New International Definition for the Metabolic Syndrome

The International Diabetes Federation (IDF) issued a global consensus statement presenting a new worldwide definition of the metabolic syndrome The metabolic syndrome, which includes diabetes or prediabetes, abdominal obesity, unfavorable lipid profile and hypertension, triples the risk of myocardial infarction or stroke and doubles mortality from these conditions. It also increases the risk of developing type 2 diabetes, if not already present, fivefold. Recent data from Australia and the U.S. suggest that up to one quarter of the adult population may have the metabolic syndrome.

Over the past six years, several definitions of the metabolic syndrome have been proposed starting with the World Health Organization (WHO) in 1999. They all differ, and this has caused confusion, particularly when attempting to compare data from different studies. It was also uncertain which, if any, of the definitions best picked out those at risk of CVD and diabetes. We therefore felt that it would be helpful to attempt to produce a unifying definition which would be easy to use worldwide and would serve as the basis for furthering our knowledge of the syndrome.

The new definition is a single, clinically accessible statement, based on the view of experts in diabetes, cardiology, lipidology, public health, epidemiology, genetics, metabolism, and nutrition from 6 continents. The goal is to improve the identification of patients with the metabolic syndrome to allow for early and aggressive management strategies that will reduce the risks of developing cardiovascular disease and type 2 diabetes. Creating a single definition to be used worldwide will make it easier for researchers to estimate the prevalence of the metabolic syndrome and compare data between nations.

According to the new definition, a person has the metabolic syndrome if they have central obesity (waist circumference > 94cm for Europid men and > 80cm for Europid women) plus any 2 of the following factors: increased triglyceride concentrations, reduced HDL cholesterol levels, increased blood pressure (systolic >130mmHg or diastolic >85mmHg), and increased fasting plasma glucose (>100mg/dL [5.6mmol/L]) or previously diagnosed type 2 diabetes. Definitions of obesity based on gender and ethnicity are provided. Recommendations for treatment, including primary and secondary interventions and recommended strategies for the individual components of the metabolic syndrome, are given.

International Diabetes Federation www.idf.org, accessed on 25 April 2005
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