Indian Journal of Endocrinology and Metabolism

LETTERS TO THE EDITOR
Year
: 2018  |  Volume : 22  |  Issue : 6  |  Page : 856-

Which criteria to use to identify metabolic syndrome among patients with addictive disorders? Observations among patients with alcohol and opioid dependence syndrome


Mahmood Dhahir Al-Mendalawi 
 Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
P.O. Box 55302, Baghdad Post Office, Baghdad
Iraq




How to cite this article:
Al-Mendalawi MD. Which criteria to use to identify metabolic syndrome among patients with addictive disorders? Observations among patients with alcohol and opioid dependence syndrome.Indian J Endocr Metab 2018;22:856-856


How to cite this URL:
Al-Mendalawi MD. Which criteria to use to identify metabolic syndrome among patients with addictive disorders? Observations among patients with alcohol and opioid dependence syndrome. Indian J Endocr Metab [serial online] 2018 [cited 2019 Aug 26 ];22:856-856
Available from: http://www.ijem.in/text.asp?2018/22/6/856/246848


Full Text



Sir,

I read with interest the distinguished study by Singh et al.[1] published in July–August 2018 issue of Indian Journal of Endocrinology and Metabolism. Singh et al.[1] assessed the prevalence of metabolic syndrome (MetS) in patients with alcohol dependence syndrome (ADS) and opioid dependence syndrome (ODS) using revised National Cholesterol Education Programme Adult Treatment Panel (NCEP ATP-III) criteria and International Diabetes Federation (IDF) criteria. The authors found that among the individuals with ADS, the MetS prevalence was 20.8% and 9.9% according to the revised NCEP ATP-III criteria and IDF criteria, respectively. However, MetS prevalence among the individuals with ODS was found to be 20.3% and 5.1% according to revised NCEP ATP-III criteria IDF criteria, respectively. While there was a good degree of concordance between IDF and modified NCEP ATP-III criteria for MetS for ADS (n = 256) (κ = 0.649, P < 0.001), the concordance was only fair for ODS (κ = 0.333, P < 0.001).[1] The study results supported the recommendation that revised NCEP ATP-III criteria is a better choice than IDF criteria for identification of MetS in individuals having addictive disorders, especially opioid dependence.[1] I presume that these results ought to be taken cautiously. The authors addressed few study limitations that could cast some suspicious on the study results, notably small sample size, only male sample, nonexclusion of nicotine dependence, and not assessing physical activity. I presume that the following methodological limitation related to the MetS definition criteria used in the study might be additionally relevant. Obviously, the used ATP-III[2] and IDF[3] criteria in Singh et al.'s study[1] are both old and no more worthy as they were set more than a decade ago. It is worthy to mention that many national associations have constructed their own MetS definition criteria to precisely estimate MetS prevalence.[4] To my knowledge, the new diagnostic MetS criteria in Indian population have been launched in 2016 to be used in the clinical setting and researches. These criteria include the following components: waist circumference greater than 35″ in men and greater than 31″ in women; serum triglycerides equal or greater than 150 mg/dL; serum high-density lipoprotein cholesterol <40 mg/dL for men and <50 mg/dl for women; blood pressure equal or greater than 130/85 mmHg; and fasting blood sugar >100 mg/dL (prediabetes).[5] I wonder why Singh et al.[1] did not refer to the Indian-specific MetS criteria in their study. I presume that using these criteria instead of NCEP ATP-III and IDF criteria could yield more accurate results.

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Conflicts of interest

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References

1Singh Balhara YP, Jain R, Kuppili PP, Shukla A, Chawla N, Gupta R. Which criteria to use to identify metabolic syndrome among patients with addictive disorders? Observations among patients with alcohol and opioid dependence syndrome. Indian J Endocr Metab 2018;22:565-8.
2Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-52.
3Zimmet P, M M Alberti KG, Serrano Ríos M. A new International Diabetes Federation worldwide definition of the metabolic syndrome: The rationale and the results. Rev Esp Cardiol 2005;58:1371-6.
4Xing Y, Xu S, Jia A, Cai J, Zhao M, Guo J, et al. Recommendations for revision of Chinese diagnostic criteria for metabolic syndrome: A nationwide study. J Diabetes 2018;10:232-9.
5Mohanan PP. Metabolic syndrome in the Indian population: Public health implications. Hypertens J 2016;2:1-6.