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Key Points

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• WHO was the first major organization to produce a definition of the metabolic syndrome that focused mainly on insulin resistance, whose diagnosis requires an oral glucose tolerance test.

• WHO criteria also proposed that microalbuminuria as a marker to identify high-risk patients with the metabolic syndrome.

• In response to WHO, EGIR sought to establish criteria that would be easier to use in clinical practice. EGIR makes measuring insulin resistance mandatory.

• The AACE position does not provide a specific scoring system for diagnosing the “insulin resistance syndrome”. Insulin resistance is at the core of AACE criteria, while waist circumference is not considered a diagnosis criterion.

• These organizations acknowledge that their diagnosis tools can be refined and that further research is needed to improve diagnosis of the metabolic syndrome in clinical practice.

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