The "metabolic syndrome" is less useful than random plasma glucose to screen for glucose intolerance.
OBJECTIVE
To compare the utility of metabolic syndrome (MetS) to random plasma glucose (RPG) in identifying people with diabetes or prediabetes.


METHODS
RPG was measured and an OGTT was performed in 1155 adults. Test performance was measured by area under the receiver-operating-characteristic curve (AROC).


RESULTS
Diabetes was found in 5.1% and prediabetes in 20.0%. AROC for MetS with fasting plasma glucose (FPG) was 0.80 to detect diabetes, and 0.76 for diabetes or prediabetes--similar to RPG alone (0.82 and 0.72). However, the AROC for MetS excluding fasting plasma glucose was lower: 0.69 for diabetes (p<0.01 vs. both RPG and MetS with FPG), and 0.69 for diabetes or prediabetes. AROCs for MetS with FPG and RPG were comparable and higher for recognizing diabetes in blacks vs. whites, and females vs. males. MetS with FPG was superior to RPG for identifying diabetes only in subjects with age <40 or BMI <25.


CONCLUSIONS
MetS features can be used to identify risk of diabetes, but predictive usefulness is driven largely by FPG. Overall, to identify diabetes or prediabetes in blacks and whites with varying age and BMI, MetS is no better than RPG--a more convenient and less expensive test.
El Bassuoni
Eman A
EA
Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.
Ziemer
David C
DC
Kolm
Paul
P
Rhee
Mary K
MK
Vaccarino
Viola
V
Tsui
Circe W
CW
Kaufman
Jack M
JM
Osinski
G Eileen
GE
Koch
David D
DD
Narayan
K M Venkat
KM
Weintraub
William S
WS
Phillips
Lawrence S
LS
D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D018149:Glucose Intolerance / Q000097:blood / Q000453:epidemiology*; D005951:Glucose Tolerance Test; D006801:Humans; D008403:Mass Screening / Q000379:methods; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis*; D018579:Patient Selection; D011236:Prediabetic State / Q000097:blood; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology
D001786:Blood Glucose
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