• Vol. 38 No. 2, 142–149
  • 15 February 2009

Prevalence of Metabolic Syndrome by the Adult Treatment Panel III, International Diabetes Federation, and World Health Organization Definitions and their Association with Coronary Heart Disease in an Elderly Iranian Population



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Introduction: To determine the prevalence of the metabolic syndrome (MS) in an Iranian elderly population and show its association with coronary heart disease (CHD). Materials and Methods: This is a cross-sectional study on 720 Iranian men and women aged ≥65 years who participated in the Tehran Lipid and Glucose Study (TLGS). Logistic regression analysis was used to estimate the odds ratio (OR) of developing CHD in model 1, an age-adjusted model; model 2, adjusted for age, smoking status, premature history of CHD and low-density lipoprotein (LDL) cholesterol; and model 3, adjusted for mentioned variables plus the MS components. Results: The prevalence of MS was 50.8%, 41.8% and 41.9% based on the Adult Treatment Panel (ATPIII), the World Health Organisation (WHO), and the International Diabetes Federation (IDF) definitions, respectively. The IDF definition showed high agreement with the ATPIII definition. Age-adjusted OR (95% CI) of the MS for CHD was 1.6 (1.2 to 2.2) by both the ATPIII and WHO definitions and 1.4 (1.0 to 1.9) by the IDF definition. IDF-defined MS lost its association with CHD in model 2. In model 3, obesity (WHO definition) and high blood pressure (ATPIII and WHO definitions) were associated with CHD. Conclusions: In an elderly Iranian population MS is highly prevalent. ATPIII and WHO definitions seem to be more pertinent than IDF for screening CHD risk. None of these definitions showed association with CHD when considering their components.

Coronary heart disease (CHD) is one of the most common causes of morbidity and mortality in different communities.1,2 Despite the lack of accurate data, there is evidence to indicate that CHD is increasing in magnitude in Iran.3 While age-adjusted mortality from CHD is gradually decreasing in developed countries,2,4 this rate has increased by 20% to 45% in Iran.5 The overall prevalence of CHD in Tehran was reported to be 21.8%.3 The metabolic syndrome (MS) is characterised by a clustering of cardiovascular risk factors, including abdominal obesity, high blood pressure (BP), increased glucose concentration and dyslipidaemia. The syndrome is associated with the development of diabetes and CHD.6,7 Two definitions of MS have been proposed by the National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATPIII) and the World Health Organization (WHO).8,9 In April 2005, the International Diabetes Federation (IDF) proposed a new definition of MS that includes central obesity, measured by waist circumference (WC), as an essential component of the MS which must be determined by ethnicity- and sex-specific cutoff values.

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