title: The relation of metabolic syndrome according to five definitions to cardiovascular risk factors--a population-based study.
abstract: 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.
authors.affiliation: Institute of Biostatistics, China Medical University, Taichung, Taiwan. cclin@mail.cmuh.org.tw
authors.forename: Cheng-Chieh
authors.initials: CC
authors.lastname: Lin
authors.forename: Chiu-Shong
authors.initials: CS
authors.lastname: Liu
authors.forename: Chia-Ing
authors.initials: CI
authors.lastname: Li
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Lin
authors.forename: Ming-May
authors.initials: MM
authors.lastname: Lai
authors.forename: Tsann
authors.initials: T
authors.lastname: Lin
authors.forename: Pei-Chia
authors.initials: PC
authors.lastname: Chang
authors.forename: Yih-Dar
authors.initials: YD
authors.lastname: Lee
authors.forename: Ching-Chu
authors.initials: CC
authors.lastname: Chen
authors.forename: Chih-Hsueh
authors.initials: CH
authors.lastname: Lin
authors.forename: Chuan-Wei
authors.initials: CW
authors.lastname: Yang
authors.forename: Chih-Yi
authors.initials: CY
authors.lastname: Hsiao
authors.forename: Walter
authors.initials: W
authors.lastname: Chen
authors.forename: Tsai-Chung
authors.initials: TC
authors.lastname: Li
mesh_terms: 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
chemical_list: D015415:Biomarkers