Analysis of the criteria used for the definition of metabolic syndrome in patients with type 2 diabetes mellitus

The aim was to compare in patients with type 2 diabetes mellitus (DM2) the prevalence of the metabolic syndrome according to the World Health Organization (WHO) and the National Cholesterol Education Program (NCEP) definitions, and to analyze the association between them and the complications of DM2. Patients with DM2 (n= 753) were evaluated for ethnics, anthropometrics and laboratory parameters and for the presence of DM2 complications: diabetic nephropathy, coronary artery disease, stroke, diabetic retinopathy and peripheral vascular disease. Insulin resistance was estimated using the HOMA index. Metabolic syndrome was found in 671 (89%) and 657 (87%) patients using the WHO definition and the NCEP definition, respectively. In the total group, there was a moderate agreement between the two definitions (k= 0.54; 95% CI 0.490.59), although, it was better for black patients (k= 0.69; 95% CI 0.600.78) than white (k= 0.54; 95% CI 0.480.6) or mulattos patients (k= 0.26; 95% CI 0.090.43). Patients with metabolic syndrome using the NCEP criteria had higher HOMA-IR values compared to those without metabolic syndrome (p= 0.001). This differentiation was not seen using the WHO definition (p= 0.152). The proportion of diabetic complications was similar for both definitions. In conclusion, regarding the risk of diabetic complications both definitions are equivalent. However, there are some ethnic differences in the agreement between the two definitions.

Metabolic syndrome; Insulin resistance; Type 2 diabetes mellitus; World Health Organization; National Cholesterol Education Program Adult Treatment Panel III; Diagnostic criteria