From the Research
The three major classifications of metabolic syndrome include the International Diabetes Federation (IDF), National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), and World Health Organization (WHO) criteria. According to the most recent evidence 1, the IDF criteria diagnose metabolic syndrome when a person has central obesity (waist circumference ≥94 cm for men or ≥80 cm for women in Europeans) plus any two of the following: triglycerides ≥150 mg/dL, HDL cholesterol <40 mg/dL in men or <50 mg/dL in women, blood pressure ≥130/85 mmHg, or fasting glucose ≥100 mg/dL. The NCEP ATP III criteria require any three of five factors: waist circumference >102 cm in men or >88 cm in women, triglycerides ≥150 mg/dL, HDL cholesterol <40 mg/dL in men or <50 mg/dL in women, blood pressure ≥130/85 mmHg, or fasting glucose ≥100 mg/dL. The WHO criteria define metabolic syndrome as insulin resistance or diabetes plus two of the following: obesity (BMI >30 kg/m² or waist-to-hip ratio >0.9 in men or >0.85 in women), triglycerides ≥150 mg/dL or HDL cholesterol <35 mg/dL in men or <39 mg/dL in women, blood pressure ≥140/90 mmHg, or microalbuminuria. These classifications are important because metabolic syndrome significantly increases the risk of cardiovascular disease and type 2 diabetes, with each component contributing to overall metabolic dysfunction, as supported by studies 2, 3, 4, 5.
Some key points to consider when diagnosing metabolic syndrome include:
- Central obesity is a key component of the IDF criteria, with waist circumference thresholds of ≥94 cm for men and ≥80 cm for women in Europeans 1.
- The NCEP ATP III criteria require any three of five factors, including waist circumference, triglycerides, HDL cholesterol, blood pressure, and fasting glucose 2.
- The WHO criteria define metabolic syndrome as insulin resistance or diabetes plus two of the following: obesity, triglycerides or HDL cholesterol, blood pressure, or microalbuminuria 3.
- The prevalence of metabolic syndrome varies depending on the criteria used, with the IDF criteria resulting in a higher prevalence in some populations 1.
- The predictive power of the different criteria for coronary events also varies, with the ATP III criteria having higher predictive power in some studies 1.
Overall, the diagnosis of metabolic syndrome should be based on a combination of clinical judgment and the use of established criteria, such as the IDF, NCEP ATP III, or WHO criteria.