Sensitivity and specificity of metabolic syndrome criteria for insulin resistance diagnosis in Spanish population

BACKGROUND AND OBJECTIVE: Metabolic syndrome (MS) is an abdominal obesity and insulin resistance (IR)-related syndrome associated with a high cardiovascular risk. Recently, the International Diabetes Federation (IDF) has proposed a modification of the Adult Treatment Panel (ATP III) diagnostic criteria. However, the sensitivity of these new criteria has not been established. The aim of the present study was to define the sensitivity and specificity of the different criteria used for the diagnosis of the MS in our population. SUBJECTS AND METHOD: We studied in 177 healthy subjects, 68 men and 109 women, the body mass index, waist circumference (WC), blood pressure, glucose, insulin, lipids and apolipoproteins A1 and B. The HOMA index was used as an IR indicator. IR was considered with an HOMA index >=. 3.8. RESULTS: Subjects with IR showed higher age, systolic blood pressure, triglycerides and apo B, and lower HDL cholesterol. A WC >= 102 cm in men and >= 88 cm in women (ATP III criteria) had a low sensitivity for IR (29.4% and 44.7% respectively), with high specificity (81% and 90%). A WC >= 94 cm in men and >= 80 cm in women (IDF criteria) showed good sensitivity (73.5% and 73.7% respectively) but less specificity (57.1% and 53.3%). The IDF criteria showed better sensitivity than ATP III, without substantial change in the specificity for the different HOMA cut-off points. CONCLUSIONS: ATP III criteria had low sensitivity in our population. The new criteria [WC >= 94 cm in men and >= 80 cm in women, and blood glucose >= 100 mg/dL) improve three-fold the diagnostic sensitivity and, therefore, seems to be more useful for detecting IR in our country.