Metabolic syndrome and development of diabetes mellitus: application and validation of recent suggested definitions of the metabolic syndrome in a prospective cohort study

Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
American Journal of Epidemiology (Impact Factor: 5.23). 12/2002; 156(11):1070-7.
Source: PubMed


The World Health Organization (WHO) and the National Cholesterol Education Program (NCEP) recently proposed definitions for the metabolic syndrome. Little is known of their validity, however. The authors assessed the sensitivity and specificity of the definitions of the metabolic syndrome for prevalent and incident diabetes mellitus in a Finnish population-based cohort of middle-aged men (n = 1,005) followed for 4 years since the late 1980s. Four definitions based on the WHO and NCEP recommendations were compared. All definitions identified persons at high risk for developing diabetes during the 4-year follow-up (odds ratios = 5.0-8.8). The WHO definition including waist-hip ratio > 0.90 or body mass index >or= 30 kg/m(2) was the most sensitive (0.83 and 0.67) and least specific (0.78 and 0.80) in detecting the 47 prevalent and 51 incident cases of diabetes. The NCEP definition in which adiposity was defined as waist girth > 102 cm detected only 61% of prevalent and 41% of incident diabetes, although it was the most specific (0.89 and 0.90). The WHO definition seems valid as judged by its relatively high sensitivity and specificity in predicting diabetes. The NCEP definition including waist > 102 cm also identifies persons at high risk for diabetes, but it is relatively insensitive in predicting diabetes.

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    • "The incidence of type 2 diabetes in individuals with impaired glucose tolerance can be reduced through diet and exercise [21]. Other risk factors, like abdominal obesity, hypertension confers an increased risk of type 2 diabetes [22], [23]. "
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    ABSTRACT: Hepatic steatosis has been related to insulin resistance and increased diabetes risk. We assessed whether combination of diabetes risk factors, evaluated by the Finnish Diabetes Risk Score, was associated with risk of hepatic steatosis in an apparently healthy Chinese population. The study samples were from a community-based health examination survey in central China. In total 1,780 men and women (18-64 y) were included in the final analyses. Hepatic steatosis was diagnosed by ultrasonography. We created combination of diabetes risk factors score on basis of age, Body Mass Index, waist circumference, physical activity at least 4 h a week, daily consumption of fruits, berries or vegetables, history of antihypertensive drug treatment, history of high blood glucose. The total risk score is a simple sum of the individual weights, and values range from 0 to 20. Hepatic steatosis was present 18% in the total population. In multivariate models, the odds ratios of hepatic steatosis were 1.20 (95%CI 1.15-1.25) in men and 1.25 (95%CI 1.14-1.37) in women by each unit increase in the combination of diabetes risk factors score, after adjustment for blood pressure, liver enzymes, plasma lipids, and fasting glucose. The area under the receiver operating characteristic curve for hepatic steatosis was 0.78 (95%CI 0.76-0.80), 0.76 in men (95%CI 0.74-0.78) and 0.83 (95%CI 0.79-0.87) in women. Our data suggest that combination of major diabetes risk factors was significantly related to risk of hepatic steatosis in Chinese adults.
    PLoS ONE 03/2014; 9(3):e90101. DOI:10.1371/journal.pone.0090101 · 3.23 Impact Factor
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    • "Metabolic syndrome is characterized by the simultaneous presence of interrelated metabolic risk factors, such as visceral obesity, high blood pressure and carbohydrate and lipid metabolism abnormalities[1], and it leads to an increased risk for type 2 diabetes mellitus and cardiovascular diseases[2],[3]. Although the criteria used to diagnose the metabolic syndrome may be different, several studies have demonstrated that the prevalence of metabolic syndrome has increased dramatically in the past two decades[4]–[6]. "
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    ABSTRACT: This study was aimed to explore the associations between the combined effects of several polymorphisms in the PPAR-γ and RXR-α gene and environmental factors with the risk of metabolic syndrome by back-error propagation artificial neural network (BPANN). We established the model based on data gathered from metabolic syndrome patients (n = 1012) and normal controls (n = 1069) by BPANN. Mean impact value (MIV) for each input variable was calculated and the sequence of factors was sorted according to their absolute MIVs. Generalized multifactor dimensionality reduction (GMDR) confirmed a joint effect of PPAR-γ and RXR-α based on the results from BPANN. By BPANN analysis, the sequences according to the importance of metabolic syndrome risk factors were in the order of body mass index (BMI), serum adiponectin, rs4240711, gender, rs4842194, family history of type 2 diabetes, rs2920502, physical activity, alcohol drinking, rs3856806, family history of hypertension, rs1045570, rs6537944, age, rs17817276, family history of hyperlipidemia, smoking, rs1801282 and rs3132291. However, no polymorphism was statistically significant in multiple logistic regression analysis. After controlling for environmental factors, A1, A2, B1 and B2 (rs4240711, rs4842194, rs2920502 and rs3856806) models were the best models (cross-validation consistency 10/10, P = 0.0107) with the GMDR method. In conclusion, the interaction of the PPAR-γ and RXR-α gene could play a role in susceptibility to metabolic syndrome. A more realistic model is obtained by using BPANN to screen out determinants of diseases of multiple etiologies like metabolic syndrome.
    03/2014; 28(2):114-22. DOI:10.7555/JBR.27.20120061
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    • "Our study confirmed that walking and health education effectively ameliorated the risk factors of metabolic syndrome. Considering that metabolic syndrome is related to the prevalence, onset rate, and mortality rate of diabetes and cardiovascular diseases19), a walking program is recommended for older adults as an effective approach for combating the harmful risk factors of metabolic syndrome. "
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    ABSTRACT: [Purpose] The aim of this study was to determine the effects of a 12-week walking program on increasing an individual's self-management and decreasing the risk factors of metabolic syndrome in the older adult population. [Subjects] A total of 31 older adults participated in this study. Eighteen participants in the experimental group and 13 controls completed the pretest and posttest measures. A walking exercise and health education were provided for the experimental group. Data were analyzed by ANCOVAs to examine group differences. [Results] At the end of the 12-week study period, the experimental group showed a significant improvement in individuals' ability to self-manage their health compared to the control group. Also, there were significant differences between the two groups in the total numbers of risk factors of metabolic syndrome, systolic blood pressure and BMI. No significant difference in blood sugar levels, HDL-C, waist circumference, and triglyceride levels were found between the experimental and control group. [Conclusion] This study revealed that a combination of health education and for walking exercise can lead to improved lifestyle management and reduce risk factors of metabolic syndrome for the elderly population of Korea.
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