Identifying metabolic syndrome without blood tests in young adultsThe Terneuzen Birth Cohort

Background: Within the context of the obesity epidemic identifying young adults at risk for type 2 diabetes and cardiovascular disease is important. A practical approach is based on the identification of metabolic syndrome (MetS). Our objective was to develop a simple and efficient stepwise strategy to identify MetS in young adults. Methods: Subjects were part of a birth cohort (n 2599) in Terneuzen, The Netherlands, born in 197786. In 200405: 642 of these young adults participated in a physical examination and blood tests. Tree regression was used to determine the optimal decision strategy to identify MetS. Results: Overall prevalence of MetS, defined according to the NCEP ATPIII, was 7.5. The tree regression yielded an optimal stepwise strategy that eliminated the need for blood tests for the diagnosis of MetS in 5090 of the cases, depending on the accepted level of error. A large group (52 of the total) with BMI 35 had a normal waist circumference (WC) and normal blood pressure (BP). None of them had MetS. Subjects with BMI 35 all had MetS. If BMI 30, 38 had an increased WC or increased BP with a risk of MetS of only 6. So for them the omission of blood tests could also be considered. Conclusion: In most young adults MetS can be identified or excluded without blood tests by a simple and stepwise strategy, based on the measurement of BMI, WC and BP. This makes it possible to develop simple prevention strategies for young adults at risk for type 2 diabetes and cardiovascular disease.