Patient Care Endocrinology & Cardiology - October 2007 - (Page 12)

I Metabolic syndrome TABLE 1 Definitions of the metabolic syndrome Risk factors WHO (1998)2 EGIR (1999)3 ATP III (2001)4 AACE (2003)5 IDF (2005)* AHA/NHLBI (2005)6 Obesity W/H: men, 0.9; women, 0.85 BMI 30 kg/m2 WC: men, 94 cm (37 in); women, 80 cm (31.5 in) 150 WC: men, 102 cm (40 in); women, 88 cm (34.6 in) 150 BMI 25 kg/m2 Ethnicspecific WC WC: men, 102 cm (40 in); women, 88 cm (34.6 in) 50+ Men: 40+ Women: 50+ 130/ 85+ IFG ( 110 mg/dL) or T2DM Triglycerides (mg/dL) HDL-C (mg/dL) BP (mm Hg) Plasma glucose 150 150 150+ Men: 40+ Women: 50+ 130/ 85+ IFG ( 110 mg/dL) or T2DM Men: 35 Women: 39 140/90 IFG ( 110 mg/dL), IGT (2h 140 mg/dL), or T2DM Low insulin sensitivity Microalbuminuria Men: 39 Women: 39 140/90 IFG ( 110 mg/dL), IGT (2h 140 mg/dL) Men: 40 Women: 50 130/85 IFG ( 110 mg/dL) or T2DM Men: 40 Women: 50 130/85 IFG ( 110 mg/dL), IGT (2h 140 mg/dL) Other Hyperinsulinemia (used only in nondiabetics) Hyperinsulinemia plus 2 of the above risk factors 3 of the above risk factors Hyperinsulinemia (used only in nondiabetics) Based on clinical judgment irrespective of number of risk factors present Central obesity plus 2 of the above risk factors 3 of the above risk factors Required for diagnosis Low insulin sensitivity or IFG/IGT or T2DM plus 2 of the above risk factors Key: +, or under treatment; 2h, 2-h postglucose load of 75 g; AACE, American Association of Clinical Endocrinologists; AHA/NHLBI, American Heart Association/National Heart, Lung, and Blood Institute; ATP III, National Cholesterol Education Program Adult Treatment Panel III; BMI, body mass index; EGIR, European Group for Study of Insulin Resistance; HDL-C, high-density lipoprotein cholesterol; IDF, International Diabetes Federation; IFG, impaired fasting glucose; IGT, impaired glucose tolerance; T2DM, type 2 diabetes mellitus; WC, waist circumference; W/H, waist-hip ratio; WHO, World Health Organization. *Alberti KG, Zimmet P, Shaw L; IDF Epidemiology Task Force Consensus Group. The metabolic syndrome—a new worldwide definition. Lancet. 2005;366:10591062. creased risk of coronary artery disease (CAD) outcomes, but not with other CV outcomes, such as stroke. However, when adjusted for age, sex, and ethnicity, the metabolic syndrome became a stronger predictor of CAD outcomes and was also predictive of stroke and all-cause mortality.10 The concept of the metabolic syndrome as a medical diagnosis is still under debate, largely because this cluster of metabolic abnormalities and CV risk factors lacks a definitive single or major unifying pathophysiologic process, and treatment of the syndrome does not differ from treatment of its compo- 12 PATIENT CARE ENDOCRINOLOGY & CARDIOLOGY www.patientcareonline.com http://www.patientcareonline.com

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Patient Care - Endocrinology & Cardiology - October 2007 Research Digest Contents Medicine in the News Recognizing and Managing Patients with the Metabolic Syndrome and Prediabetes Using Troponins to Evaluate Cardiac Injury The 15-Minute Visit Classified Advertising Clinical Clips

Patient Care Endocrinology & Cardiology - October 2007

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