Boronat M, Saavedra P, Varillas V F, Wagner A M, López-Plasencia Y, Alberiche M P, Nóvoa F J
Section of Endocrinology and Nutrition, Hospital Universitario Insular, Avda. Marítima del Sur s/n, 35016 Las Palmas de Gran Canaria, Spain.
Nutr Metab Cardiovasc Dis. 2009 Jul;19(6):417-22. doi: 10.1016/j.numecd.2008.07.010. Epub 2008 Sep 25.
Several working definitions of metabolic syndrome have been proposed for clinical use. However, individuals can be discordantly classified as having or not having metabolic syndrome depending on the choice of one or another definition. This study compared the cardiovascular risk profile of subjects concordantly and discordantly diagnosed by the criteria of the National Cholesterol Education Program (NCEP) and the criteria of the International Diabetes Federation (IDF).
Nine hundred and twenty-nine non-diabetic adult subjects belonging to a cross-sectional population-based study in Gran Canaria island (Spain) were assessed. Participants completed a questionnaire and underwent physical examination, fasting blood analyses, and a standardized oral glucose tolerance test. Two hundred and four subjects (22%) had metabolic syndrome according to both definitions, 31 (3.3%) only by the IDF criteria, and 5 (0.5%) only by the NCEP criteria. Participants fulfilling both proposals showed more adverse age and sex-adjusted measures of BMI, waist, HDL cholesterol, triglycerides, post-load glucose, HOMA-IR and plasminogen inhibitor activator-1 (PAI-1) than individuals exclusively satisfying the IDF criteria. Moreover, in contrast to subjects meeting both criteria, those that fulfilled only the IDF criteria had levels of BMI, waist, total and HDL cholesterol, post-load glucose, glycated HbA1c, C-reactive protein, PAI-1 and fibrinogen not significantly different from those observed in subjects without metabolic syndrome.
The IDF definition identifies a surplus of individuals whose cardiovascular risk profile, particularly regarding to some non-traditional cardiovascular risk factors, is less adverse than that observed in subjects also diagnosed by the NCEP definition.
已提出几种代谢综合征的工作定义以供临床使用。然而，根据选择的不同定义，个体可能会被不一致地分类为患有或未患有代谢综合征。本研究比较了根据美国国家胆固醇教育计划（NCEP）标准和国际糖尿病联盟（IDF）标准被一致和不一致诊断的受试者的心血管风险概况。
对来自西班牙大加那利岛一项基于人群的横断面研究的929名非糖尿病成年受试者进行了评估。参与者完成了一份问卷，并接受了体格检查、空腹血液分析和标准化口服葡萄糖耐量试验。根据两种定义，204名受试者（22%）患有代谢综合征，31名（3.3%）仅符合IDF标准，5名（0.5%）仅符合NCEP标准。与仅符合IDF标准的个体相比，符合两种标准的参与者在年龄和性别调整后的BMI、腰围、高密度脂蛋白胆固醇、甘油三酯、负荷后血糖、胰岛素抵抗指数（HOMA-IR）和纤溶酶原激活物抑制剂-1（PAI-1）方面表现出更不利的指标。此外，与符合两种标准的受试者相比，仅符合IDF标准的受试者的BMI、腰围、总胆固醇和高密度脂蛋白胆固醇、负荷后血糖、糖化血红蛋白A1c、C反应蛋白、PAI-1和纤维蛋白原水平与未患代谢综合征的受试者观察到的水平无显著差异。
IDF定义识别出了一部分个体，其心血管风险概况，特别是在一些非传统心血管危险因素方面，比也根据NCEP定义诊断的受试者的情况更有利。
