Table 1. Various definitions of metabolic syndrome.
| WHO (1998)1 | EGIR (1999)2 | NCEP‐ATP III (2001)3 | AACE (2003)18 | IDF (2005)20 | IDF (2009)21 | |
|---|---|---|---|---|---|---|
| Definition | Type 2 diabetes, IFG, IGT or insulin resistance plus at least two of the criteria below | Fasting hyperinsulinemia (highest 25%), plus at least two criteria below | At least three criteria below | Specific clinical factorsa plus at least two criteria below | Central obesity plus at least two criteria below | At least three criteria below |
| Glucose | IFG, IGT, type 2 diabetes | FPG ≥6.1 mmol/L (excludes diabetes) | FPG ≥110 mg/dL (includes diabetes; FPG ≥100 mg/dL, modified in 2006) | IFG (FPG 110–125 mg/dL) or IGT (excludes diabetes) | FPG ≥100 mg/dL (includes diabetes) | FPG ≥100 mg/dL (includes diabetes) |
| Abdominal obesity | WHR >0.9 in men and >0.85 in women or BMI >30 kg/m2 | WC ≥94 cm in men and ≥80 cm in women | WC >102 cm in men and >88 cm in women | BMI ≥25 kg/m2 | Ethnic‐specific definitionb | Population‐ and country‐specific definitionc |
| BP | BP ≥140/90 mmHg | BP ≥140/90 mmHg or treated for hypertension | BP ≥130/85 mmHg or treatedfor hypertension | BP ≥130/85 mmHg | BP ≥130/85 mmHg or treated for hypertension | BP ≥130/85 mmHg or treated for hypertension |
| TG | TG ≥150 mg/dL and/or HDL‐C <35 mg/dL in men | TG ≥150 mg/dL or HDL‐C <39 mg/dL or treated for dyslipidemia | TG ≥150 mg/dL or treated for dyslipidemia | TG >150 mg/dL | TG ≥150 mg/dL or treated for dyslipidemia | TG ≥150 mg/dL or treated for dyslipidemia |
| HDL‐C | And HDL‐C <39 mg/dL in women | HDL‐C <40 mg/dL in men or HDL‐C <50 mg/dL in women or treated for dyslipidemia | HDL‐C <40 mg/dL in men or HDL‐C <50 mg/dL in women | HDL‐C <40 mg/dL in men or HDL‐C <50 mg/dL in women or treated for dyslipidemia | HDL‐C <40 mg/dL in men or HDL‐C <50 mg/dL in women or treated for dyslipidemia | |
| Other | Microalbuminuria (UAER >20 μg/min) |
AACE, American Association of Clinical Endocrinologists; BMI, body mass index; BP, blood pressure; EGIR, European Group for the Study of Insulin Resistance; FPG, fasting plasma glucose; HDL‐C, high‐density lipoprotein cholesterol; IDF, International Diabetes Federation; IFG, impaired fasting glucose; IGT, impaired glucose tolerance; NCEP‐ATP III, National Cholesterol Education Program Adult Treatment Panel III; TG, triglyceride; UAER, urinary albumin excretion rate; WHO, World Health Organization; WHR, waist‐to‐hip ratio.
Diagnosis of cardiovascular diseases (CVD), hypertension, polycystic ovary syndrome, non‐alcoholic fatty liver disease, or acanthosis nigricans; family history of type 2 diabetes, hypertension or CVD; history of gestational diabetes or glucose intolerance; non‐Caucasian ethnicity; sedentary lifestyle; waist circumference (WC) >40 inches in men and WC >35 inches in women; age >40 years.
Europe, ≥94 cm in men and ≥80 cm in women; South Asian and Chinese, ≥90 cm in men and ≥80 cm in women; Japanese, ≥85 cm in men and ≥90 cm in women; South and Central America, South Asian recommendations until more specific data become available; Sub‐Saharan Africa, Eastern Mediterranean and Middle East populations, European data until more specific data becomes available.
WC thresholds are recommended based on organization and risk of metabolic complications.