Prevalence of metabolic syndrome and its components among type 2 diabetic mellitus Syrian patients according to NCEP-ATP III and IDF diagnostic criteria

Open access


The metabolic syndrome (MetS) is an important group of components responsible of high incidence of cardio-vascular disease (CVD) and stroke among the type 2 diabetic mellitus (DM) patients. Studies on the prevalence of the MetS and its components among DM patients are limited in developing countries and such studies never been done in Syria before. The objectives of current study were two-folds: (a) to investigate the prevalence of MetS in a group of DM Syrian patients as defined by NCEP-ATP III and IDF diagnostic criteria, and (b) to identify the individual MetS associated risk factors components in the studied group. A cross-sectional study carried out at one of the diabetic clinics of the health ministry in Damascus, Syria between 2016–2017. A random sample of 424 patients (209 males, 215 females) DM patients aged 40–79 years were participated in this study. Anthropometric indices, blood pressure (BP), fasting blood sugar (FBS), total cholesterol, high density lipoprotein cholesterol (HDL-C), triglycerides (TG) were determined. The overall prevalence of the MetS was 67% and 69.3% according to the NCEP-ATP III and IDF criteria, respectively. The prevalence was higher in females and increased with age. According to NCEP/ATP III criteria and for the overall group, high TG was the most prevalent component of the MetS. However, when an IDF criterion was applied, central obesity was the commonest component in the overall group. According to both diagnostic criteria, hypertension was significantly higher in males while central obesity was dominated in females (p<0.05, p<0.001, respectively). In conclusion, the results revealed high prevalence of the MetS in DM Syrian patients using both diagnostic criteria but slightly higher with IDF criteria. Especial care, health awareness, life style modifications, and proper medications should be directed towards controlling the risk factors components of this syndrome.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • Ahmed A Khan TE Yasmeen T et al. 2012. Metabolic syndrome in type 2 diabetes: comparison of WHO modified ATPIII & IDF criteria. J Pak Med Assoc 62:574-79.

  • Azizi F Salehi P Etemadi A et al. 2003. Prevalence of metabolic syndrome in an urban population: Tehran Lipid and Glucose Study. Diabetes Res Clin Pract 61(1):29-37.

  • Anderson PJ Critchley JA Chan JC et al. 2001. Factor analysis of the metabolic syndrome: obesity vs insulin resistance as the central abnormality. Int J Obes 25:1782.

  • Alberti KG Zimmet PZ. 1998. Definition diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15:539-53.

  • Badran M Laher I. 2012. Type II Diabetes Mellitus in Arabic-Speaking Countries. International Journal of Endocrinology Volume Article ID 902873 11 pages.

  • Bhattarai S Kohli SC Sapkota S. 2012. Prevalence of metabolic syndrome in type 2 diabetes mellitus patients using NCEP/ATP III and IDF criteria in Nepal. Nepal J Med Sci 1:79-83.

  • Bonadonna RC Cucinotta D Fedele D et al. 2006. The metabolic syndrome is a risk indicator of microvascular and macrovascular complications in diabetes: results from Metascreen a multicenter diabetes clinic-based survey. Diabetes Care 29:2701-7.

  • Bruno G Merletti F Biggeri A et al. 2004. Metabolic syndrome as a predictor of all-cause and cardiovascular mortality in type 2 diabetes: The Casale Monferrato study. Diabetes Care 27:2689–94.

  • Bonora E Kiechl S Willeit J et al. 1998. Prevalence of insulin resistance in metabolic disorders: the Bruneck study. Diabetes 47:1643-9.

  • Cho NH Shaw JE Karuranga S et al. 2018. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045 Diabetes Res Clin Pract 138:271-81.

  • Carr DB Utzschneider KM Hull RL et al. 2004. Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. Diabetes 53(8):2087-94.

  • Dandona P Aljada A Chaudhuri A et al. 2005. Metabolic syndrome a comprehensive perspective based on interactions between obesity diabetes and inflammation. Circulation 111:1448-54.

  • Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) 2001. JAMA 285:2486-97.

  • Foucan L Deloumeaux J Donnet JP. 2006. Metabolic syndrome components in Indian immigrants with type 2 diabetes. A matched comparative study. Diabetes Metab 32:337-42.

  • Ford ES. 2005. Risks for all-cause mortality cardiovascular disease and diabetes associated with the metabolic syndrome: A summary of the evidence. Diabetes Care 28:1769-78.

  • Florez H Silva E Fernandez V et al. 2005. Prevalence and risk factors associated with the metabolic syndrome and dyslipidemia in White Black Amerindian and Mixed Hispanics in Zulia State Venezuela. Diabetes Res Clin Pract 69:63-77.

  • Hossain MS Rahaman MZ Banik S et al. 2012. Prevalence of the metabolic syndrome in diabetic patients living in a coastal region of Bangladesh. IJPSR 3(8):2633-38.

