Prevalence of metabolic syndrome using WHO, ATPIII and IDF definitions in Asian Indians: the Chennai Urban Rural Epidemiology Study (CURES‐34)

Abstract

Aim To compare the prevalence of metabolic syndrome (MS) using the World Health Organisation (WHO), Adult Treatment Panel III (ATPIII) and International Diabetes Federation (IDF) criteria of MS in an urban south Indian population, and their ability to identify coronary artery disease (CAD) in males and females.Methods Chennai Urban Rural Epidemiology Study (CURES) is one of the largest epidemiological studies on diabetes carried out in India, in which 26 001 individuals aged ≥20 years were screened using systematic random sampling method. Every tenth subject recruited in Phase 1 of CURES was requested to participate in Phase 3, and the response rate was 90.4%. An oral glucose tolerance test (OGTT) was performed in all individuals except self-reported diabetic subjects. Anthropometric measurements and lipid estimations were done in all subjects and the prevalence of MS estimated using the three criteria. Diagnosis of CAD, made by resting 12 lead ECG, was compared by the three criteria of MS.Results MS was identified in 546 subjects (23.2%) by WHO criteria, 430 subjects (18.3%) by ATPIII criteria and 607 subjects (25.8%) by IDF criteria. Only 224 of these subjects were identified by all the three criteria. There was an increased risk of probable CAD in MS subjects diagnosed by WHO criteria (odds ratio (OR) 3.86, 95% Confidence Interval (CI), 2.37-6.29, p < 0.001), compared to ATPIII criteria (OR 2.19, p < 0.05) and IDF criteria (OR 1.90, p < 0.05). The WHO criteria marked out a much higher population for CAD risk compared to ATPIII and IDF criteria in males, but not in females. ConclusionIn Asian Indians, the WHO, ATPIII and IDF criteria of MS identify different individuals. The WHO criteria identify a greater number of CAD subjects in males, but not in females.

Prevalence and Determinants of Metabolic Syndrome According to Three Definitions in Middle-Aged Chinese Men

“…In Asian Indians metabolic syndrome prevalence was reported to be 23.2%, 25.8%, and 18.3% according to WHO, IDF, and ATP III criteria, respectively. 17 Using ATP III criteria, the prevalence of metabolic syndrome among Asian Indians was higher (28.8%) than that reported for Malays (24.2%) and Chinese (14.8%) living in Singapore. 18 In a report comparing the prevalence of metabolic syndrome using four criteria in four Asia-Pacific populations, age-adjusted prevalences for the four definitions ranged from 16% to 42% in Australia, 3% to 11% in Japan, 7% to 29% in Korea, and 17% to 60% in Samoa.…”

Incidence of Diabetes and Prediabetes and Predictors of Progression Among Asian Indians: 10-Year Follow-up of the Chennai Urban Rural Epidemiology Study (CURES)

“…Serum insulin concentration was estimated using the electrochemiluminescence method (cobas e 411; Roche Diagnostics). Insulin resistance was measured using the HOMA of insulin resistance method, using the formula [(fasting glucose in mg/dL 3 fasting insulin in mU/mL)/405] (8), and individuals with values .2.58 were considered to have insulin resistance (9). The intra-and interobserver coefficients of variation for the biochemical assays ranged from 3.1 to 7.6%.…”

Prevalência de síndrome metabólica em indivíduos brasileiros pelos critérios de NCEP-ATPIII e IDF

“…Concentrações séricas elevadas de TG nos controles também indicam desvantagem 31 , contribuindo para caracterizar SM em indivíduos previamente isentos de manifestações cardiovasculares. Neste estudo, a constatação da prevalência de HAS em pacientes sem critério para SM alerta para a alta incidência dessa comorbidade como fator de risco independente para DCV 32 34 . Nesse caso, a valorização da obesidade central pela IDF como parâmetro-diagnóstico, compreendendo valores de referência reduzidos para cintura abdominal comparados ao NCEP-ATPIII, parece justificar o aumento da prevalência da SM ora evidenciado 28 .…”