Abstract 4049: Metabolic Syndrome: Does Definition Determine Prevalence?
OBJECTIVE - To estimate the prevalence of metabolic syndrome (MetSyn) in a study population recruited for a dietary weight loss intervention trial using definitions proposed by the World Health Organization (WHO), the European Group for Study of Insulin Resistance (EGIR), the National Cholesterol Education Program Adult Treatment Panel III (ATP III), the American Association of Clinical Endocrinology (AACE), and the International Diabetes Foundation (IDF). Modest changes in body weight can influence metabolic abnormalities therefore; a secondary objective was to examine the effects of 7% weight reduction on MetSyn status.
RESEARCH DESIGN AND METHODS - MetSyn diagnosis was determined among 256 pre-menopausal women (age = 41 ± 6 yrs, BMI = 32 ± 4 kg/m2) participating in a dietary weight loss study according to the definitions proposed by WHO, EGIR, ATP III, AACE, and IDF. MetSyn diagnosis was re-evaluated after 6 months of study participation.
RESULTS - Based on the working definitions, 16.1% (EGIR), 21.5% (WHO), 23.1% (AACE), 31.0% (ATP III), and 31.8% (IDF) of the participants met the criteria for MetSyn. Between 76.6% − 99.2% of all participants were consistently classified across the five definitions. The highest agreement was between ATP III and IDF (kappa = 0.99; 95% CI 0.99 − 1.0) and the lowest agreement was between WHO and AACE (kappa = 0.32; 95% CI 0.19 − 0.46). Among those diagnosed with MetSyn at baseline between 64.0% − 88.9% of the participants (n = 83) who lost ≥7% of their baseline body weight in 6 months no longer met the various definitions of MetSyn.
CONCLUSION - The prevalence of MetSyn varies substantially between different definitions which raise questions about the clinical utility of this diagnosis. Regardless of the specific definition, weight reduction at a level of ≥S7% has a beneficial impact on many of the criteria that determine MetSyn status.