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No existing definition of metabolic syndrome meets criteria as a syndrome

International Journal of Obesity volume 32, page 393 (2008)Cite this article

Yoon et al.1 reported that the revised National Cholesterol Education Program (NCEP) criteria seemed to be more appropriate for diagnosing metabolic syndrome (MS) given that the International Diabetes Federation (IDF) criteria could not identify high-risk patients who lacked central obesity but who nevertheless showed a clustering of metabolic risk factors. The IDF criteria did not identify 44.9% of men or 16.6% of women identified with the revised NCEP definition of metabolic syndrome in their data.1 In our data, the IDF criteria also did not identify 40% of the men and 11% of the women identified with the revised NCEP definition of metabolic syndrome.2 As for definitions of MS, Reaven3 commented that the approach of WHO was the most rational effort, and the recent version of IDF was the most dangerous because approximately two-thirds of those in insulin-resistant tertile were either normal weight or overweight, and only about one-third of most insulin-resistant persons were actually obese, and he subscribed a joint statement from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)4 that the providers should avoid labeling patients with the term metabolic syndrome. Besides, the Obesity Society, the American Society for Nutrition and ADA jointly stated that the clinical usefulness of measuring waist circumference (WC) is limited and further studies are needed to establish WC cut-points which will be complex.5 Obesity is not merely an anthropometric issue but an endocrine disorder closely linked to the insulin resistance and chronic low-grade systemic inflammation. Anthropometric markers of obesity such as body mass index (BMI), WC, waist-to-hip ratio, and waist-to-height ratio are not direct causes for the clustering of the cardiovascular risk factors but remote upstream factors indirectly leading to the clustering through metabolic susceptibility as illustrated by Grundy6 and should be used as simple tools for the screening of more proximal risk factors for cardiovascular disease. C-reactive protein7 may be superior to anthropometric parameters as an obesity-related risk factor.

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References

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  1. Department of Internal Medicine, Niigata Prefectural Yoshida Hospital, Yoshida Daibochou 32-14, Tsubame, Niigata, Japan

    E Oda

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Oda, E. No existing definition of metabolic syndrome meets criteria as a syndrome. Int J Obes 32, 393 (2008). https://doi.org/10.1038/sj.ijo.0803714

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