title: The importance of diagnostic criteria in the association between the metabolic syndrome and cardiovascular disease in obese subjects.
abstract: OBJECTIVE
  To investigate whether the association between the metabolic syndrome (MS) and cardiovascular disease (CVD) in obese adults is influenced by the criteria used to diagnose the MS.
  
  
  METHODS
  Cross-sectional study in 389 obese adults (male/female: 26%/74%; body mass index (BMI): 30.1-63.2 kg/m2; age: 18-79 y).
  
  
  METHODS
  To diagnose the MS by the WHO or the ATPIII criteria, body mass index, waist circumference, fasting and 2-h oral Glucose tolerance test plasma glucose, fasting plasma triglycerides and HDL cholesterol, systolic and diastolic blood pressure, 24-h albumin excretion, and fasting insulin were measured. The association between the MS diagnosed with either definition and self-referred CVD was investigated.
  
  
  RESULTS
  The prevalence of the MS by the WHO was higher than by the ATPIII criteria (WHO 69.1%, ATPIII 49.4%; P<0.001). The MS diagnosed by the WHO criteria was significantly associated with self-referred CVD (odds ratio (OR) 5.80, 95% CI 1.35-24.95, P<0.05), whereas the ATPIIII MS was not (OR 1.34, 95% CI 0.59-3.03). An elevated blood pressure (OR 5.04, 95% CI 1.41-18.01, P<0.05) and microalbuminuria (OR 2.61, 95% CI 1.06-6.40, P<0.05) were independently associated with CVD. Consideration of the OGTT data as part of the ATPIII MS definition improved its associations with CVD (OR 4.39, 95% CI 1.29-14.94, P<0.05).
  
  
  CONCLUSIONS
  The WHO criteria appear to identify a greater number of obese adults at risk for CVD. Nevertheless, the addition of an OGTT at least in nondiabetic patients with two ATPIII-defined metabolic risk factors may help to improve the association between the MS and CVD in obese adults.
authors.affiliation: Obesity unit, Hospital Clínic Universitari, Barcelona, Spain. jovidal@clinic.ub.es
authors.forename: J
authors.initials: J
authors.lastname: Vidal
authors.forename: R
authors.initials: R
authors.lastname: Morínigo
authors.forename: V H
authors.initials: VH
authors.lastname: Codoceo
authors.forename: R
authors.initials: R
authors.lastname: Casamitjana
authors.forename: S
authors.initials: S
authors.lastname: Pellitero
authors.forename: R
authors.initials: R
authors.lastname: Gomis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications*; D011237:Predictive Value of Tests; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides