Journal List > Korean Diabetes J > v.32(4) > 1002233

Lee, Rhee, Choi, Kim, Won, Park, Lee, Oh, Park, and Kim: Comparison of the Predictability of Cardiovascular Disease Risk According to Different Metabolic Syndrome Criteria of American Heart Association/National Heart, Lung, and Blood Institute and International Diabetes Federation in Korean Men

Abstract

Background

We compared the prevalences of two criteria of metabolic syndrome, that is, American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and International Diabetes Federation (IDF), in Korean male adults and compared the predictability of insulin resistance and future cardiovascular diseases using Framingham Risk Score.

Methods

In total 23,467 male adults (mean age 43.3 years) who participated in medical check-up in 2005, the prevalences of metabolic syndrome according to AHA/NHLBI and IDF criteria and the presence of insulin resistance, defined by the highest quartile of Homeostasis Model Assessment of insulin resistance index (HOMA-IR), were compared. The relative risk (calculated risk/average risk) for 10-year risk for coronary artery disease (CHD) assessed by Framingham Risk Score were compared.

Results

5.8% of the subjects had diabetes mellitus. 20.7% and 13.2% of the subjects had metabolic syndrome defined by AHA/NHLBI and IDF criteria, and the two criteria showed high agreement with kappa value of 0.737 (P < 0.01). More subjects in IDF-defined group had insulin resistance compared with AHA/NHLBI definition (59.8 vs. 54%, P < 0.01). The odds ratio for increased relative risk (> 1.0) for 10-year CHD were higher in AHA/NHLBI-defined subjects compared with IDF-defined subject (3.295 vs. 3.082). The Kappa values for the analysis of agreement between each criteria and prediction of insulin resistance or cardiovascular disease risk, were too low for comparison.

Conclusion

In Korean males, the prevalence for metabolic syndrome defined by AHA/NHLBI criteria was higher than those defined by IDF criteria. IDF criteria detected more subjects with insulin resistance, but didn't have better predictability for CHD compared with AHA/NHLBI criteria.

Figures and Tables

Table 1
Baseline characteristics of study population
kdj-32-317-i001

HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; HOMA-IR, Homeostasis Model Assessment of insulin resistance index. *Insulin resistant status is defined by being within the highest quartile of HOMA-IR.

Table 2
The crude prevalence of metabolic syndrome and its components by American Heart Association/National Heart, Lung, and Blood Institute and International Diabetes Federation criteria
kdj-32-317-i002

HDL-C, high-density lipoprotein cholesterol; TG, triglyceride; WC, waist circumference.

Table 3
The proportion of insulin resistant subjects in each metabolic syndrome groups defined by different criteria and the abilities of each criteria to detect insulin resistant subjects
kdj-32-317-i003

*Insulin resistant status is defined by being within the highest quartile of HOMA-IR (≥ 0.706).

Table 4
The comparison for the abilities to predict increased relative risk (RR > 1.0) for 10-year risk for coronary heart disease calculated by Framingham Risk Score in Korean male subjects
kdj-32-317-i004

RR, relative risk; AHA/NHLBI, American Heart Association/National Heart, Lung, and Blood Institute; IDF, International Diabetes Federation.

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