title: Which insulin resistance-based definition of metabolic syndrome has superior diagnostic value in detection of poor health-related quality of life? Cross-sectional findings from Tehran Lipid and Glucose Study.
abstract: BACKGROUND
  The superiority of the diagnostic power of different definitions of metabolic syndrome (MetS) in detecting objective and subjective cardiovascular outcomes is under debate. We sought to compare diagnostic values of different insulin resistance (IR)-based definitions of MetS in detecting poor health-related quality of life (HRQoL) in a large sample of Tehranian adults.
  
  
  METHODS
  This cross-sectional study conducted within the framework of the Tehran Lipid and Glucose Study on a total sample of 742 individuals, aged ≥ 20 years. Metabolic syndrome was defined according to the World Health Organization (WHO), the European Group for the study of Insulin Resistance (EGIR), and the American Association of Clinical Endocrinology (AACE). Health-related quality of life was assessed using the Short Form Health Survey (SF-36). Logistic regression analysis and Receiver Operating Characteristic (ROC) curve were used to investigate the impact of the three IR-based definitions of MetS on HRQoL and compare their discriminative powers in predicting poor HRQoL.
  
  
  RESULTS
  Compared with other definitions, the WHO definition identified more participants with MetS (41.8 %). Although the AACE definition had higher adjusted odds ratios for reporting poor physical HRQoL (OR: 1.95; CI: 0.84-4.53 and OR: 1.01; CI: 0.55-1.85 in men and women respectively) and mental HRQoL (OR: 0.97; CI: 0.41-2.28 and OR: 1.00; CI: 0.56-1.79 in men and women respectively), none of the three studied definitions were significantly associated with poor physical or mental HRQoL in either gender; nor did ROC curves show any significant difference in the discriminative powers of IR-based definitions in detecting poor HRQoL in either gender.
  
  
  CONCLUSIONS
  None of the three studied IR-based definitions of MetS could significantly detect poor HRQoL in the physical or mental domains, indicating no significant superior diagnostic value for any of these definitions.
authors.affiliation: Research Center for Social Determinants of Endocrine Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.|Students' Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Tina
authors.initials: T
authors.lastname: Deihim
authors.affiliation: Research Center for Social Determinants of Endocrine Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. amiri@endocrine.ac.ir.
authors.forename: Parisa
authors.initials: P
authors.lastname: Amiri
authors.affiliation: Research Center for Social Determinants of Endocrine Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.|Students' Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Taherian
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Tohidi
authors.affiliation: Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Asghar
authors.initials: A
authors.lastname: Ghasemi
authors.affiliation: Research Center for Social Determinants of Endocrine Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Cheraghi
authors.affiliation: Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Azizi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007333:Insulin Resistance; D007492:Iran; D008297:Male; D024821:Metabolic Syndrome / Q000145:classification* / Q000175:diagnosis*; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D011788:Quality of Life; D012372:ROC Curve; D012307:Risk Factors; D012955:Societies, Medical / Q000592:standards*; D044465:White People / Q000706:statistics & numerical data; D014944:World Health Organization; D055815:Young Adult