Evaluating CMR

Metabolic Syndrome and Type 2 Diabetes/CVD Risk


EGIR Definition and Criteria

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According to EGIR, the insulin resistance syndrome should be diagnosed if insulin resistance is observed with two or more of the following abnormalities: fasting plasma glucose concentrations ≥6.1 mmol/l without diabetes, blood pressure ≥140/90 mmHg or treatment for elevated blood pressure, triglyceride levels >2.0 mmol/l (177 mg/dl) or treatment for elevated triglycerides and/or HDL cholesterol levels <1.0 mmol/l (88 mg/dl) or treatment for reduced HDL cholesterol levels, or an increased waist circumference (≥94 cm for men and ≥80 cm for women). EGIR criteria for blood pressure and dyslipidemia were drawn from the report of the Second Joint Task Force of European and other Societies on Coronary Prevention, which suggested that proposed cut-off values for blood pressure, triglyceride, and HDL cholesterol levels were associated with increased coronary heart disease risk (9). Regarding obesity criteria, EGIR did not incorporate BMI in its diagnosis variables because the association between BMI and insulin resistance is not very clear, obesity being heterogeneous and not always associated with insulin resistance (10). In addition, waist-to-hip ratio was omitted and waist circumference included since it is a better correlate of intra-abdominal adiposity than waist-to-hip ratio (5). EGIR also excluded microalbuminuria from its criteria since the relationship between microalbuminuria and insulin resistance is not clear.

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5. Pouliot M-C, Després JP, Lemieux S, et al. Waist circumference and abdominal sagitttal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol 1994; 73: 460-8.
9. Wood D, De Backer G, Faergeman O, et al. Prevention of coronary heart disease in clinical practice. Summary of recommendations of the Second Joint Task Force of European and other Societies on Coronary Prevention. Blood Press 1998; 7: 262-9.
10. Farin HM, Abbasi F and Reaven GM. Body mass index and waist circumference both contribute to differences in insulin-mediated glucose disposal in nondiabetic adults. Am J Clin Nutr 2006; 83: 47-51.