Comparison Of The Application Of Three Diagnostic Criteria Of Metabolic Syndrome And The Prevalence Of Cardiovascular Disease And Type 2 Diabetes Affected By Metabolic Syndrome With Or Without Waist Circumference And Body Mass Index

ObjectiveTo compared the application of three diagnostic criteria of Metabolic Syndrome (MS) proposed by Adult Treatment Panel III of National Cholesterol Education Program, International Diabetes Foundation and Chinese Diabetes Suggestion in community population of JiangSu province, to analyze the ability of Waist Circumference (WC) and Body Mass Index (BMI) in proceeding of MS to Cardiovascular Disease (CVD) and Type 2 Diabetes (T2DM).Methods1. Participants (male 823, female 1123) were recruited from the Prevention of multiple metabolic disorders and MS in JiangSu province, which have been followed-up for five years. The criteria proposed by Adult Treatment Panel III of National Cholesterol Education Program, International Diabetes Foundation and Chinese Diabetes Suggestion were used to define the MS. The COX regression and Receiver Operation Characteristic (ROC) curve were conducted to compare the predictive ability of three diagnostic criteria.2. According to the MS combinations with or without WC and BMI at baseline, to compare the risk of CVD, T2DM of two groups MS.Results1. The Incident Density (ID) of CVD and T2DM with MS and without MS diagnosis by NECP-ATPⅢis 12.15‰, 19.39‰and 2.46‰, 8.12‰, respectively. The ID of CVD and T2DM with MS and without MS diagnosis by IDF is 10.70‰, 15.41‰and 3.61‰, 9.71‰, respectively.The ID of CVD and T2DM with MS and without MS diagnosis by CDS is 14.61‰, 24.93‰and 3.52‰, 9.09‰, respectively.2. Compared the predictive ability of three MS criteria, MS diagnosis by NECP-ATPⅢcriteria was the best predictor to CVD and T2DM. 3. The highest sensitivity of MS criteria was NECP-ATPⅢwhen MS predicted CVD (63.27%) and T2DM (46.32%). The highest specificity of MS criteria was CDS when MS predicted CVD (89.57%) and T2DM (91.97%). And the NECP-ATPⅢpossessed the best ROC curve of indicating CVD (0.70) and T2DM (0.63).4. Compared to subjects without MS, the aRRs and 95%CI of incidence CVD and T2DM of MS patient with normal WC were 5.43(2.56~11.53) and 3.57(2.07~6.16), the aRRs and 95%CI of MS patient with higher WC were 3.69(1.82~7.49) and 2.06(1.22~3.47). There were no significance between two group in indicating CVD and T2DM.5. Compared to subjects without MS, the aRRs and 95%CI of incidence CVD and T2DM of MS patient with BMI<25kg/m2 were 4.63(2.23~9.60), 3.20(1.91~5.34), repectively. The aRRs and 95%CI of MS patient with BMI≥25kg/m2 were 4.08(2.01~9.29), 2.09(1.21~3.63), respectively. There were no significance between two group in indicating CVD and T2DM.Conclusion1. The risk of CVD and T2DM was increased in subjects with MS compared to without MS;2. The application of NECP-ATPⅢwas better than IDF and CDS in JiangSu community popualtion to diagnose MS;3. IDF will ignore the risk of subjects without higher WC, and will under estimate the risk of CVD and T2DM in population;4. The WC was an optional rather than essential component identified MS, whatever increasing in visceral adiposity or body fat could not completely explain the pathophysiology of MS.