The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) clinical criteria for the metabolic syndrome are shown in Table 1 . 3 The diagnosis of metabolic syndrome is based on the presence of any 3 of the criteria listed. Several problems have been noted with this definition of the syndrome. First, it can be met without the presence of insulin resistance, which is a central component of the World Health Organization (WHO) definition of the syndrome. 4 Second, waist circumference criteria fail to capture abdominal obesity in many Asian persons. Third, the separate triglyceride and high-density lipoprotein (HDL) cholesterol criteria fail to capture dyslipidemia in many African Americans, particularly men. Finally, the fasting blood glucose cut point is too high; the American Diabetes Association recommends a cut point of 5.6 mmol/L (100 mg/dL). Further, in light of many recent findings indicating that elevated levels of inflammatory markers, such as high-sensitivity C-reactive protein (hs-CRP), increase risk of diabetes and CVD, it has also been proposed that inflammation, as measured by such markers, be included in the definition of the syndrome. These and other issues are likely to be addressed in future revisions of the NCEP ATP III criteria.
Is Metabolic Syndrome a Novel Inheritable Trait? Suh-Hang Hank Juo, MD, PhD Director Graduate Institute of Medical Genetics Kaohsiung Medical University
Metab Synd can be caused (or replaced) two major factors: lipid/glucose/obesity and BP
Lipid/glucose/obesity factor may share a common genetic mechanism, and the BP factor is more likely influenced by another set of genes
To test for familia l aggregation of the synd according to its severity
Dividing the families into different severity subgroups according to the number of risk components in the most severely affected individual in each family.
“ 5-risk” family: the most severe family member had 5 risk components (ATPIII).
“ 4-risk” family: the most severe member had 4 risk components.
Prevalence of the syndrome among severity subgroups 2 1.9% 27.1% 38.7% Percentage of MS affected Individuals 47.3 45.6 48.4 Age, mean 7.7 11.3 8.5 Family size, mean 2 9 3 9 11 Numbers of families 3-risk families 4-risk families 5-risk families