한국인에서 다양한 진단기준에 따른 대사증후군의 유병률과 인슐린 저항성 반영의 차이 = The Difference in Prevalence of Metabolic Syndrome and Reflection of Insulin Resistance According to Various Diagnostic Criteria in Korean

다국어 초록 (Multilingual Abstract)

Objective: NCEP ATP III criteria, recent IDF and AHA/NHLBI criteria of metabolic syndrome (MetS) are useful to diagnose briefly MetS clinically, but exclude concept of insulin resistance in definition of MetS unlikely WHO criteria. We compared prevalence of MetS using various diagnostic criteria and evaluated if recent definitions of MetS reflect insulin resistance better than earlier criteria. Methods: Among 1,708 subjects aged 23~85 years (1,088 men; 620 women) who underwent medical checkup at health promotion center, we evaluated components of MetS with the basis of modified ATP III criteria using BMI≥25 kg/m2 instead of waist circumference (WC), classic ATP III criteria, IDF criteria, modified IDF criteria of Korea (IDF-K) using WC≥85 cm for women and AHA/NHLBI criteria, and calculated HOMA-IR in 708 subjects. Results: The prevalence of MetS according to AHA criteria was 25.3%, significantly higher than the other criteria (P<0.05) and that in IDF-K was 16.8%, significantly lower than the others, especially in women (P<0.001). In all criteria, prevalence of MetS increased significantly with aging in women (P<0.001) but decreased in 8th decade in men. Diagnosis of MetS showed positive relationships with HOMA-IR, and risk of HOMA-IR was higher in modified ATP III (OR 2.54, 95% CI 2.04~3.17) and AHA criteria (2.52, 2.03~3.14) in men, then high in classic ATP III (2.51, 1.64~3.85) and IDF criteria (2.65, 1.70~4.11) but lowest in modified ATP III criteria (1.88, 1.31~2.69) in women. Conclusion: In Koreans, according to AHA/NHLBI criteria, prevalence of MetS was higher than to the other criteria, and diagnosis of MetS reflected insulin resistance better than other criteria only in men.