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The usefulness of the International Diabetes Federation and the National Cholesterol Education Program's Adult Treatment Panel III definitions of the metabolic syndrome in predicting coronary heart disease in subjects with type 2 diabetes.
Diabetes Care 2007; 30(5):1206-11DC

Abstract

OBJECTIVE

The purpose of this study was to compare the predictive value for coronary heart disease (CHD) of the International Diabetes Federation (IDF) definition (with Asian criteria for central obesity) of the metabolic syndrome with existing criteria of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) in Chinese subjects with type 2 diabetes.

RESEARCH DESIGN AND METHODS

Subjects with type 2 diabetes and without macrovascular diseases or end-stage renal disease were categorized by the criteria of the IDF and the NCEP ATP III. CHD was defined as myocardial infarction, ischemic heart disease, coronary revascularization, heart failure, and death related to CHD.

RESULTS

Of 4,350 patients (aged 54.4 +/- 13.4 years; median follow-up period 7.1 [interquartile range 5.2-8.5] years), 65.9% had metabolic syndrome according to either IDF or NCEP ATP III criteria. The NCEP ATP III definition identified metabolic syndrome in 786 subjects (18.1%) who did not fulfill the criteria of the IDF. HDL cholesterol and systolic blood pressure were predictors of CHD after adjustment for other confounding factors. Compared with subjects without metabolic syndrome, the IDF criteria failed to predict CHD (hazard ratio 1.13 [95% CI 0.86-1.48], P = 0.374). In contrast, the NCEP ATP III definition (2.51 [1.80-3.50], P < 0.001) predicted an increased risk of CHD with the NCEP-only group having the highest risk (2.49 [1.66-3.73], P < 0.001).

CONCLUSIONS

With established type 2 diabetes, the IDF definition of the metabolic syndrome failed to identify a subgroup of patients who had the highest risk for CHD. Practitioners must recognize the appropriate setting for its application.

Authors+Show Affiliations

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, The Prince of Wales Hospital Shatin, NT, Hong Kong. ptong@cuhk.edu.hkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17259472

Citation

Tong, Peter C., et al. "The Usefulness of the International Diabetes Federation and the National Cholesterol Education Program's Adult Treatment Panel III Definitions of the Metabolic Syndrome in Predicting Coronary Heart Disease in Subjects With Type 2 Diabetes." Diabetes Care, vol. 30, no. 5, 2007, pp. 1206-11.
Tong PC, Kong AP, So WY, et al. The usefulness of the International Diabetes Federation and the National Cholesterol Education Program's Adult Treatment Panel III definitions of the metabolic syndrome in predicting coronary heart disease in subjects with type 2 diabetes. Diabetes Care. 2007;30(5):1206-11.
Tong, P. C., Kong, A. P., So, W. Y., Yang, X., Ho, C. S., Ma, R. C., ... Cockram, C. S. (2007). The usefulness of the International Diabetes Federation and the National Cholesterol Education Program's Adult Treatment Panel III definitions of the metabolic syndrome in predicting coronary heart disease in subjects with type 2 diabetes. Diabetes Care, 30(5), pp. 1206-11.
Tong PC, et al. The Usefulness of the International Diabetes Federation and the National Cholesterol Education Program's Adult Treatment Panel III Definitions of the Metabolic Syndrome in Predicting Coronary Heart Disease in Subjects With Type 2 Diabetes. Diabetes Care. 2007;30(5):1206-11. PubMed PMID: 17259472.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The usefulness of the International Diabetes Federation and the National Cholesterol Education Program's Adult Treatment Panel III definitions of the metabolic syndrome in predicting coronary heart disease in subjects with type 2 diabetes. AU - Tong,Peter C, AU - Kong,Alice P, AU - So,Wing-Yee, AU - Yang,Xilin, AU - Ho,Chung-Shun, AU - Ma,Ronald C, AU - Ozaki,Risa, AU - Chow,Chun-Chung, AU - Lam,Christopher W, AU - Chan,Juliana C N, AU - Cockram,Clive S, Y1 - 2007/01/26/ PY - 2007/1/30/pubmed PY - 2007/6/15/medline PY - 2007/1/30/entrez SP - 1206 EP - 11 JF - Diabetes care JO - Diabetes Care VL - 30 IS - 5 N2 - OBJECTIVE: The purpose of this study was to compare the predictive value for coronary heart disease (CHD) of the International Diabetes Federation (IDF) definition (with Asian criteria for central obesity) of the metabolic syndrome with existing criteria of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) in Chinese subjects with type 2 diabetes. RESEARCH DESIGN AND METHODS: Subjects with type 2 diabetes and without macrovascular diseases or end-stage renal disease were categorized by the criteria of the IDF and the NCEP ATP III. CHD was defined as myocardial infarction, ischemic heart disease, coronary revascularization, heart failure, and death related to CHD. RESULTS: Of 4,350 patients (aged 54.4 +/- 13.4 years; median follow-up period 7.1 [interquartile range 5.2-8.5] years), 65.9% had metabolic syndrome according to either IDF or NCEP ATP III criteria. The NCEP ATP III definition identified metabolic syndrome in 786 subjects (18.1%) who did not fulfill the criteria of the IDF. HDL cholesterol and systolic blood pressure were predictors of CHD after adjustment for other confounding factors. Compared with subjects without metabolic syndrome, the IDF criteria failed to predict CHD (hazard ratio 1.13 [95% CI 0.86-1.48], P = 0.374). In contrast, the NCEP ATP III definition (2.51 [1.80-3.50], P < 0.001) predicted an increased risk of CHD with the NCEP-only group having the highest risk (2.49 [1.66-3.73], P < 0.001). CONCLUSIONS: With established type 2 diabetes, the IDF definition of the metabolic syndrome failed to identify a subgroup of patients who had the highest risk for CHD. Practitioners must recognize the appropriate setting for its application. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/17259472/The_usefulness_of_the_International_Diabetes_Federation_and_the_National_Cholesterol_Education_Program's_Adult_Treatment_Panel_III_definitions_of_the_metabolic_syndrome_in_predicting_coronary_heart_disease_in_subjects_with_type_2_diabetes_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=17259472 DB - PRIME DP - Unbound Medicine ER -