolic syndrome (MS) against the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) definition as the reference for optimally defining MS in adult Asian Indians.


METHODS
We used clinical and biochemical data from our previous cross-sectional epidemiological studies. Candidate definitions of MS were proposed by modifying the NCEP ATPIII definition. These modifications included the following: waist circumference cutoffs as >90 cm in men and >80 cm in women, BMI cutoff as >23 kg/m(2), and a measure of truncal subcutaneous fat (subscapular skinfold thickness [SST] >18 mm).


RESULTS
The highest prevalence (29.9%) of MS was observed by the inclusion of modified cutoffs of waist circumference and BMI and SST in place of the existing cutoffs of waist circumference in the NCEP ATPIII criteria. Further, this modified definition showed the maximum absolute gain in the percentage of prevalence of MS over the NCEP ATPIII definition, and it was the best predictor for MS in subjects with impaired fasting glucose, type 2 diabetes, and different age-groups. The lowest percentage of prevalence of MS was observed with the definition that excluded biochemical variables and blood pressure.


CONCLUSIONS
The criteria for defining MS in adult Asian Indians need revision. Inclusion of modified cutoffs of waist circumference and BMI and measures of truncal subcutaneous fat in the NCEP ATPIII definition requires further validation.
Misra
Anoop
A
Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India. anoopmisra@metabolicresearchindia.com
Wasir
Jasjeet Singh
JS
Pandey
Ravinder Mohan
RM
D000328:Adult; D044466:Asian People; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000208:ethnology*; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000208:ethnology; D015995:Prevalence; D049629:Waist-Hip Ratio