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Table 2 Exact NCEP ATP-III, AHA/NHLBI and IDF-definitions of the Metabolic Syndrome as originally published

From: Impact of 4 different definitions used for the assessment of the prevalence of the Metabolic Syndrome in primary healthcare:The German Metabolic and Cardiovascular Risk Project (GEMCAS)

Risk factor

NECP ATP III

2001 [1]*

AHA/NHLBI

2004 [3]

AHA/NHLBI

2005 [4]

IDF

2005 [5]**

Central/Abdominal obesity (Waist circumference)

M >102 cm

W > 88 cm

M >102 cm

W > 88 cm

M ≥ 102 cm §,||

W ≥ 88 cm §,||

Must have: Central obesity, defined as WC with ethnicity specific values. Europids: male ≥ 94 cm, female ≥ 80 cm plus any two of following 4 factors:

Blood pressure

≥130/≥85 mmHg

≥130/≥85 mmHg

≥130 mm Hg systolic BP, or ≥ 85 mm Hg diastolic BP, or drug treatment for hypertension

≥130 mm Hg systolic blood pressure, or ≥ 85 mm Hg diastolic blood pressure, or treatment of previously diagnosed hypertension

Fasting glucose

110 mg/dL#

110 mg/dL**

≥100 mg/dL or drug treatment for elevated glucose

≥5.6 mmol/L (100 mg/dL) or previously diagnosed diabetes. If above 5.6 mmol/L, OGTT is strongly recommended but is not necessary to define presence of the syndrome

Triglycerides

150 mg/dL

150 mg/dL

≥150 mg/dL (1.7 mmol/L) or drug treatment for elevated TG††

≥1.7 mmol/L (150 mg/dL) or specific treatment for this lipid abnormality

HDL cholesterol

M <40 mg/dL

W <50 mg/dL

M <40 mg/dL

W<50 mg/dL

M <40 mg/dL (0.9 mmol/L)†† W <50 mg/dL (1.1 mmol/L)†† or drug treatment for reduced HDL-C‡‡

M <1.03 mmol/L (40 mg/dL) W <1.29 mmol/L (50 mg/dL) or specific treatment for this lipid abnormality

  1. Differences relative to the NCEP ATP III definition are shown in bold ; M = men, W = women
  2. * sometimes referred to as [44]
  3. often cited as NCEP ATP III definition
  4. **see also [6]
  5. § changed from ">" to "≥"
  6. † † erratum in: Circulation. 2005 Oct 25;112(17):e297 and e298 (1.03 and 1.3 mmol/L) for apparently wrong original published values;
  7. Following remarks are all citations of the original definitions:
  8. ‡ Overweight and obesity are associated with insulin resistance and the metabolic syndrome. However, the presence of abdominal obesity is more highly correlated with the metabolic risk factors than is an elevated BMI. Therefore, the simple measure of WC is recommended to identify the body weight component of the metabolic syndrome
  9. || Lower WC cut point (eg, ≥ 90 cm in men and ≥ 80 cm in women) appears to be appropriate for Asian Americans
  10. ¶if BMI is >30, central obesity can be assumed and waist circumference does not need to be measured
  11. # "... the presence of type 2 diabetes does not exclude a diagnosis of metabolic syndrome."
  12. ** "The ADA has recently established a cutpoint of ≥ 100 mg/dL, above which persons have either prediabetes (impaired fasting glucose) or diabetes. This new cutpoint should be applicable for identifying the lower boundary to define an elevated glucose as one criterion for the metabolic syndrome"
  13. ‡‡ Fibrates and nicotinic acid are the most commonly used drugs for elevated TG and reduced HDL-C. Patients taking 1 of these drugs presumed to have high TG and low HDL.