Usefulness of metabolic syndrome definitions in predicting metabolic abnormalities in older Taiwanese

Background: The Metabolic Syndrome (MetS) concept has been introduced as a national public health campaign in Taiwan. Objective: The present study examined the usefulness of two popular MetS definitions, the IDF and the updated-ATP III in health promotion.Methods: Data for this analysis were from the SEBAS in Taiwan, a subsample of a nationally representative cohort study involving 1023 54-91-year old participants. All anthropometric and biochemical indicators were measured according to standard procedures. Each subject was rated with the IDF and the updated-ATP III for MetS. The significance of the intra-(those having MetS vs. those having no MetS) and inter-definition differences was evaluated with independent t and McNemar's nonparametric tests. Results: The two definitions agreed well (Cohen's Kappa 0.852) in rating MetS, but the updated-ATP III was more effective than the IDF in identifying those who have metabolic disorders. Among those (918) who had one or more MetS-item disorders, the IDF identified 346 (37.7%) and the updated-ATP III identified 417 (45.4%) as having MetS. Conclusion: These results suggest that more than half of those who have MetS-item abnormalities are not identified as having MetS. Since persons with individual metabolic disorders have as much risk as those who have MetS, the definitions may not have great relevance in health promotion. From the public health perspective, people who have metabolic disorders, regardless of having MetS or not, should be informed of their abnormalities by specific metabolic disorders and encouraged to plan interventions.