What about non-alcoholic fatty liver disease as a new criterion to define metabolic syndrome?

Table 1 National Cholesterol Education Programme Adult Treatment Panel III - 2001/American Heart Association - 2005 metabolic syndrome (diagnosis: 3 of 5)

Risk factor	Defining level (AHA 2005)
Abdominal obesity (waist, inches)
Men	> 40
Women	> 35
Triglycerides (mg/dL)	150 (or Med)
HDL-C (mg/dL)
Men	< 40 (or Med)
Women	< 50
BP (mmHg)	130/85 (or Med)
Fasting glucose (mg/dL)	110 (100)

AHA: American Heart Association; HDL-C: High-density lipoprotein-cholesterol; BP: Blood pressure; Med: Medium.

Table 2 International Diabetes Federation: Definitions of metabolic syndrome

Central obesity plus any two of the following four factors
Raised triglyceride	150 mg/dL, or specific treatment for this lipid abnormality
Reduced HDL-C	< 40 mg/dL in men and < 50 mg/dL in women, or specific treatment for this lipid abnormality
Raised BP	Systolic BP 130 or diastolic BP 85 mmHg, or treatment of previously diagnosed hypertension
Raised FPG	100 mg/dL, or previously diagnosed type 2 diabetes. If above 100 mg/dL, OGTT is strongly recommended but is not necessary to define presence of the syndrome

OGTT: Oral glucose tolerance test; FPG: Fasting plasma glucose; HDL-C: High-density lipoprotein-cholesterol; BP: Blood pressure.

Table 3 Central obesity defined according to the International Diabetes Federation

Country/ethnic group	WC
Europids (In the United States, the NCEP-ATP III values1 are likely to continue to be used for clinical purposes)
Male	≥ 94 cm (37 in)
Female	≥ 80 cm (32 in)
South Asians (based on a Chinese, Malay, and Asian-Indian population)
Male	≥ 90 cm (35 in)
Female	≥ 80 cm (32 in)
Chinese
Male	≥ 90 cm (35 in)
Female	≥ 80 cm (32 in)
Japanese
Male	≥ 85 cm (34 in)
Female	≥ 90 cm (32 in)

¹102 cm, 40 in, male; 88 cm, 35 in, female. NCEP: National Cholesterol Education Programme; WC: Waist circumference; ATP: Adult Treatment Panel.