The DOI matches its Crossref record; 19 of the 19 references it cites were found in a registry or an index.
Harmonizing the Metabolic Syndrome: A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity
Open accessAbstract
A cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, which occur together more often than by chance alone, have become known as the metabolic syndrome. The risk factors include raised blood pressure, dyslipidemia (raised triglycerides and lowered high-density lipoprotein cholesterol), raised fasting glucose, and central obesity. Various diagnostic criteria have been proposed by different organizations over the past decade. Most recently, these have come from the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. The main difference concerns the measure for central obesity, with this being an obligatory component in the International Diabetes Federation definition, lower than in the American Heart Association/National Heart, Lung, and Blood Institute criteria, and ethnic specific. The present article represents the outcome of a meeting between several major organizations in an attempt to unify criteria. It was agreed that there should not be an obligatory component, but that waist measurement would continue to be a useful preliminary screening tool. Three abnormal findings out of 5 would qualify a person for the metabolic syndrome. A single set of cut points would be used for all components except waist circumference, for which further work is required. In the interim, national or regional cut points for waist circumference can be used.
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“Although lean individuals can have insulin resistance and CMD, weight gain together with CMD exacerbates insulin resistance and leads to greater storage of fat in the intra-abdominal depot, ectopic accumulation of fat in liver and muscle cells, and heightened dysregulation of adipocytokines and systemic inflammation.670–673”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [672]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The health effects of excess adiposity are manifest by the development of adverse weight-related complications that are the cause of morbidity and mortality.672,673”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [672]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“BMI is currently used as a general screening tool to diagnose overweight (BMI 25 to 29.9 kg/m2) and obesity (BMI ≥30 kg/m2), but these BMI cutoffs do not capture risk of adiposity among varied ethnic groups, nor do they identify individual CMD risk.”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [672]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Visceral fat distribution, i.e. abdominal obesity, mediates the majority of the cardiometabolic risk. 42”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [42]
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“The current cut-offs of > -94 cm in men and > -80 cm in women for Caucasians (and adjusted for other ethnicities) are associated with an increased cardiometabolic risk 40,42 and increased risk for MASLD.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [42]
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In the citing paper
“ABCD is a medical diagnostic term that recognizes that excessive weight gain engenders abnormalities in the mass, distribution, and function of adipose tissue and leads to chronic complications that confer morbidity and mortality.672,673”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [672]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
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“Thus, ABCD is clinically meaningful in contradistinction to the BMI-based diagnosis that provides no indication of the impact on health675 and avoids multiple meanings and stigmatization associated with the term obesity.672”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [672]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
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“AACE672 and the European Association for the Study of Obesity673 have advocated for the use of ABCD as a medical diagnostic term for obesity.”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [672]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Women with PCOS have an increased prevalence of the metabolic syndrome (74, 75).”
From Metformin and Combined Oral Contraceptive Pills in the Management of Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis (2024) · cites this paper as [74]
Experimental — accuracy not yet measuredIn the citing paper
“A combination of high waist circumference and elevation of TG is a simple and inexpensive screening tool to discriminate people with MetS at high CVD risk for global risk evaluation.95”
From ESC/EAS Guidelines for the management of dyslipidaemias (2011) · cites this paper as [95]
In the citing paper
“Measurements of waist circumference . 80 cm for women of any ethnicity and . 94 cm for men of European ancestry or . 90 cm for men of Asian origin indicate the presence of abdominal adiposity, even in people of normal weight ( Table 14 ). 180”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [180]
In the citing paper
“A combination of large waist circumference and elevation of TGs is a simple and inexpensive screening tool to discriminate people with MetS at high CVD risk for global risk evaluation. 180”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [180]
In the citing paper
“Measurements of waist circumference >80 cm for women of any ethnicity and >94 cm for men of European ancestry or >90 cm for men of Asian origin indicate the presence of abdominal adiposity, even in people of normal weight (Table 14).180”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [180]
In the citing paper
“In 2009, several major organizations released a statement harmonizing the criteria for MetS, which is in use today (38).”
From The CardioMetabolic Health Alliance (2015) · cites this paper as [38]
In the citing paper
“Nonetheless, clinical outcome studies have failed to demonstrate the prognostic significance of triglyceride levels in MetS.”
From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [184]
In the citing paper
“Rather, other factors (eg, low HDL-C, elevated glucose, or elevated blood pressure) independently predicted CVD and all-cause mortality in RCTs.184 -187”
From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [184]
In the citing paper
“The prevalence of triglyceride levels Ն150 mg/dL is nearly twice as high in subjects with MetS as in those without MetS.184,185”
From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [184]
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Metadata
- Authors
- Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., Fruchart, J.-C., James, W. P. T., Loria, C. M., & Smith, S. C.
- Affiliations
- American Heart Association (US)
- Baker Heart and Diabetes Institute (AU)
- Wolters Kluwer Health (US)
- Venue
- Circulation
- Published
- 2009-10-20
- Volume
- 120
- Issue
- 16
- Pages
- 1640-1645
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2143104968
- Cited by
- 14,860
- References
- 19
- Citations by year
- 2026: 815 · 2025: 908 · 2024: 1080 · 2023: 1002 · 2022: 1120 · 2021: 1238 · 2020: 1080 · 2019: 969 · 2018: 950 · 2017: 901 · 2016: 875 · 2015: 857 · 2014: 836 · 2013: 775 · 2012: 658
- FWCI
- 346.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- 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 › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- metabolic syndrome, diagnostic criteria, cardiovascular risk factors, type 2 diabetes, abdominal obesity, waist circumference, dyslipidemia, hypertriglyceridemia, low HDL cholesterol, hyperglycemia, hypertension, IDF criteria, AHA/NHLBI criteria, cut points, screening
- MeSH terms
- Blood Glucose, Cardiovascular Diseases, Diabetes Mellitus, Humans, Hypertension, Insulin Resistance, Cholesterol, HDL, Terminology as Topic, Obesity, Risk Factors, Triglycerides, Metabolic Syndrome, Abdominal Fat, Waist Circumference
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