Evidence on the applicability of the ATPIII, IDF and CDS metabolic syndrome diagnostic criteria to identify CVD and T2DM in the Chinese population from a 6.3-year cohort study in mid-eastern China.

AIMS

This study evaluates the effectiveness of three metabolic syndrome (MS) criteria in identifying cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) in the Chinese population.

METHODS

3598 subjects were recruited from a cohort study on Prevention of Multiple Metabolic disorders and MS in Jiangsu of China (PMMJS), followed at 6.3 years. MS was diagnosed using criteria of the National Cholesterol Education Program's Adult Treatment Panel III (ATPIII), the International Diabetes Federation (IDF) and Chinese Diabetes Society (CDS). Cox regression model was used to analysis the association between MS and onset of CVD and T2DM. Receiver operating characteristic (ROC) curve, sensitivity and specificity were also used to test the ability of three MS criteria to identify CVD or T2DM.

RESULTS

Among three criteria, CDS has the highest specificity but lowest sensitivity. Using the CDS criterion, over 50 percent of patients would be misdiagnosed. ATPIII criterion has the shortest distance in ROC curve, lowest false positive rate and false negative rate for identifying CVD and T2DM. ATPIII+/IDF+ has lower ability to predict CVD than ATPIII+/IDF-. ATPIII+/IDF+ and ATPIII+/IDF- has similar ability to predict T2DM.

CONCLUSIONS

The ATPIII-MS criterion has the highest ability to predict CVD and T2DM. ATPIII is the best MS criterion for the Chinese population.