A Comparison between Revised NCEP ATP III and IDF Definitions in Diagnosing Metabolic Syndrome in an Urban Sri Lankan Population: The Ragama Health Study
Background. The prevalence of metabolic syndrome (MetS) within individual cohorts varies with the definition used. The aim of this study was to compare the prevalence of MetS between IDF and revised NCEP ATP III criteria in an urban Sri Lankan population and to investigate the characteristics of discrepant cases. Methods. 2985 individuals, aged 35–65 years, were recruited to the study. Anthropometric and blood pressure measurements and laboratory investigations were carried out following standard protocols. Results. Age and sex-adjusted prevalences of MetS were 46.1% and 38.9% by revised NCEP and IDF definitions, respectively. IDF criteria failed to identify 21% of men and 7% of women identified by the revised NCEP criteria. The discrepant group had more adverse metabolic profiles despite having a lower waist circumference than those diagnosed by both criteria. Conclusion. MetS is common in this urban Sri Lankan cohort regardless of the definition used. The revised NCEP definition was more appropriate in identifying the metabolically abnormal but nonobese individuals, especially among the males predisposed to type 2 diabetes or cardiovascular disease. Further research is needed to determine the suitability of the currently accepted Asian-specific cut-offs for waist circumference in Sri Lankan adults. 1. Introduction Metabolic syndrome (MetS) is a complex web of metabolic risk factors that are associated with a 5-fold risk of type 2 diabetes (T2DM) and a 2-fold risk of cardiovascular disease (CVD) [1, 2]. Individuals with MS have a 30–40% probability of developing diabetes and/or CVD within 20 years, depending on the number of components present [3]. Although there are different definitions of MetS, the uniform pathophysiology of this syndrome is insulin resistance [4]. MetS appears to have a component of heritability, which suggests a genetic basis [5]. However, the association is complex, and the role of gene-environment interactions, ethnicity, and gender in the pathogenesis of MetS needs to be further explored. The prevalence of MetS increases with altered glucose metabolism [6] and with the increasing worldwide prevalence of T2DM, the expected increase in the frequency of occurrence of MS will rise to alarming proportions. South Asians have an unusually high tendency to develop T2DM and coronary heart disease (CHD) [7–9]. Higher prevalence, earlier onset, and increased complications of T2DM and CHD are often seen at lower levels of body mass index (BMI) and waist circumference (WC) in South Asians than in white Caucasians [10, 11]. It was estimated
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