The metabolic syndrome (syndrome X, insulin resistance syndrome) consists of a constellation of metabolic abnormalities that confer increased risk of cardiovascular disease (CVD) and diabetes mellitus (DM). The criteria for the metabolic syndrome have evolved since the original definition by the World Health Organization in 1998, reflecting growing clinical evidence and analysis by a variety of consensus conferences and professional organizations. The major features of the metabolic syndrome include central obesity, hypertriglyceridemia, low high-density lipoprotein (HDL) cholesterol, hyperglycemia, and hypertension (Table 242-1).
Table 242–1. NCEP:ATPIII 2001 and IDF Criteria for the Metabolic Syndrome |Favorite Table|Download (.pdf)
Table 242–1. NCEP:ATPIII 2001 and IDF Criteria for the Metabolic Syndrome
|NCEP:ATPIII 2001||IDF Criteria for Central Adipositya|
|Three or more of the following:||Waist circumference|
|Central obesity: Waist circumference >102 cm (M), >88 cm (F)||Men||Women||Ethnicity|
|Hypertriglyceridemia: Triglycerides ≥150 mg/dL or specific medication||≥94 cm||≥80 cm||Europid, Sub-Saharan African, Eastern and Middle Eastern|
|Low HDL cholesterol: <40 mg/dL and <50 mg/dL, respectively, or specific medication||≥90 cm||≥80 cm||South Asian, Chinese, and ethnic South and Central American|
|Hypertension: Blood pressure ≥130 mm systolic or ≥85 mm diastolic or specific medication||≥85 cm||≥90 cm||Japanese|
|Fasting plasma glucose ≥100 mg/dL or specific medication or previously diagnosed Type 2 diabetes||Two or more of the following:|
|Fasting triglycerides >150 mg/dL or specific medication|
|HDL cholesterol <40 mg/dL and <50 mg/dL for men and women, respectively, or specific medication|
|Blood pressure >130 mm systolic or >85 mm diastolic or previous diagnosis or specific medication|
|Fasting plasma glucose ≥100 mg/dL or previously diagnosed Type 2 diabetes|
The prevalence of metabolic syndrome varies around the world, in part reflecting the age and ethnicity of the populations studied and the diagnostic criteria applied. In general, the prevalence of metabolic syndrome increases with age. The highest recorded prevalence worldwide is in Native Americans, with nearly 60% of women ages 45–49 and 45% of men ages 45–49 meeting National Cholesterol Education Program and Adult Treatment Panel III (NCEP:ATPIII) criteria. In the United States, metabolic syndrome is less common in African-American men and more common in Mexican-American women. Based on data from the National Health and Nutrition Examination Survey (NHANES) 1999–2000, the age-adjusted prevalence of the metabolic syndrome in United States adults who did not have diabetes is 28% ...