Vol 5, No 5 (2004): Practical Diabetology
Other materials agreed with the Editors
Published online: 2004-10-26
Relationship to insulin resistance of the Adult Treatment Panel III diagnostic criteria for identification of the metabolic syndrome
Diabetologia Praktyczna 2004;5(5):295-304.
Abstract
The Adult Treatment Panel III (ATP III) has published
criteria for diagnosing the metabolic syndrome,
a cluster of closely related abnormalities related to insulin resistance that increase cardiovascular disease
risk. The present analysis was performed to evaluate
the ability of these criteria to identify insulin-
-resistant individuals. The population consisted of
443 healthy volunteers, with measurements of BMI,
blood pressure, fasting plasma glucose, triglycerides,
HDL cholesterol concentrations, and steady-state plasma
glucose (SSPG) concentration. Insulin resistance
was defined as being in the top tertile of SSPG concentrations.
Of the population, 20% satisfied ATP III
criteria for the metabolic syndrome. Although insulin
resistance and the presence of the metabolic syndrome
were significantly associated (P < 0.001), the
sensitivity and positive predictive value equaled 46%
(69 of 149) and 76% (69 of 91), respectively. Being
overweight, with high triglycerides, low HDL cholesterol,
or elevated blood pressure, most often resulted
in a diagnosis of the metabolic syndrome. Thus,
the ATP III criteria do not provide a sensitive approach
to identifying insulin-resistant individuals.
The individual components vary both in terms of their
utility in making a diagnosis of the metabolic syndrome
and their relationship to insulin resistance,
with the obesity and lipid criteria being most useful.
Keywords: metabolic syndromediagnostic criteriainsulin resistancecardiovascular diseases