title: Design and validation of a population-based definition of the metabolic syndrome.
abstract: OBJECTIVE
  The National Cholesterol Education Program (NCEP) definition of the metabolic syndrome was modified to be described as a continuous variable and adapted to the characteristics of a Hispanic population.
  
  
  METHODS
  Age/sex population percentiles for every component of the NCEP criteria were included in this approach using population-based data from a Mexican nationwide survey (2,158 subjects). One point was given per decile for every component. The total number of points accumulated was used to classify subjects. The predictive power for incident diabetes was evaluated using the 7-year follow-up results of the Mexico City Diabetes Study.
  
  
  RESULTS
  Our population-based method had a significantly better prognostic power compared with the original and the updated NCEP definitions (area under the receiver operating characteristic curve 0.746 vs. 0.697 and 0.723, respectively, P < 0.05). Using individuals with </=1 component of the NCEP definition as reference, the odds ratio was greater in the upper quartile of the points scale (>/=39 points) (12.71 [95% CI 5.67-28.49]) compared with that calculated for the original (9.52 [4.69-19.31]) and the updated (11.14 [5.33-23.30]) NCEP criteria. The major advantage of our approach is the detection of subjects at the extremes of the range of diabetes risk and the ability to estimate this risk as a continuum.
  
  
  CONCLUSIONS
  Our method adapts the NCEP criteria to the characteristics of a Hispanic population. It improves the predictive power of the NCEP criteria for future diabetes.
authors.affiliation: National Institute of Public Health, Av. Universidad 655, Col Sta Maria Ahuacatitlan, Cuernavaca, Morelos, C.P. 62508, Mexico.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Aguilar-Salinas
authors.forename: Rosalba
authors.initials: R
authors.lastname: Rojas
authors.forename: Clicerio
authors.initials: C
authors.lastname: Gonzalez-Villalpando
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Gómez-Pérez
authors.forename: Roopa
authors.initials: R
authors.lastname: Mehta
authors.forename: Gustavo
authors.initials: G
authors.lastname: Olaiz
authors.forename: Juan A
authors.initials: JA
authors.lastname: Rull
authors.forename: David R
authors.initials: DR
authors.lastname: Cox
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D006946:Hyperinsulinism / Q000208:ethnology; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000208:ethnology*; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D014505:Urban Population / Q000706:statistics & numerical data*