IDF Metabolic Syndrome Definition

The International Diabetes Federation (IDF) in April 2005 issued a new definition (outlined below) of the so-called metabolic syndrome, a cluster of factors that sharply increase the risk of a heart attack when found in combination with one another. These risk factors include diabetes or a pre-diabetic condition, abdominal obesity and elevated blood pressure and cholesterol. The IDF estimates that 25 percent of the world's adults have metabolic syndrome.

History

• The history of the metabolic syndrome can be traced back to the mid-20th century and the work of French physician Jean Vague, who was among the first to suggest that the location of body fat is a more significant factor in the risk for hypertension, cardiovascular disease and diabetes than obesity itself. Vague postulated that people with accumulations of fat in the trunk area, or "android obesity," were more likely to suffer serious health consequences than those whose fatty tissue was clustered lower on the body, a condition he described as "gynoid obesity."

Dire Warning

• In releasing its new definition of metabolic syndrome, the IDF warned that this cluster of risk factors is largely responsible for the sharp increase internationally in Type 2 diabetes and cardiovascular disease. It added that "if current trends continue, the premature deaths and disabilities resulting from these conditions will cripple the health budgets of many nations---both developed and developing." People with metabolic syndrome, the federation cautioned, are three times more likely to suffer a heart attack or stroke than those who don't have the syndrome. And the risk of dying from such an event is doubled for those with metabolic syndrome.

New Definition

• Under the new IDF definition, a person can be considered to have metabolic syndrome if he has a waist circumference greater than IDF's parameters in combination with two or more of the following conditions: triglycerides greater than 150 mg/dL (milligrams per deciliter); high-density cholesterol less than 40 mg/dL for men and 50 mg/dL for women; systolic blood pressure above 130 mm/Hg (millimeters of mercury); diastolic pressure above 85 mg/Hg; and a fasting blood glucose level greater than 100 mg/dL.

Waist Circumference

• Under IDF's ethnicity-specific parameters for waist circumference, men of European descent with a waist larger than 37 inches and European women larger than 31.5 inches at the waist are deemed obese. Comparable figures for Chinese, Japanese and South Asian men and women are 35.4 and 31.5 inches, respectively. The IDF specified special limits for American men and women: 40.2 inches and 34.7 inches, respectively.

New Diagnostic Tool

• In announcing IDF's new definition, Sir George Alberti, a past president of the federation, said, "With a single, universally accepted diagnostic tool, clinicians can now more quickly identify patients with the metabolic syndrome in the practice setting. Early and aggressive action will inevitably reduce the increased risk to the patient of developing cardiovascular disease and/or Type 2 diabetes."