Relationship to insulin resistance of the adult treatment panel III diagnostic criteria for identification of the metabolic syndrome.
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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.
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Although insulin resistance is associated with high triglycerides, VLDL and triglyceride concentrations can be similar in patients with widely divergent insulin sensitivity.
“Although insulin resistance is associated with high triglycerides, VLDL and triglyceride concentrations can be similar in patients with widely divergent insulin sensitivity (68, 69).”
From Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline (2012) · cites this paper as [69]
The Results report an association between hypertriglyceridemia and insulin resistance. The Discussion says triglyceride concentration accounts for no more than 40% of the variation in the insulin-resistance measure, supporting the point that triglycerides can be similar despite differing insulin sensitivity. The cited passages do not establish the corresponding claim about VLDL; page numbers are not available in our copy. (LLM, conf=0.87)
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- Authors
- Cheal, K. L., Abbasi, F., Lamendola, C., McLaughlin, T., Reaven, G. M., & Ford, E. S.
- Affiliations
- Brigham and Women's Hospital (US)
- Stanford Medicine (US)
- Centers for Disease Control and Prevention (US)
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2004-05-01
- Volume
- 53
- Issue
- 5
- Pages
- 1195-1200
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2018346950
- Cited by
- 312
- References
- 41
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 6 · 2021: 2 · 2020: 6 · 2019: 5 · 2018: 6 · 2017: 5 · 2016: 7 · 2015: 6 · 2014: 19 · 2013: 15 · 2012: 15
- FWCI
- 23.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- metabolic syndrome, insulin resistance, Adult Treatment Panel III criteria, diagnostic sensitivity, positive predictive value, steady-state plasma glucose, triglycerides, HDL cholesterol, blood pressure, obesity, cardiovascular risk
- MeSH terms
- Adult, Aged, Blood Glucose, Blood Pressure, Body Weight, Diagnostic Tests, Routine, Female, Homeostasis, Humans, Insulin Resistance, Cholesterol, HDL, Male, Middle Aged, Osmolar Concentration, Predictive Value of Tests, Sensitivity and Specificity, Triglycerides, Metabolic Syndrome
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