title: Impact of metabolic syndrome definitions on prevalence estimates: a study in a Portuguese community.
abstract: This study compared the prevalence of metabolic syndrome (MS) according to World Health Organization (WHO), National Cholesterol Education Program Third Adult Treatment Panel (NCEP-ATP III), International Diabetes Federation (IDF) and American Heart Association/ National Heart, Lung and Blood Institute (AHA/NHLBI) definitions, to evaluate how well the different classifications agreed. The study also compared their 10-year predicted risk of coronary heart disease (CHD) with the Framingham risk score (FRS). Some 886 women and 547 men aged 18-92 years were included in the study. Demographic and personal medical history data were obtained at interview. Four operational definitions of MS were used (those of the WHO, NCEP-ATP III, AHA/NHLBI and IDF). The prevalence of metabolic syndrome was found to be 26.4% (WHO criteria), 24.0% (NCEP-ATP III criteria), 41.9% (IDF criteria) and 37.2% (AHA/NHLBI criteria). According to the definition used, central obesity ranged from 41.9% to 75.1% and high blood pressure from 52.9% to 65.8%. Agreement between classifications ranged from 75.2% (kappa=0.47) to 90.4% (kappa=0.80) and was lower in males. The 10-year predicted risk of CHD by FRS was similar between the different definitions. IDF and AHA/NHLBI definitions resulted in a higher prevalence of MS than the NCEP-ATP III or WHO definition. Overall, however, good agreement was found between definitions, and the predicted 10-year of CHD risk was similar.
authors.affiliation: Department of Hygiene and Epidemiology, University of Porto Medical School, 4200-319 Porto, Portugal. acsantos@med.up.pt
authors.forename: Ana-Cristina
authors.initials: AC
authors.lastname: Santos
authors.forename: Henrique
authors.initials: H
authors.lastname: Barros
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000572:American Heart Association; D003327:Coronary Disease / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000145:classification* / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D054555:National Heart, Lung, and Blood Institute (U.S.); D011174:Portugal / Q000453:epidemiology; D012955:Societies, Medical; D014481:United States; D014944:World Health Organization