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Definitions of the Metabolic Syndrome
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To the Editor: Dr Lakka and colleagues1 tested both the NCEP classification of the metabolic syndrome, as well as a modification suggested by a World Health Organization (WHO) working group. Unlike the modified WHO definition, the NCEP definition did not predict cardiovascular mortality. Although the original WHO definition measured insulin resistance by the euglycemic hyperinsulinemic clamp and/or impaired glucose regulation, Lakka et al instead used fasting serum hyperinsulinemia as a surrogate. They also changed the blood pressure cutoff from 160/90 mm Hg to 140/90 mm Hg, and omitted microalbuminuria.
It would be of interest to compare the differences in prevalence of the metabolic syndrome by using these definitions, especially with regard to the occurrence of insulin resistance, which seems to be a key component in the metabolic syndrome. We used data from a previously published study of 104 men who were examined with the clamp method.2 In this sample the . . . [Full Text of this Article]
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