Info

ATP, Adult Treatment Panel; HDL, high-density lipoprotein; WHO, World Health Organization.

Adapted from Alberti, K. G.; Zimmet, P. Z. Diabet Med. 1998, 15, 539-553 and Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001, 285, 2486, with permission from the American Medical Association.

aThe American Diabetes Association and National Heart Lung and Blood Institute have suggested lowering this threshold to 100 mgdL "1.

Overview). This combination of risk factors is responsible for a majority of cardiovascular morbidity among overweight and obese individuals and those with T2DM. Each component of the metabolic syndrome has been independently associated with an increased risk of CVD.17

The WHO initially defined criteria for the diagnosis of the metabolic syndrome18 in 1998 (Table 3), requiring the presence of insulin resistance and two or more of the following metabolic abnormalities: waist-to-hip ratio (>0.90 for men; > 0.85 for women), triglycerides (>150 mg dL_ 1), HDL cholesterol (< 35 mg dL_ 1 for men; <39 mg dL_ 1 for women), blood pressure (> 140/90 mmHg or documented use of antihypertensive therapy), or microalbumiuria (Urinary albumin/creatinine ratio >30mgg_ 1).

In its third report, the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATP III) developed an alternative classification for metabolic syndrome,19 requiring the presence of at least three metabolic abnormalities to make the diagnosis. The NCEP-ATP III criteria do not make insulin resistance an absolute requirement to define the metabolic syndrome, has lower threshold values for blood pressure (> 130/85 mmHg or documented use of antihypertensive therapy) and HDL cholesterol (<40mgdL_ 1 for men; <50mgdL_ 1 for women), uses waist circumference (>102 cm in men; >88cm in women) instead of waist-to-hip ratio, and does not include microalbuminuria.

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