  • Imam SK Shahid SK Hassan et al.2007. Frequency of the metabolic syndrome in type 2 diabetic subjects attending the diabetes clinic of a tertiary care hospital. J Pak Med Assoc 57:239-42.

  • Isezuo SA Ezunu E. 2005. Demographic and clinical correlates of metabolic syndrome in Native African type-2 diabetic patients. J Natl Med Assoc 97:557-63.

  • Johnson LW Weinstock RS. 2006. The metabolic syndrome: concepts and controversy Mayo Clinic Proceedings 81(12):1615-20.

  • Kengne AP Limen SN Sobngwi E et al. 2012. Metabolic syndrome in type 2 diabetes: comparative prevalence according to two sets of diagnostic criteria in sub-Saharan Africans. Diabetology Metabic Syndrome 4:22.

  • Leslie BR. 2006. Metabolic Syndrome: Historical Perspectives. Am J Med Sci 330:264-8.

  • Lorenzo C Okoloise M Williams K et al. 2003. The metabolic syndrome as predictor of type 2 diabetes the San Antonio Heart Study. Diabetes Care 26:3153-59.

  • Meo SA Usmani AM Qalbani E. 2017. Prevalence of type 2 diabetes in the Arab world: impact of GDP and energy consumption. Eur Rev for Med and Ph Sci 21:1303-12.

  • Marchesini G Forlani G Cerrelli F et al. 2004. WHO and ATP III proposals for the definition of the metabolic syndrome in patients with type 2 diabetes. Diabetes Med 21:383-7.

  • Nsiah N Shang VO Boateng KA et al. 2015. Prevalence of metabolic syndrome in type 2 diabetes mellitus patients. Int J App Basic Med Res 5(2):133-8

  • Nesto RW. 2003. The relation of insulin resistance syndromes to risk of cardiovascular disease. Rev Cardio vasc Med 4(6):S11-S18.

  • Nakamura T Tokunga K Shimomura et al.1994. Contribution of visceral fat accumulation to the development of coronary artery disease in non-obese men. Atherosclerosis 107:239-46.

  • Osuji CU Nzerem BA Dioka CE et al. 2012. Metabolic syndrome in newly diagnosed type 2 diabetes mellitus using NCEP-ATP III the Nnewi experience. Niger J Clin Pract 15:475-80.

  • Resolution 66/2. 2011. Political Declaration of the High-Level Meeting of the General Assembly on the Prevention and Control of Non communicable Diseases. In Sixty-sixth session of the United Nations General Assembly. New York: United Nations.

  • Reaven GM. 1998. Role of insulin resistance in human disease. Diabetes 37:1595-607.

  • Shin JA Lee JH Lim SY et al. 2013. Metabolic syndrome as a predictor of type 2 diabetes and its clinical interpretations and usefulness. J Diabetes Invest 4(4):334-43.

  • Surana SP Shah DB Gala K et al. 2008. Prevalence of metabolic syndrome in an urban Indian diabetic population using the NCEP ATP III Guidelines. J Assoc Physicians India 56:865-8.

  • Stern MP Williams K González-Villalpando C et al. 2004. Does the metabolic syndrome improve identification of individuals at risk of type 2 diabetes and/or cardiovascular disease? Diabetes Care 27:2676-81.

  • Saad MF Lillioja S Nyomba BL et al.1991. Racial differences in the relation between blood pressure and insulin resistance. New England Journal of Medicine 324:733-9.

  • The International Diabetes Federation 2005: The IDF consensus worldwide definition of metabolic syndrome. Available at: (e-mail at

  • Unadike B Akpan N Peters E et al. 2009. Prevalence of the metabolic syndrome among patients with type 2 diabetes mellitus in Uyo Nigeria. African Journal of Endocrinology and Metabolism 8(1):7-9

  • World Health Organization 2016. Global Report on Diabetes. Available at

  • Wilson PW D’Agostino RB Parise H et al. 2005. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation 112:3066-72.

  • World Health Organization. 1999. Definition diagnosis and classification of diabetes mellitus and its complications: report of a WHO Consultation. Part 1: diagnosis and classification of diabetes mellitus. Geneva Switzerland: World Health Organization. Available at

  • Yadav D Mahajan S Subramanian SK et al. 2013. Prevalence of metabolic syndrome in type 2 diabetes mellitus using NCEP-ATPIII IDF and WHO definition and its agreement in Gwalior Chambal Region of Central India. Global J Health Sci 5:144-55.

Journal information
Impact Factor

CiteScore 2018: 0.55

SCImago Journal Rank (SJR) 2018: 0.22
Source Normalized Impact per Paper (SNIP) 2018: 0.472

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 203 203 15
PDF Downloads 162 162 16