The metabolic syndrome in an Arab population: a first look at the new International Diabetes Federation criteria.
OBJECTIVE
To report the prevalence of the metabolic syndrome in Arab men and women using the new International Diabetes Federation (IDF) criteria, and to compare this with the prevalence using the 1999 World Health Organization (WHO) and 2001 National Cholesterol Education Program Adult Treatment Panel III (NECP ATPIII) definitions.


METHODS
The study involved 863 subjects (343 men and 520 women) aged > or = 40 years living in Tunis, Tunisia, taken from an initially randomized, population sample.


RESULTS
The prevalence of the metabolic syndrome using the IDF criteria was found to be 45.5%; 55.8% in women and 30.0% in men (P < 0.001), higher than the rates of 28.7% (WHO) and 24.3% (NECP ATPIII) using the previous definitions. Using all the definitions, the prevalence was higher in women than in men predominantly because of significant differences in central obesity and high-density lipoprotein (HDL) cholesterol and, to a lesser extent, hypertension.


CONCLUSIONS
The increased prevalence using the IDF criteria compared with the 1999 WHO criteria and the 2001 NCEP ATPIII definitions is striking and has huge implications for public health worldwide. The major reason for the higher rate using the new definition seems to be the predominant focus placed on central obesity. Using tighter criteria for fasting glycaemia has also played a factor. The question remains as yet unanswered as to whether the new IDF criteria are better at predicting hard outcomes such as diabetes mellitus and cardiovascular diseases.
Harzallah
F
F
Endocrinology-Diabetology Department, La Rabta Hospital, Tunis, Tunisia and School of Clinical Medical Sciences, University of Newcastle, Newcastle upon Tyne, UK.
Alberti
H
H
Ben Khalifa
F
F
D000368:Aged; D000704:Analysis of Variance; D018912:Arabs; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D015995:Prevalence; D014416:Tunisia / Q000453:epidemiology; D014944:World Health Organization