Prevalence of metabolic syndrome using WHO, ATPIII and IN definitions in Asian indians: The Chennai Urban Rural Epidemiology Study (CURES-34)

Aim To compare the prevalence of metabolic syndrome (MS) using the World Health Organisation (WHO), Adult Treatment Panel III (ATPIII) and International Diabetes Federation (IDF) criteria of MS in an urban south Indian population, and their ability to identify coronary artery disease (CAD) in males and females. Methods Chermai Urban Rural Epidemiology Study (CURES) is one of the largest epidemiological studies on diabetes carried out in India, in which 26001 individuals aged >= 20 years were screened using systematic random sampling method. Every tenth subject recruited in Phase 1 of CURES was requested to participate in Phase 3, and the response rate was 90.4%. An oral glucose tolerance test (OGTT) was performed in all individuals except self-reported diabetic subjects. Anthropometric measurements and lipid estimations were done in all subjects and the prevalence of MS estimated using the three criteria. Diagnosis of CAD, made by resting 12 lead ECG, was compared by the three criteria of MS. Results NIS was identified in 546 subjects (23.2%) by WHO criteria, 430 subjects (18.3%) by ATPIII criteria and 607 subjects (25.8%) by IDF criteria. Only 224 of these subjects were identified by all the three criteria. There was an increased risk of probable CAD in NIS subjects diagnosed by WHO criteria (odds ratio (OR) 3.86, 95% Confidence Interval (CI), 2.37-6.29, p < 0.001), compared to ATPHI criteria (OR 2.19, 95% CI 1.30-3.67, p < 0.05) and IDF criteria (OR 1.90, 95% CI 1.16-3.12, p < 0.05). The WHO criteria marked out a much higher population for CAD risk compared to ATPIII and IDF criteria in males, but not in females. Conclusion In Asian Indians, the WHO, ATPIII and IDF criteria of NIS identify different individuals. The WHO criteria identify a greater number of CAD subjects in males, but not in females. Copyright (c) 2006 John Wiley & Sons, Ltd.