This study aims to identify which among the metabolic syndrome (MS) definitions are closely associated with pathological levels of leptin, adiponectin, resistin, tumour necrosis alpha (TNF‐α) and C‐reactive protein (CRP) among type 2 diabetics.

Three hundred and five (160 males; 145 females) adult type 2 diabetic Saudis participated in this cross‐sectional study. Leptin, adiponectin, resistin, TNF‐α and CRP were analysed, using enzyme‐linked immunosorbent assays (ELISA). Each participant was screened for MS based on the definitions of WHO, AHA/NHLBI and IDF.

IDF holds the most identified patients [190 (62.3%)] in both, males [107 (66.9%)], and females [83 (57.2%)]. In males, hyperleptinemia, hypoadiponectinemia and hyperresistinemia were strongest in the AHA/NHLBI‐defined MS [odds ratio (95% confidence interval ‘CI’) of 2.03 (1.05–3.93); 1.31 (0.55–3.1); 1.63 (0.42–6.4) respectively]. The risk of elevated CRP was highest on the WHO definition [odds ratio (95% CI) of 2.04 (0.46–9.04)]. In females, the IDF‐defined MS has the strongest association in all four parameters: odds ratio (95% CI), as follows: leptin [2.09 (0.14–30.71)]; adiponectin [6.00 (0.47–76.17)]; resistin [0.47 (0.18–1.23)] and CRP [3.07 (0.21–45.10)].

Gender differences exist in assessing the risk of various adipocytokine abnormalities in relation to the various criteria. This study supports the use of IDF definition among females and AHA/NHLBI in males in studies involving MS and obesity, since these definitions hold stronger predicting powers in detecting pathological levels of key adipocytokines. Copyright © 2007 John Wiley & Sons, Ltd.