Multiple biomarkers and their relative contributions to identifying metabolic syndrome. 
Several biological markers have been identified as risk factors for cardiovascular disease and are associated with increased risk of metabolic syndrome.  We thus compared biomarkers and their association with metabolic syndrome.  We measured the white blood cell count, high-sensitivity C-reactive protein, homeostasis model assessment of insulin resistance (HOMA-IR), homocysteine, cystatin C, gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT) and uric acid levels in 4624 adults without a medical history of cardiovascular disease.  Metabolic syndrome was defined using criteria from the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and the International Diabetes Federation (IDF).  The HOMA-IR and GGT were most strongly correlated with metabolic syndrome.  The area under the receiver operating characteristic curve was highest for the HOMA-IR (0.773, 95% CI: 0.755-0.791 [men]; 0.792, 95% CI: 0.775-0.808 [women]) and the GGT (0.687, 95% CI: 0.667-0.706 [men]; 0.721, 95% CI: 0.703-0.739 [women]) in AHA/NHLBI criteria.  The best cut-off value of HOMA-IR and GGT for identifying metabolic syndrome was (1.22, 30 IU/l [men], 1.28, 15 IU/l [women]).  HOMA-IR and GGT are most strongly associated with metabolic syndrome, suggesting that theses biomarkers may contribute to identifying metabolic syndrome more than other factors.