Recommendations for revision of Chinese diagnostic criteria for metabolic syndrome: A nationwide study

Abstract Background Diagnostic criteria for metabolic syndrome ( MS ) proposed by the Chinese Diabetes Society ( CDS ) may have limitations because an additional 2‐h postprandial plasma glucose (2‐h PPG ) test is required to diagnose hyperglycemia. The aim of this study was to revise the CDS‐MS criteria by removing the 2‐h PPG test and determining the optimal fasting plasma glucose ( FPG ) cut‐off for a diagnosis of hyperglycemia in the Chinese population. Methods The study population was from the 2007–08 China Diabetes and Metabolic Disorders Study. The optimal FPG diagnostic cut‐off value was determined using receiver operating characteristic curves. Hyperglycemia defined using CDS‐MS criteria was the end‐point. Agreement between different diagnostic methods was assessed using κ values. Results The study enrolled 46 239 participants (mean age 44.95 years). The optimal diagnostic cut‐off for FPG was found to be 5.62 mmol/L, which showed a sensitivity of 66.92%, a specificity of 89.09%, and an area under the curve of 0.848. Using this diagnostic criterion, the standardized prevalence of MS was similar to that using the CDS‐MS criteria (18.26% vs 17.89%, respectively), with both values being lower than those obtained using conventional international criteria (20.64–26.67%). Compared with the CDS‐MS criteria, the recommended FPG cut‐off showed better agreement (κ) with international criteria: 0.695, 0.774, and 0.730 with the International Diabetes Federation ( IDF ), revised Adult Treatment Panel III , and Joint Interim Statement of the IDF criteria, respectively. Conclusions We recommend eliminating the 2‐h PPG blood test and lowering the FPG diagnostic cut‐off value to 5.6 mmol/L in the CDS‐MS diagnostic criteria.