Abstract

Introduction: This study amis at determining which components of the metabolic syndrome are the best predictors of its development. Material and Methods: In this cohort study, from the participants of the cross sectional phase of the Tehran Lipid and Glucose Study(TLGS), 2279 subjects (aged 20-87) who did not have the metabolic syndrome, based on modified ATP III criteria, and 2310 subjects (aged 20-87) without the metabolic syndrome according to IDF criteria were followed. Results: After a mean interval of 6.5 years, 462 and 602 new cases of the metabolic syndrome were diagnosed on basis of the modified ATP III and IDF criteria, respectively. The adjusted odds ratio for development of the metabolic syndrome by ATP III criteria was highest for central obesity in men, 2.8 (2.2-3.7) and for triglycerides in women, 2.8 (2.0-4.1). The adjusted odds ratio for development of the metabolic syndrome by IDF criteria was highest for triglycerides in both men and women, OR being: 2.8 (2.2-3.7) and 2.9 (1.9-4.3) respectively. The area under the ROC curves for waist circumference, triglycerides and HDL were the highest. A model that included waist circumference and triglycerides or waist circumference and HDL predicted the metabolic syndrome as well as a model that included all five metabolic syndrome components. Conclusion: High risk subjects should undergo periodic screening, including measurement of waist circumference, triglycerides and plasma HDL, for timely prediction of development of metabolic syndrome.