Am J Epidemiol 2002; 156:1070-1077.
Copyright © 2002 by Johns
Hopkins Bloomberg School of Public Health
PRACTICE OF EPIDEMIOLOGY |
Metabolic Syndrome and Development of Diabetes Mellitus: Application and Validation of Recently Suggested Definitions of the Metabolic Syndrome in a Prospective Cohort Study
1 Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
2 Department of Physiology, University of Kuopio, Kuopio, Finland.
3 Research Institute of Public Health, University of Kuopio, Kuopio, Finland.
4 Department of Public Health and General Practice, University of Kuopio, Kuopio, Finland.
5 Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI.
6 Inner Savo Health Centre, Suonenjoki, Finland.
7 Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.
The World Health Organization (WHO) and the National Cholesterol Education Program (NCEP) recently proposed definitions for the metabolic syndrome. Little is known of their validity, however. The authors assessed the sensitivity and specificity of the definitions of the metabolic syndrome for prevalent and incident diabetes mellitus in a Finnish population-based cohort of middle-aged men (n = 1,005) followed for 4 years since the late 1980s. Four definitions based on the WHO and NCEP recommendations were compared. All definitions identified persons at high risk for developing diabetes during the 4-year follow-up (odds ratios = 5.0–8.8). The WHO definition including waist-hip ratio > 0.90 or body mass index 
30 kg/m2 was the most sensitive (0.83 and 0.67) and least specific (0.78 and 0.80) in detecting the 47 prevalent and 51 incident cases of diabetes. The NCEP definition in which adiposity was defined as waist girth > 102 cm detected only 61% of prevalent and 41% of incident diabetes, although it was the most specific (0.89 and 0.90). The WHO definition seems valid as judged by its relatively high sensitivity and specificity in predicting diabetes. The NCEP definition including waist > 102 cm also identifies persons at high risk for diabetes, but it is relatively insensitive in predicting diabetes.
diabetes mellitus; hyperinsulinism; hyperlipidemia; hypertension; insulin resistance; obesity
Abbreviations: Abbreviations: EGIR, European Group for the Study of Insulin Resistance; HDL, high density lipoprotein; NCEP, National Cholesterol Education Program; QUICKI, quantitative insulin sensitivity check index; WHO, World Health Organization.
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C. J. Girman, J. M. Dekker, T. Rhodes, G. Nijpels, C. D. A. Stehouwer, L. M. Bouter, and R. J. Heine An Exploratory Analysis of Criteria for the Metabolic Syndrome and Its Prediction of Long-term Cardiovascular Outcomes: The Hoorn Study Am. J. Epidemiol., September 1, 2005; 162(5): 438 - 447. [Abstract] [Full Text] [PDF]
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 R. A. Hegele and R. L. Pollex Genetic and physiological insights into the metabolic syndrome Am J Physiol Regulatory Integrative Comp Physiol, September 1, 2005; 289(3): R663 - R669. [Abstract] [Full Text] [PDF]
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W. S. Tzou, P. S. Douglas, S. R. Srinivasan, M. G. Bond, R. Tang, W. Chen, G. S. Berenson, and J. H. Stein Increased Subclinical Atherosclerosis in Young Adults With Metabolic Syndrome: The Bogalusa Heart Study J. Am. Coll. Cardiol., August 2, 2005; 46(3): 457 - 463. [Abstract] [Full Text] [PDF]
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M. I. Schmidt, B. B. Duncan, H. Bang, J. S. Pankow, C. M. Ballantyne, S. H. Golden, A. R. Folsom, L. E. Chambless, and for the Atherosclerosis Risk in Communities Invest Identifying Individuals at High Risk for Diabetes: The Atherosclerosis Risk in Communities study Diabetes Care, August 1, 2005; 28(8): 2013 - 2018. [Abstract] [Full Text] [PDF]
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A S Wierzbicki, S Nishtar, P J Lumb, M Lambert-Hammill, C N Turner, M A Crook, M S Marber, and J Gill Metabolic syndrome and risk of coronary heart disease in a Pakistani cohort Heart, August 1, 2005; 91(8): 1003 - 1007. [Abstract] [Full Text] [PDF]
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M. J. LaMonte, C. E. Barlow, R. Jurca, J. B. Kampert, T. S. Church, and S. N. Blair Cardiorespiratory Fitness Is Inversely Associated With the Incidence of Metabolic Syndrome: A Prospective Study of Men and Women Circulation, July 26, 2005; 112(4): 505 - 512. [Abstract] [Full Text] [PDF]
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E. S. Ford Risks for All-Cause Mortality, Cardiovascular Disease, and Diabetes Associated With the Metabolic Syndrome: A summary of the evidence Diabetes Care, July 1, 2005; 28(7): 1769 - 1778. [Abstract] [Full Text] [PDF]
