Differences in traditional and emerging cardiovascular risk factors of subjects discordantly classified by metabolic syndrome definitions of the International Diabetes Federation and the National Cholesterol Education Program

Sep 30, 2008Nutrition, metabolism, and cardiovascular diseases : NMCD

Differences in heart disease risk factors in people classified differently by two metabolic syndrome definitions

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Abstract

Two hundred and four subjects (22%) had metabolic syndrome according to both the National Cholesterol Education Program and International Diabetes Federation definitions.

Individuals diagnosed with metabolic syndrome by both definitions exhibited more adverse cardiovascular risk factors compared to those diagnosed only by the IDF criteria.
Among the subjects meeting both definitions, worse age and sex-adjusted measures of BMI, waist circumference, HDL cholesterol, triglycerides, post-load glucose, HOMA-IR, and plasminogen inhibitor activator-1 (PAI-1) were observed.
Only 31 subjects (3.3%) were identified with metabolic syndrome exclusively by the IDF criteria, while just 5 subjects (0.5%) were identified solely by the NCEP criteria.
The cardiovascular risk profile for those meeting solely the IDF criteria was not significantly different from those without metabolic syndrome.
The findings suggest that the IDF definition may classify individuals with a relatively less adverse cardiovascular risk profile compared to the NCEP definition.

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BACKGROUND AND AIM: Several working definitions of metabolic syndrome have been proposed for clinical use. However, individuals can be discordantly classified as having or not having metabolic syndrome depending on the choice of one or another definition. This study compared the cardiovascular risk profile of subjects concordantly and discordantly diagnosed by the criteria of the National Cholesterol Education Program (NCEP) and the criteria of the International Diabetes Federation (IDF).

METHODS AND RESULTS: Nine hundred and twenty-nine non-diabetic adult subjects belonging to a cross-sectional population-based study in Gran Canaria island (Spain) were assessed. Participants completed a questionnaire and underwent physical examination, fasting blood analyses, and a standardized oral glucose tolerance test. Two hundred and four subjects (22%) had metabolic syndrome according to both definitions, 31 (3.3%) only by the IDF criteria, and 5 (0.5%) only by the NCEP criteria. Participants fulfilling both proposals showed more adverse age and sex-adjusted measures of BMI, waist, HDL cholesterol, triglycerides, post-load glucose, HOMA-IR and plasminogen inhibitor activator-1 (PAI-1) than individuals exclusively satisfying the IDF criteria. Moreover, in contrast to subjects meeting both criteria, those that fulfilled only the IDF criteria had levels of BMI, waist, total and HDL cholesterol, post-load glucose, glycated HbA1c, C-reactive protein, PAI-1 and fibrinogen not significantly different from those observed in subjects without metabolic syndrome.

CONCLUSION: The IDF definition identifies a surplus of individuals whose cardiovascular risk profile, particularly regarding to some non-traditional cardiovascular risk factors, is less adverse than that observed in subjects also diagnosed by the NCEP definition.

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Differences in traditional and emerging cardiovascular risk factors of subjects discordantly classified by metabolic syndrome definitions of the International Diabetes Federation and the National Cholesterol Education Program

Abstract

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