The relation of metabolic syndrome according to five definitions to cardiovascular risk factors--a population-based study.
BACKGROUND
Although National Cholesterol Education Program (NCEP), International Diabetes Federation (IDF), American Heart Association and National Heart, Lung and Blood Institute (AHA/NHLBI), World Health Organization (WHO), and the European Group for the Study of Insulin Resistance (EGIR) definitions of metabolic syndrome (MetS) have been commonly used by studies, little is known about agreement among these five definitions. We examined the agreement among these five definitions and explored their relationship with risk factors of cardiovascular disease in a Taiwan population.


METHODS
A total of 1305 subjects aged 40 years and over in Taiwan were analyzed. Biomedical markers and anthropometric indices were measured. Agreement among definitions was determined by the kappa statistic. Logistic regression models were fit to estimate the odds of a high cardiovascular risk group for five definitions of MetS.


RESULTS
The agreement among the NCEP, IDF, and AHA/NHLBI definitions was from substantial to very good, and agreement between the WHO and EGIR definitions was also substantial. All MetS definitions were significantly associated prevalence of microalbuminuria, elevated highly sensitive CRP (hs-CRP), and arterial stiffness only in women. In men, MetS by NCEP and AHA/NHLBI was associated with elevated level of hs-CRP and arterial stiffness. MetS by WHO and EGIR were significantly associated with microalbuminuria. And MetS by WHO was the only MetS definition that significantly associated with prevalence of arterial stiffness (OR: 2.75, 95% CI: 1.22-6.19).


CONCLUSIONS
The associations of these five definitions with cardiovascular risk factors were similar in women, and it was evident that the five definitions performed better in women than in men, with higher ORs observed in relation to arterial stiffness, elevated hs-CRP, and higher Framingham risk scores.
Lin
Cheng-Chieh
CC
Institute of Biostatistics, China Medical University, Taichung, Taiwan. cclin@mail.cmuh.org.tw
Liu
Chiu-Shong
CS
Li
Chia-Ing
CI
Lin
Wen-Yuan
WY
Lai
Ming-May
MM
Lin
Tsann
T
Chang
Pei-Chia
PC
Lee
Yih-Dar
YD
Chen
Ching-Chu
CC
Lin
Chih-Hsueh
CH
Yang
Chuan-Wei
CW
Hsiao
Chih-Yi
CY
Chen
Walter
W
Li
Tsai-Chung
TC
D000328:Adult; D000886:Anthropometry; D015415:Biomarkers / Q000032:analysis; D002318:Cardiovascular Diseases / Q000145:classification*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000145:classification*; D008875:Middle Aged; D012307:Risk Factors; D013624:Taiwan; D009626:Terminology as Topic; D014944:World Health Organization
D015415:Biomarkers