Components of the metabolic syndrome predictive of its development: a 6-year longitudinal study in Hong Kong Chinese.
OBJECTIVE
To investigate which of the components of the metabolic syndrome best predict its development.


METHODS
Long-term cohort of randomly selected adults.


METHODS
One thousand five hundred and forty-eight subjects from the Hong Kong Cardiovascular Risk Factor Prevalence Study who did not have the metabolic syndrome by the US National Cholesterol Education Program (NCEP) or International Diabetes Federation (IDF) criteria at baseline.


METHODS
Waist circumference, blood pressure, glucose, triglycerides and high-density lipoprotein-cholesterol (HDL).


RESULTS
After a median interval of 6.4 years, there were 219 and 143 new cases (21.9 and 14.3 per 1000 person-years) of the metabolic syndrome by the NCEP and IDF criteria, respectively. The odds ratio for the NCEP metabolic syndrome was highest for low HDL, 4.08 [95% confidence interval (CI): 2.90-5.73] and that for the IDF metabolic syndrome was highest for central obesity, 5.94 [95% CI: 3.98-8.87]. Low HDL, found in 27.8% men and 34.3% women, had the highest sensitivity for the NCEP metabolic syndrome (48% in men and 57% in women) and the IDF metabolic syndrome (41% in men and 54% in women). Central obesity had the highest positive predictive values except that triglycerides had the highest positive predictive value for the NCEP metabolic syndrome in women. The areas under the receiver operator characteristic curve for waist circumference, triglycerides and HDL were similar. A model that included waist circumference and HDL predicted the metabolic syndrome as well as a model that included all five metabolic syndrome components.


CONCLUSIONS
Obese Chinese adults should be periodically screened for the metabolic syndrome and have waist and HDL measurement.
Cheung
Bernard M Y
BM
Department of Medicine, University of Hong Kong, Hong Kong. b.cheung@bham.ac.uk
Wat
Nelson M S
NM
Tam
Sidney
S
Thomas
G Neil
GN
Leung
Gabriel M
GM
Cheng
Chun Ho
CH
Woo
Jean
J
Janus
Edward D
ED
Lau
Chu Pak
CP
Lam
Tai Hing
TH
Lam
Karen S L
KS
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D001794:Blood Pressure; D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D006723:Hong Kong; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis*; D008875:Middle Aged; D011237:Predictive Value of Tests; D014280:Triglycerides / Q000097:blood*; D055105:Waist Circumference
D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides