title: Empirical derivation to improve the definition of the metabolic syndrome in the evaluation of cardiovascular disease risk.
abstract: OBJECTIVE
  To examine whether a quantitatively derived metabolic syndrome definition predicts incident cardiovascular disease (CVD) events better than do existing definitions.
  
  
  METHODS
  Data were pooled from the Atherosclerosis Risk in Communities, Cardiovascular Health, and Framingham Offspring studies (n = 20,581). Incident coronary heart disease and stroke events were ascertained over 9 years.
  
  
  RESULTS
  The sensitivity for incident CVD events was higher and the specificity lower for the empirically derived versus the Adult Treatment Panel (ATP) III, International Diabetes Federation (IDF), or Harmonized metabolic syndrome definitions (sensitivity/specificity 0.65/0.53 vs. 0.53/0.63, 0.51/0.66, and 0.64/0.56, respectively), resulting in no overall improvement in discrimination. Multivariable-adjusted hazard ratios for incident CVD events were similar across definitions and were 1.7 (95% CI 1.6-1.9) for ATP III, 1.8 (1.6-2.0) for IDF, 1.9 (1.7-2.0) for Harmonized, and 1.7 (1.6-1.9) for the empirically derived definition.
  
  
  CONCLUSIONS
  Empirical derivation of the metabolic syndrome definition did not improve CVD discrimination or risk prediction.
authors.affiliation: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA. rachel.wildman@einstein.yu.edu
authors.forename: Rachel P
authors.initials: RP
authors.lastname: Wildman
authors.forename: Aileen P
authors.initials: AP
authors.lastname: McGinn
authors.forename: Mimi
authors.initials: M
authors.lastname: Kim
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Dan
authors.initials: D
authors.lastname: Wang
authors.forename: Hillel W
authors.initials: HW
authors.lastname: Cohen
authors.forename: Alexandra D
authors.initials: AD
authors.lastname: Ogorodnikova
authors.forename: Kristi
authors.initials: K
authors.lastname: Reynolds
authors.forename: Vivian
authors.initials: V
authors.lastname: Fonseca
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D024821:Metabolic Syndrome / Q000503:physiopathology*; D012307:Risk Factors