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Evaluating CMR

Metabolic Syndrome and Type 2 Diabetes/CVD Risk

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EGIR Definition and Criteria

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EGIR published its own clinical criteria for the metabolic syndrome in response to the provisional report from the WHO consultation in 1999 (Table) (7). EGIR’s approach was described as very “glucocentric” (8). It has the advantage of being simple for ready use in clinical practice and epidemiological studies. Since there were “non-metabolic” abnormalities included in the metabolic syndrome criteria, EGIR felt that it should be labelled the “insulin resistance syndrome.” EGIR also saw insulin resistance as the core component of this syndrome. EGIR hypothesized that the insulin resistance syndrome was a constellation of mild abnormalities that worked in conjunction to considerably increase CVD risk. To facilitate diagnosis of the insulin resistance syndrome, EGIR criteria do not require the use of the clamp technique. As fasting insulin levels are one of the best markers of insulin resistance, EGIR suggested that insulin resistance be defined as the presence of fasting hyperinsulinemia (i.e., the top 25% of the distribution of fasting insulin levels in non-diabetic individuals).


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7. Balkau B and Charles MA. Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR). Diabet Med 1999; 16: 442-3.
8. Alberti KG, Zimmet P and Shaw J. The metabolic syndrome--a new worldwide definition. Lancet 2005; 366: 1059-62.