Comparison of diagnostic criteria and prevalence of metabolic syndrome using WHO, NCEP-ATP III, IDF and harmonized criteria: A case study from urban southeast Nigeria

Abstract

Background and aims: Metabolic syndrome (MetS) is a worldwide public health problem, affecting not just developed countries but also developing countries and impacts all age groups. Different criteria are available for its assessment. The present study aims at comparing the prevalence of MetS using four criteria.

Methods: A total of 4202 (male: 2772 and female: 1430) with mean age 41.23 ± 9.58 years participated in the study. For all definitions, presence of 3 abnormalities out of 5 qualify an individual for MetS. Various statistical analyses including unpaired student's t-test, chi-square crosstabs (or Fisher's exact test where appropriate), analysis of variance, logistic regression, receiver operating characteristic (ROC) curve and Cohen's Kappa were performed.

Results: The prevalence of MetS were 17.1%, 21.8%, 11.4% and 23.6% for National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III (NCEP-ATP III), International Diabetes Federation (IDF), World Health Organization (WHO) and the Harmonized definitions respectively. Further, the order of significance of screening components for MetS is elevated blood pressure (BP) > impaired fasting glucose > abdominal adiposity. Whereas, the order of significant performance of the four screening tools are Harmonized > IDF > NCEP-ATP III > WHO.

Conclusion: The prevalence of MetS among young adults in southeast Nigeria was moderately high. The Harmonized definition was the best screening tool for MetS. High BP was the most sensitive and specific screening tool for detecting risk of MetS.

Keywords: Metabolic syndrome; Prevalence; Raised blood pressure; Southeast Nigeria.