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Metabolic Syndrome and Development of Diabetes Mellitus: Application and Validation of Recently Suggested Definitions of the Metabolic Syndrome in a Prospective Cohort Study

Laaksonen, D. E.·2002·American Journal of Epidemiology

DOI 10.1093/aje/kwf145

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Abstract

The World Health Organization (WHO) and the National Cholesterol Education Program (NCEP) recently proposed definitions for the metabolic syndrome. Little is known of their validity, however. The authors assessed the sensitivity and specificity of the definitions of the metabolic syndrome for prevalent and incident diabetes mellitus in a Finnish population-based cohort of middle-aged men (n = 1,005) followed for 4 years since the late 1980s. Four definitions based on the WHO and NCEP recommendations were compared. All definitions identified persons at high risk for developing diabetes during the 4-year follow-up (odds ratios = 5.0-8.8). The WHO definition including waist-hip ratio > 0.90 or body mass index >or= 30 kg/m(2) was the most sensitive (0.83 and 0.67) and least specific (0.78 and 0.80) in detecting the 47 prevalent and 51 incident cases of diabetes. The NCEP definition in which adiposity was defined as waist girth > 102 cm detected only 61% of prevalent and 41% of incident diabetes, although it was the most specific (0.89 and 0.90). The WHO definition seems valid as judged by its relatively high sensitivity and specificity in predicting diabetes. The NCEP definition including waist > 102 cm also identifies persons at high risk for diabetes, but it is relatively insensitive in predicting diabetes.

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Authors: Laaksonen, D. E.
Affiliations: University of Eastern Finland (FI)
Corresponding author: Laaksonen, D. E.
Venue: American Journal of Epidemiology
Publisher: Oxford University Press (OUP)
Published: 2002-12-01
Volume: 156
Issue: 11
Pages: 1070-1077
ISSN: 0002-9262 (ISSN-L)
DOI: 10.1093/aje/kwf145
OpenAlex: W2149040949
Cited by: 916
References: 32
Citations by year: 2026: 7 · 2025: 7 · 2024: 9 · 2023: 19 · 2022: 17 · 2021: 19 · 2020: 11 · 2019: 18 · 2018: 16 · 2017: 26 · 2016: 25 · 2015: 26 · 2014: 38 · 2013: 29 · 2012: 40
FWCI: 34.39
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Epidemiology (publishedVersion)
PubMed (publishedVersion)
Funders: Academy of Finland (2041022, 41471, 1041086)
National Heart, Lung, and Blood Institute (HL-44199, R01HL044199)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
Keywords: metabolic syndrome, diabetes mellitus, diagnostic criteria validity, WHO definition, waist-to-hip ratio, waist circumference, body mass index, adiposity, sensitivity and specificity, new-onset diabetes, middle-aged men
MeSH terms: Adult, Body Constitution, Diabetes Mellitus, Type 2, Finland, Humans, Insulin Resistance, Male, Middle Aged, Prospective Studies, Sensitivity and Specificity, World Health Organization, Body Mass Index, Metabolic Syndrome

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Metabolic Syndrome and Development of Diabetes Mellitus: Application and Validation of Recently Suggested Definitions of the Metabolic Syndrome in a Prospective Cohort Study

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