Metabolic syndrome according to different definitions in a rapidly developing country of the African region

Table 1 Criteria for three definitions of the metabolic syndrome (WHO, ATP, IDF)

	WHO 1998	NCEP ATP III 2005	IDF 2005
	Diabetes, IFG, IGT or insulin resistance¹ plus two or more of the remaining criteria.	Any three or more criteria.	Central obesity plus two or more of the remaining criteria.
1. Adiposity	Waist/hip ratio > 0.9 (M), > 0.85 (F) or BMI > 30 kg/m²	WC ≥ 102 cm (M), ≥ 88 cm (F)	WC ≥ 94 cm (M), ≥ 80 cm (F)²
2. Raised blood pressure	BP ≥ 140/90 mmHg or medication	BP ≥ 130/85 mmHg or medication
3. Dyslipidemia	TG ≥ 1.7 mmol/l or HDL < 0.9 mmol/L (M), < 1.0 mmol/L (F)	TG ≥ 1.7 mmol/L or medication³
		HDL-C < 1.03 mmol/L (M) or < 1.29 mmol/L (F) or medication³
4. Impaired glucose regulation (dysglycemia)	Diabetes, IFG (FBG ≥ 6.1 mmol/l), IGT, or insulin resistance¹	FBG ≥ 5.6 mmol/L⁴	FBG ≥ 5.6 mmol/L or previously diagnosed diabetes
5. Microalbuminuria	Microalbuminuria: albumin ≥ 20 μg/min or albumin/creatinine ratio (ACR) ≥ 30 mg/g

WHO: World Health Organization [19]; ATP: National Cholesterol Education Program-Adult Treatment Panel III [20]; IDF: International Diabetes Federation [21].
BMI: body mass index; BP: blood pressure; HDL-C: high density lipoprotein cholesterol; FBG: fasting blood glucose; IFG: impaired fasting glucose; IGT: impaired glucose tolerance; TG: triglycerides; WC: waist circumference.
¹ Glucose uptake below lowest quartile under hyperinsulinemic euglycemic conditions for background population under investigation.
² Cut off for Sub Saharan Africans, Europids, and Eastern Mediterranean and Middle Eastern populations; ≥ 90 cm (M), ≥ 80 cm (F) for South Asians, Chinese, Japanese, and ethnic South and Central Americans [21].
³Specific treatment for hypertriglyceridemia or low HDL-cholesterol such as fibrate or nicotinic acid.
⁴This cut off was lowered from ≥ 6.1 mmol/L to ≥ 5.6 mmol/l in 2005 [20].

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