Obesity and Its Related Diseases in China: The Impact of the Nutrition Transition in Urban and Rural Adults
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Obesity and Its Related Diseases in China: The Impact of the Nut ...

Chapter 2:  Background
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At present, there are no uniform criteria for the syndrome. WHO proposed a working definition in 1998 (85). According to the WHO criteria, a participant has metabolic syndrome if he or she has diabetes, impaired glucose tolerance (IGT), impaired fasting glucose (IFG), or insulin resistance measured by a glucose clamp plus two or more the following disorders:

  • raised plasma triglycerides (1.7 mmol/L; 150 mg/dL) and/or low HDL-cholesterol (< 0.9 mmol/L, 35 mg/dL men; < 1.0 mmol/L, 39 mg/dL women);
  • central obesity (males: waist to hip ratio > 0.90; females: waist to hip ratio > 0.85 and/or BMI > 30 kg/m2);
  • raised arterial pressure ≥ 140/90 mmHg;
  • microalbuminuria (urinary albumin excretion rate ≥ 20 µg/min or an albumin-to-creatinine ratio ≥ 20 mg/g).

    • In 2001, the National Cholesterol Education Program Adult Treatment Panel III (ATP III) (86) proposed the use of the following five features to classify the metabolic syndrome. Subjects meeting three or more criteria are classified as having the syndrome. This definition has now been widely accepted.

  • fasting plasma glucose ≥ 6.1 mmol/L;
  • waist circumference ≥ 102 cm for men and ≥ 88 cm for women;
  • triglyceride ≥ 1.7 mmol/L;
  • HDL-cholesterol < 1.0 mmol/L for men and < 1.3 mmol/L for women;
  • blood pressure ≥ 130/85 mmHg.

    • Both these definitions focus on central obesity, dyslipidemia, hyperglycemia, and hypertension. Compared with the WHO criteria, the ATP III criteria give more weight to dyslipidemia and use a lower cutoff for blood pressure and higher cutoff for HDL-cholesterol.