The prevalence of metabolic syndrome in a Polish population-based study: a comparison of previous and updated diagnostic criteria.

Introduction:  Metabolic syndrome (MetS) is a growing global health concern characterized by adiposity, elevated blood pressure, and lipid and glucose metabolism abnormalities-that synergistically increase cardiovascular (CV) risk. The newly introduced concept of cardio-kidney-metabolic (CKM) syndrome aims to capture the continuum of metabolic dysfunction and its direct link to CV risk.

Objectives:  To assess the prevalence of MetS and CKM, compare traditional and updated MetS definitions, examine their diagnostic concordance, and explore associations with CV risk.

Patients and methods:  We analyzed 2110 adults (mean age (SD) 49.3 (15.3); 44.4% male) from the population-based Białystok PLUS cohort. MetS was defined using the 2009 and updated 2022 criteria. CKM staging was applied, and CV risk was estimated using SCORE2 and SCORE2-OP. Anthropometric, biochemical, and imaging data were assessed. Receiver operating characteristics analyses were performed to evaluate diagnostic utility.

Results:  MetS was diagnosed in 22.1% using both definitions; 5.1% met only the 2022 and 13.1% only the 2009 criteria. Individuals fulfilling both definitions had higher age, body mass index (BMI), and adiposity. BMI (AUC = 0.941, 95% CI 0.931-0.951) and waist circumference (AUC = 0.912, 95% CI 0.900-0.924) showed the highest diagnostic accuracy under the 2022 criteria. CV risk and subclinical atherosclerosis were most prevalent in those meeting both definitions. CKM stage ≥2 was present in 55.3%, with increasing prevalence of higher CV risk observed across stages.

Conclusions:  MetS and CKM are highly prevalent, yet their diagnostic overlap is limited. CKM staging captures high-risk individuals beyond MetS criteria, underscoring its broader utility for integrated cardiometabolic risk assessment.