Brown TM， Voeks JH， Bittner V， Safford MM.
    Division of Cardiovascular Diseases， University of Alabama at Birmingham， Birmingham， AL， USA. tmbrown@uab.edu
Abstract
    BACKGROUND: The International Diabetes Federation (IDF) and Adult Treatment Panel (ATP) III define metabolic syndrome (MetSyn) differently， with unclear implications for cardiovascular disease (CVD) risk.
    METHODS: We examined 22，719 participants in the REGARDS study. We classified participants as: no MetSyn， MetSyn by ATP-III and IDF criteria， MetSyn by ATP-only， or MetSyn by IDF-only. To assess current CVD， we determined the odds of self-reported CVD by MetSyn category using multivariable logistic regression， controlling for socio-demographic and behavioral factors. To estimate future coronary heart disease risk， we calculated Framingham risk scores (FRS).
    RESULTS: Overall， 10，785 individuals (47%) had MetSyn. Of these， 79% had MetSyn by both definitions， 6% by ATP-only， and 14% by IDF-only. Compared to those without MetSyn， ATP-only individuals had the highest odds of current CVD and of having a FRS >20%. Also compared to those without MetSyn， IDF-only individuals had 43% higher odds of current CVD and 2-fold increased odds of having a FRS >20%.
    CONCLUSIONS: Consistent with previous reports， ATP-III MetSyn criteria identified individuals with increased odds of CVD and elevated future coronary heart disease risk. However， the IDF definition identified a clinically important number of additional individuals at excess CVD risk.