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The new worldwide definition of metabolic syndrome is not a better diagnostic predictor of cardiovascular disease in Japanese diabetic patients than the existing definitions: additional analysis from the Japan Diabetes Complications Study.

We previously reported (1) the limited clinical significance for Japanese diabetic patients of the widely used World Health Organization (WHO) (2) and National Cholesterol Education Program (NCEP) (3) definitions of metabolic syndrome and suggested that an international definition of metabolic syndrome that was applicable regardless of ethnicity was necessary (1).

Recently, the International Diabetes Federation published a long-awaited new worldwide definition of metabolic syndrome (4) that is intended to be applicable to various ethnic groups. The new definition is similar to the NCEP definition (3) but has several important differences. Notably, most components of the new definition now include subjects who are receiving specific treatments for the abnormalities that comprise metabolic syndrome. Also, central obesity (defined by waist circumference with ethnic modification in its thresholds) has become a mandatory component in the new definition. In this report, we evaluated the predictive power of the new international definition for cardiovascular disease (CVD), as compared with that of previous definitions, in Japanese diabetic patients.

The Japan Diabetes Complications Study (JDCS) has been described in detail elsewhere (1, 5). The same dataset was used for evaluation so that the new definition of metabolic syndrome could be directly compared with the WHO and NCEP definitions (1–4). A total of 1,424 Japanese patients (771 men and 653 women, age 58.4 ± 7.4 years [means ± SD]) with previously diagnosed type 2 diabetes but without known CVD were …