Metabolic syndrome: Comparing Performance of Three Different Diagnostic Criteria in Pakistan

BACKGROUND Metabolic syndrome was reported prevalence of 33.4% with the WHO, 22.6% with the NCEP-R, and 30.9% with the IDF criteria in urban population. According to literature, NCEP-R and IDF were most consistent in picking metabolic syndrome (MetS) in non insulin dependent diabetic patients. AIM This study evaluated three diagnostic criteria of metabolic syndrome with respect to their sensitivity and specificity, comparing the relation of WHO with IDF and NCEP-R, suggesting most suitable criteria for our population. MATERIAL AND METHOD It was a descriptive case-control study carried out in the Diabetes, Endocrine and Metabolic Center, Lahore General Hospital, Lahore (DEMC, LGH) between November 2011 to November 2013. Total 3300 subjects were selected and. interviewed for demographics, everyday features (diet, exercise, smoking, alcohol consumption). Laboratory analysis were used to develop biochemical parameters. .Anthropometric measurements were carried out. Data was analysed using SPSS version 23. Chi-square was used for comparison of proportions. Kappa statistic was used to test degree of agreement between them. RESULTS The incidence of MetS in type2 diabetic patients according to WHO criteria was highest, followed by IDF and NCEP-R.  IDF and NCEP-R had better specificity. Positive Predictive Value (PPV) was high for NCEP-R and Negative Predictive Value (NPV) for IDF. Kappa showed both were in agreement, with IDF criteria better. CONCLUSION WHO criteria was most sensitive in picking diagnosis of MetS. IDF was second in sensitivity and NCEP-R was most specific. There is need to improve awareness, in view of the alarming number of patients.