Concordancia diagnóstica entre siete definiciones de síndrome metabólico en adultos con sobrepeso y obesidad

Eduardo Cabrera-Rode, Beatriz Stusser, Wenny Cálix, Neraldo Orlandi, Janet Rodríguez, Ileana Cubas-Dueñas, Ragmila Echevarría, Aimee Álvarez

The aim of this study was to determine the level of diagnostic concordance between seven definitions of metabolic syndrome (MS) in a group of overweight and obese adults. 350 subjects aged from 19 to 70 years were recruited for study from a clinic for overweight and obese subjects. The definitions of MS used were those given by the WHO (World Health Organization), EGIR (European Group for the Study of Insulin Resistance), NCEP- ATPIII (Adult Treatment Panel), AHA/NHLBI (American Heart Association), IDF (International Diabetes Federation), and JIS (Joint Interim Statement) as well as the Szabo criteria. Concordance between the definitions was calculated with the Kappa coefficient. Insulin resistance (IR) was assessed using the HOMA-IR index. According to the Szabo, WHO, EGIR, NCEP-ATPIII, AHA/NHLBI, IDF, and JIS criteria, MS frequency was 74.3%, 42.0%, 46.8%, 56.0%, 52.9%, 58.6%, and 58.6%, respectively. The concordance between the Szabo and AHA/NHLBI criteria was 0.559, while the Kappa coefficient between the Szabo criteria and the rest of the guides (NCEP-ATPIII, IDF, and JIS) was from 0.612 to 0.657, respectively. The concordance of the WHO with the EGIR was 0.602, but it was between 0.358 and 0.422 with the other guidelines. IR was distributed similarly in all guidelines. There is a considerable concordance between the NCEP-ATPIII, IDF, and JIS guidelines and the Szabo criteria. The Szabo criteria could be an option for the active surveillance of MS in populations.