[Evaluation of diagnostic criteria for metabolic syndrome to identify insulin resistance]

Abstract

The aim of study was to evaluate the possibilities of different diagnostic criteria for metabolic syndrome in identifying subjects with insulin resistance and to assess the prevalence of metabolic syndrome according to gender in one Lithuanian district.

Materials and methods: A randomly selected sample of 1,115 subjects aged 45-96 years (562 men and 553 women) was formed from general population of Raseiniai district. Insulin resistance was estimated using the homeostasis model assessment. Metabolic syndrome was determined according to the definitions of the World Health Organization, National Cholesterol Education Program Adults Treatment Panel III, and International Diabetes Federation.

Results: Using the World Health Organization criteria, metabolic syndrome was observed in 384 (34.4%) subjects (no difference between genders); according to the National Cholesterol Education Program--in 336 (30.1%) patients (in 107 men (19.0%) and 229 women (41.4%), p < 0.001); using International Diabetes Federation criteria--in 474 (42.5%) (175 men (31.1%) and 299 women (54.1%), p < 0.001). Overall, 314 (28.5%) subjects were insulin resistant (no difference between genders). The highest prevalence of insulin resistance was determined in subjects with metabolic syndrome diagnosed according to the World Health Organization criteria--70.3% (n = 267), p < 0.05. Odds ratios to identify insulin-resistant subjects with metabolic syndrome according to the World Health Organization criteria and the International Diabetes Federation criteria were 22.4 and 2.3, respectively.

Conclusions: The highest prevalence of metabolic syndrome was determined according to the International Diabetes Federation criteria. According to the National Cholesterol Education Program and International Diabetes Federation criteria metabolic syndrome was observed more frequently in women. The highest prevalence of insulin resistance was determined in metabolic syndrome group based on World Health Organization criteria. Using the World Health Organization and International Diabetes Federation criteria for metabolic syndrome provides more opportunities to identify subjects with insulin resistance.