The SA Journal Diabetes & Vascular Disease Vol 13 No 1 (July 2016)

41 / 56

VOLUME 13 NUMBER 1 • JULY 2016 39
SA JOURNAL OF DIABETES & VASCULAR DISEASE RESEARCH ARTICLE
Asian Indians. Moreover, inclusion of BMI and making WC a
non-obligatory criterion, more cases of the MS were detected.
However, for Asian Indians, making WC a mandatory variable to
define the MS would lead to non-inclusion of many patients who
would otherwise be diagnosed as having the MS according to the
modified NCEP ATP III definition.
A study from China also revealed that in subjects with
established type 2 diabetes, the International Diabetes Federation
(IDF) definition of the MS failed to identify a subgroup of patients
who had the highest risk for CHD, whereas the ATP III definition
predicted an increased risk of CHD in the same cohort.13 In a study
in an adult Iranian population, the IDF definition of the MS was
found to have a good correlation with the ATP III definition but a
lower correlation with the WHO definition.14
It is therefore reasonable to argue that to use the presence
of the MS as a more sensitive guideline, factors such as family
history of cardiovascular disease, lack of physical activity, abuse
of alcohol, cigarette smoking and tobacco chewing, along with
region-specific cut-off values are required to better comprehend
the MS in people of Indian origin. There is an urgent need to
develop a comprehensive risk profile for Asian Indians. Moreover,
owing to ethnic and cultural heterogeneity in people of Indian
origin, studies incorporating those subjects living in the Indian
subcontinent, as well as migrants elsewhere in the world are
required before making any statement about the definition of the
MS in people of Indian origin.
Conclusion
The major limitation of the present investigation was that the study
was performed on a relatively small sample size and therefore
is not representative of the Asian Indian population. Because of
considerable ethnic and cultural heterogeneity in the Asian Indian
population, it is imperative to study other ethnic groups to see
whether the observed trend also exists there. Results from such
studies could be used to define the metabolic syndrome in the
Asian Indian population. Moreover, investigations should also be
initiated in the Indian diaspora worldwide to elucidate whether
migrant Asian Indians show similar trends to those of sedentes
in India or to native populations of their respective counties.
Such studies would generate valuable information on the clinical
management of the metabolic syndrome.
Acknowledgements
The authors are indebted to all participants for their cooperation
during data collection.
References
1. WHO/IASO/IOTF. The Asia-Pacific Perspective: Redefining Obesity and its
Treatment. Health Communication Australia, Pty, Ltd, 2000.
2. McKeigue PM, Shah B, Marmot MG. Relation of central obesity and insulin
resistance with high diabetes prevalence and cardiovascular risk in South Asians.
Lancet 1991; 337: 382–386.
3. Misra A, Wasir JS, Pandey RM. An evaluation of candidate definition of the
metabolic syndrome. Diabetes Care 2005; 28: 398–403.
4. Das M, Pal S, Ghosh A. Which one is better predictor of metabolic syndrome
among adult Asian Indians: Indian Diabetes risk score or Framingham score? J
Diabetes 2009; 1(Suppl.1): A-69.
5. Lohman TG, Roche AF, Martorell R. Anthropometric Standardization Reference
Manual. Champaign, IL: Human Kinetics, 1988.
6. NCEP. Executive summary of the third report of the National Cholesterol Education
Program (NCEP): expert panel on detection, evaluation, and treatment of high
blood cholesterol in adults (Adult Treatment Panel III). J Am Med Assoc 2001;
285: 2479–2486.
7. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al.
Diagnosis and management of the metabolic syndrome: an American Heart
Association/National Heart, Lung, and Blood Institute Scientific Statement
(executive summary). Circulation 2005; 112: e285–e290.
8. Das M, Pal S, Ghosh A. Synergistic effects of ACE (I/D) and ApoE (HhaI) gene
polymorphisms among the adult Asian Indians with and without metabolic
syndrome. Diab Res Clin Prac 2009; 86: e58–61.
9. Ho SC, Chen YM, Woo JL, Leung SS, Lam TH, Janus ED. Association between
simple anthropometric indices and cardiovascular risk factors. Int J Obes Relat
Metab Disord 2001; 25: 1689–1697.
10. Deepa M, Farroq S, Datta M, Deepa R, Mohan V. Prevalence of metabolic
syndrome using WHO, ATPIII and IDF definitions in Asian Indians: the Chennai
Urban Rural Epidemiology Study (CURES-34). Diab Metab Res Rev 2007; 23:127–
134.
11. Kanjilal S, Shanker J, Rao VS, Khadrinarasimhaih NB, Mukherjee M, Iyengar SS,
Kakkar VV. Prevalence and component analysis of metabolic syndrome: an Indian
atherosclerosis research study perspective. Vasc Hlth Risk Manag 2008; 4:189–
197.
12. Wasir JS, Misra A, Vikram NK, Pandey RM, Gupta R. Comparison of definitions of
the metabolic syndrome in adult Asian Indians. J Assoc Physicians India 2008; 56:
158–164.
13. Tong PC, Kong AP, So WY, Yang X, Ho CS, Ma RC, et al. The usefulness of
the International Diabetes Federation and the National Cholesterol Education
Program's Adult Treatment Panel III definitions of the metabolic syndrome in
predicting coronary heart disease in subjects with type 2 diabetes. Diabetes Care
2007; 30:1206–1211.
14. Zabetian A, Hadaegh F, Azizi F. Prevalence of metabolic syndrome in Iranian
adult population, concordance between the IDF with the ATP-III and the WHO
definitions. Diab Res Clin Prac 2007; 77: 251–257.
DynaGliclazideSR30mg.Eachmodified release :RSAS342/21.2/0249
NAM NS2 12/21.2/0110. For full prescribing information, refer to the package insert approved by the Medicines
Control Council, 10 December 2011. DGLC156/04/2015
CUSTOMER CARE LINE 0860 PHARMA (742 762)
for
SUSTAINED
CONTROL
A Lupin Group Company