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M. Kurella, J. C. Lo, and G. M. Chertow Metabolic Syndrome and the Risk for Chronic Kidney Disease among Nondiabetic Adults J. Am. Soc. Nephrol., July 1, 2005; 16(7): 2134 - 2140. [Abstract] [Full Text] [PDF]
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 C. C. Lee, S. G. Glickman, D. R. Dengel, M. D. Brown, and M. A. Supiano Abdominal Adiposity Assessed by Dual Energy X-Ray Absorptiometry Provides a Sex-Independent Predictor of Insulin Sensitivity in Older Adults J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2005; 60(7): 872 - 877. [Abstract] [Full Text] [PDF]
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J. Hung, B. M. McQuillan, C. M. L. Chapman, P. L. Thompson, and J. P. Beilby Elevated Interleukin-18 Levels Are Associated With the Metabolic Syndrome Independent of Obesity and Insulin Resistance Arterioscler Thromb Vasc Biol, June 1, 2005; 25(6): 1268 - 1273. [Abstract] [Full Text] [PDF]
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U. Ekelund, S. Brage, P. W. Franks, S. Hennings, S. Emms, and N. J. Wareham Physical Activity Energy Expenditure Predicts Progression Toward the Metabolic Syndrome Independently of Aerobic Fitness in Middle-Aged Healthy Caucasians: The Medical Research Council Ely Study Diabetes Care, May 1, 2005; 28(5): 1195 - 1200. [Abstract] [Full Text] [PDF]
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N. R. Qi, J. Wang, V. Zidek, V. Landa, P. Mlejnek, L. Kazdova, M. Pravenec, and T. W. Kurtz A New Transgenic Rat Model of Hepatic Steatosis and the Metabolic Syndrome Hypertension, May 1, 2005; 45(5): 1004 - 1011. [Abstract] [Full Text] [PDF]
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M. E. Otiniano, X. L. Du, M. R. Maldonado, L. Ray, and K. Markides Effect of Metabolic Syndrome on Heart Attack and Mortality in Mexican-American Elderly Persons: Findings of 7-Year Follow-Up From the Hispanic Established Population for the Epidemiological Study of the Elderly J. Gerontol. A Biol. Sci. Med. Sci., April 1, 2005; 60(4): 466 - 470. [Abstract] [Full Text] [PDF]
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A. Scuteri, S. S. Najjar, C. H. Morrell, and E. G. Lakatta The Metabolic Syndrome in Older Individuals: Prevalence and Prediction of Cardiovascular Events: The Cardiovascular Health Study Diabetes Care, April 1, 2005; 28(4): 882 - 887. [Abstract] [Full Text] [PDF]
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R. J. Petrella, C. N. Lattanzio, A. Demeray, V. Varallo, and R. Blore Can Adoption of Regular Exercise Later in Life Prevent Metabolic Risk for Cardiovascular Disease? Diabetes Care, March 1, 2005; 28(3): 694 - 701. [Abstract] [Full Text] [PDF]
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A. M. McNeill, W. D. Rosamond, C. J. Girman, S. H. Golden, M. I. Schmidt, H. E. East, C. M. Ballantyne, and G. Heiss The Metabolic Syndrome and 11-Year Risk of Incident Cardiovascular Disease in the Atherosclerosis Risk in Communities Study Diabetes Care, February 1, 2005; 28(2): 385 - 390. [Abstract] [Full Text] [PDF]
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P. T. Katzmarzyk, T. S. Church, I. Janssen, R. Ross, and S. N. Blair Metabolic Syndrome, Obesity, and Mortality: Impact of cardiorespiratory fitness Diabetes Care, February 1, 2005; 28(2): 391 - 397. [Abstract] [Full Text] [PDF]
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J. Dallongeville, D. Cottel, J. Ferrieres, D. Arveiler, A. Bingham, J. B. Ruidavets, B. Haas, P. Ducimetiere, and P. Amouyel Household Income Is Associated With the Risk of Metabolic Syndrome in a Sex-Specific Manner Diabetes Care, February 1, 2005; 28(2): 409 - 415. [Abstract] [Full Text] [PDF]
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D. E. Laaksonen, L. Niskanen, K. Punnonen, K. Nyyssonen, T.-P. Tuomainen, V.-P. Valkonen, and J. T. Salonen The Metabolic Syndrome and Smoking in Relation to Hypogonadism in Middle-Aged Men: A Prospective Cohort Study J. Clin. Endocrinol. Metab., February 1, 2005; 90(2): 712 - 719. [Abstract] [Full Text] [PDF]
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V. Lyssenko, P. Almgren, D. Anevski, R. Perfekt, K. Lahti, M. Nissen, B. Isomaa, B. Forsen, N. Homstrom, C. Saloranta, et al. Predictors of and Longitudinal Changes in Insulin Sensitivity and Secretion Preceding Onset of Type 2 Diabetes Diabetes, January 1, 2005; 54(1): 166 - 174. [Abstract] [Full Text] [PDF]
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