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05-08-2010 | Diabetes | Article

All metabolic syndrome definitions predict future diabetes and CVD

Abstract

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MedWire News: A Finnish study reports that the metabolic syndrome, irrespective of the definition used, is a significant predictor for diabetes and cardiovascular disease (CVD).

Pia Pajunen (National Institute for Health and Welfare, Helsinki) and team say that the new Harmonization definition for the metabolic syndrome, devised by the American Heart Association, National Heart, Lung, and Blood Institute, and the International Diabetes Federation (IDF), "had significantly greater sensitivity, but lower specificity for the CVD endpoint than did other definitions."

Writing in the journal Diabetes & Metabolism, they explain that other available definitions include those produced by the (IDF), the 2005 National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP) III, and The World Health Organization (WHO).

Pajunen et al investigated incident CVD and diabetes among 6105 men and women who were aged 30 to 79 years and without diabetes at baseline.

Over a follow-up period of 7 years, 238 and 172 incident CVD and diabetes cases occurred, respectively.

The team found that metabolic syndrome prevalence within the group was at least 1.6% and 3.1% higher for men and women, respectively, when the Harmonization definition was used, compared with all other definitions, with a prevalence of 47.8% among the men, and 40.7% among the women.

All definitions of the metabolic syndrome significantly predicted incident diabetes and CVD cases; however, the Harmonization definition had the highest sensitivity, at 83.0% for diabetes and 70.2% for CVD, compared with the sensitivities ranging from 61.6% to 82.3% for diabetes, and 44.4% to 67.0% for CVD using other definitions.

Conversely, the Harmonization definition had the lowest specificity for predicting incident diabetes and CVD, at 59.4% and 57.6%, respectively, while the specificities of other definitions ranged from 80.1% to 61.7% for diabetes, and from 77.2% to 59.8% for CVD.

The team also found that the Harmonization definition of the metabolic syndrome as one entity was a better predictor of incident CVD than the sum of its individual components, such as elevated waist circumference and elevated triglycerides.

The metabolic syndrome as defined by Harmonization was also a better predictor of CVD than the Framingham risk equation among women but not men.

Pajunen et al conclude: "Irrespective of definition, the metabolic syndrome is a significant predictor of incident CVD events and incident diabetes."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Lauretta Ihonor