Comparison of coronary heart disease risk among four diagnostic definitions of metabolic syndrome

J Endocrinol Invest. 2016 Nov;39(11):1337-1346. doi: 10.1007/s40618-016-0538-1. Epub 2016 Aug 29.


Purpose: Metabolic syndrome (MetS) is now well known as one of the major risk factors for coronary heart disease (CHD). Currently, there are several methods used to define MetS. The aim of this study was to determine to what extent current MetS definition reflects CHD risk using the probability of CHD in 10 years based on Framingham risk score algorithms.

Methods: A total of 7575 adults, aged 16-93 years (2532 men and 5043 women), were recruited. We conducted a cross-sectional health survey in China using MetS criteria from four different definitions: modified National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF), Chinese and Japanese.

Results: Differences in the prevalence of MetS by each definition were small in males (22.9-25.9 %), whereas in females, MetS was three times more prevalent using the IDF definition (29.1 %) versus the Japanese definition (9.7 %). Framingham risk scores in participants with MetS were significantly higher than in those without MetS by all definition criteria (p < 0.001). The CHD risk scores for participants with MetS by each definition showed similar values in males (range 11.5-12.1 %) with no significant differences among definitions. Conversely, in females with MetS the risk score for CHD was low (range 3.5-4.3 %) by each MetS definition.

Conclusions: These findings suggest that further studies are required to establish appropriate criteria of MetS in females.

Keywords: China; Framingham risk score; International Diabetes Federation (IDF); Japan; Metabolic syndrome; NCEP-ATP III.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / analysis
  • China / epidemiology
  • Coronary Disease / diagnosis
  • Coronary Disease / epidemiology
  • Coronary Disease / etiology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / diagnosis
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Young Adult


  • Biomarkers