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Diabetes Care 26:575-581, 2003
© 2003 by the American Diabetes Association, Inc.


Clinical Care/Education/Nutrition
Original Article

A Comparison of the Prevalence of the Metabolic Syndrome Using Two Proposed Definitions

Earl S. Ford, MD, MPH1 and Wayne H. Giles, MD, MSC2

1 Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
2 Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia

OBJECTIVE—To compare the prevalence of the metabolic syndrome using two definitions: one proposed by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III [ATP III]) and one by the World Health Organization (WHO).

RESEARCH DESIGN AND METHODS—We used data from a nationally representative sample of the noninstitutionalized civilian population of the U.S. from the Third National Health and Nutrition Examination Survey, a cross-sectional health examination survey (1988–1994).

RESULTS—Among 8,608 participants aged >=20 years, the age-adjusted prevalence was 23.9% using the ATP III definition and 25.1% using the WHO definition. Among all participants, 86.2% were classified as either having or not having the metabolic syndrome under both definitions. Estimates differed substantially for some subgroups, however. For example, in African-American men, the WHO estimate was 24.9%, compared with the ATP III estimate of 16.5%.

CONCLUSIONS—A universally accepted definition of the metabolic syndrome is needed.

Abbreviations: ATP III, Adult Treatment Panel III • HOMA, homeostatis model assessment • NHANES III, Third National Health and Nutrition Examination Survey • WHO, World Health Organization


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