Am J Epidemiol 2002; 156:1070-1077.
Copyright © 2002 by Johns
Hopkins Bloomberg School of Public Health
PRACTICE OF EPIDEMIOLOGY |
Metabolic Syndrome and Development of Diabetes Mellitus: Application and Validation of Recently Suggested Definitions of the Metabolic Syndrome in a Prospective Cohort Study
1 Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
2 Department of Physiology, University of Kuopio, Kuopio, Finland.
3 Research Institute of Public Health, University of Kuopio, Kuopio, Finland.
4 Department of Public Health and General Practice, University of Kuopio, Kuopio, Finland.
5 Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI.
6 Inner Savo Health Centre, Suonenjoki, Finland.
7 Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.
The World Health Organization (WHO) and the National Cholesterol Education Program (NCEP) recently proposed definitions for the metabolic syndrome. Little is known of their validity, however. The authors assessed the sensitivity and specificity of the definitions of the metabolic syndrome for prevalent and incident diabetes mellitus in a Finnish population-based cohort of middle-aged men (n = 1,005) followed for 4 years since the late 1980s. Four definitions based on the WHO and NCEP recommendations were compared. All definitions identified persons at high risk for developing diabetes during the 4-year follow-up (odds ratios = 5.0–8.8). The WHO definition including waist-hip ratio > 0.90 or body mass index 
30 kg/m2 was the most sensitive (0.83 and 0.67) and least specific (0.78 and 0.80) in detecting the 47 prevalent and 51 incident cases of diabetes. The NCEP definition in which adiposity was defined as waist girth > 102 cm detected only 61% of prevalent and 41% of incident diabetes, although it was the most specific (0.89 and 0.90). The WHO definition seems valid as judged by its relatively high sensitivity and specificity in predicting diabetes. The NCEP definition including waist > 102 cm also identifies persons at high risk for diabetes, but it is relatively insensitive in predicting diabetes.
diabetes mellitus; hyperinsulinism; hyperlipidemia; hypertension; insulin resistance; obesity
Abbreviations: Abbreviations: EGIR, European Group for the Study of Insulin Resistance; HDL, high density lipoprotein; NCEP, National Cholesterol Education Program; QUICKI, quantitative insulin sensitivity check index; WHO, World Health Organization.
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