Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Lakka and colleagues1 tested both the NCEP classification of the metabolic
syndrome, as well as a modification suggested by a World Health Organization
(WHO) working group. Unlike the modified WHO definition, the NCEP definition
did not predict cardiovascular mortality. Although the original WHO definition
measured insulin resistance by the euglycemic hyperinsulinemic clamp and/or
impaired glucose regulation, Lakka et al instead used fasting serum hyperinsulinemia
as a surrogate. They also changed the blood pressure cutoff from 160/90 mm
Hg to 140/90 mm Hg, and omitted microalbuminuria.
Behre CJ, Fagerberg B. Definitions of the Metabolic SyndromeDefinitions of the Metabolic Syndrome. JAMA. 2003;289(10):1240-1241. doi:10.1001/jama.289.10.1240-a