A Comparison of the Prevalence of the Metabolic Syndrome Using Two Proposed Definitions

Abstract
OBJECTIVE—To compare the prevalence of the metabolic syndrome using two definitions: one proposed by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III [ATP III]) and one by the World Health Organization (WHO). RESEARCH DESIGN AND METHODS—We used data from a nationally representative sample of the noninstitutionalized civilian population of the U.S. from the Third National Health and Nutrition Examination Survey, a cross-sectional health examination survey (1988–1994). RESULTS—Among 8,608 participants aged ≥20 years, the age-adjusted prevalence was 23.9% using the ATP III definition and 25.1% using the WHO definition. Among all participants, 86.2% were classified as either having or not having the metabolic syndrome under both definitions. Estimates differed substantially for some subgroups, however. For example, in African-American men, the WHO estimate was 24.9%, compared with the ATP III estimate of 16.5%. CONCLUSIONS—A universally accepted definition of the metabolic syndrome is needed.