The applicability of the Asian modified criteria of the metabolic syndrome in the Korean population

Background: We compared the metabolic profiles and risk of coronary artery disease (CAD) in Koreans with non-diabetic metabolic syndrome (MetS). [We applied four criteria of MetS: the NCEP criteria, the Asian modified NCEP (a-NCEP) criteria, the WHO criteria and the Asian modified WHO (a-WHO).]. Methods: The study group composed of 2724 subjects enrolled in the cardiovascular genome center. There were 728 patients with significant CAD. The different criteria of the MetS were applied for the study population. Results: Among the 2724 participants, 522 (19.2%) met the NCEP criteria, 796 (29.2%) met the a-NCEP criteria, 361 (13.3%) met the WHO criteria and 576 (21.1%) met the a-WHO criteria. The clinical parameters, lipid profile, apoA1 and apoB level were not different between the participants classified as MetS by using the different criteria. The odds ratio for CAD prediction were not significantly different according to the metabolic criteria (odd ratio: 1.755 [95% CI: 1.423-2.163] in NCEP criteria, 2.120 [1.763-2.549] in a-NCEP criteria, 1.854 [1.466-2.343] in WHO criteria, 2.205 [1.810-2.687] in a-WHO criteria). The serum level of apoA1 and apoB showed strong correlations with MetS classified by all criteria and the HOMA index and insulin level showed better correlations with WHO-MetS criteria. Conclusions: All the MetS criteria showed similar metabolic profiles and all four criteria had similar predictive value for CAD. Conventional MetS criteria, applied to the non-diabetic Asian population, may underestimate the population at risk. Our data suggests that the Asian modified criteria will decrease the risk for underdiagnosis while demonstrating similar metabolic profiles and CAD risk compared to the conventional criteria.