Abstract
Background Presence of metabolic syndrome (MetS) in patients with type 2 diabetes mellitus (type 2 DM) increases the risk of cardiovascular morbidity and mortality. Therefore, recognition of MetS in type 2 DM is important in initiating the appropriate preventive and therapeutic measures. The commonly used definitions have similarities and discrepancies. Aims of this study was to investigate the prevalence of MetS among patients with type 2DM using all three well known (WHO, IDF, and NCEP-ATP III) definitions and to identify the concordance and the difference of these three definitions. Methods This cross-sectional study included patients with type 2 DM who were followed up at the regional diabetes centre in Galle, Sri Lanka. A total of 2913 type 2 DM patients were recruited by convenient sampling method, and their clinical and biochemical data were collected. Results The mean age (SD) of the sample was 49.9 (10.2) years and the mean duration of diabetes was 5.04 (5.71). Prevalence of MetS was highest by WHO (70%) followed by IDF (44%) and NCEP-ATP III (29%) definitions. The prevalence was significantly higher in women according to all three definitions, and the difference was most marked with NCEP-ATP III and IDF definitions. Around 25% were identified as having MetS by all three definitions whereas around 45% were recognized with MetS by two definitions. While concordances between WHO with IDF (0.37, p < 0.001) and NCEP-ATP III (0.24, p < 0.001) criteria were poor, they were average (0.53, p < 0.001) between NCEP-ATP III and IDF criteria. Conclusions The prevalence of MetS among patients with type 2 DM can significantly be varied based on the definition used and the three definitions of MetS recognized different set of individuals. The highest prevalence of MetS was observed with WHO (70.6%) whereas lowest was observed with NCEP-ATP III definition.
Highlights
Type 2 diabetes mellitus has become a global epidemic with significant disability, premature death, and enormous medical costs [1]
South Asians with diabetes have higher risk of developing cardiovascular events (CVD) [3]. This is partly due to the presence of peculiar body phenotype known as South Asian phenotype [5, 6]. It is characterized by increased waist circumference, increased waist hip ratio, excessive body fat mass, increased plasma insulin levels and insulin resistance, and an atherogenic dyslipidaemia, with low levels of HDL cholesterol and increased triglyceride levels [6]
The main aim of this study was to determine the prevalence of metabolic syndrome (MetS) among patients with type 2DM using all three well known (WHO, International Diabetes Federation (IDF), and National Cholesterol Education Program-Adult Treatment Panel III (NCEP)-ATP III) definitions and assess the influence of factors such as gender, glycemic control, and duration of diabetes, on the prevalence of MetS
Summary
Type 2 diabetes mellitus (type 2 DM) has become a global epidemic with significant disability, premature death, and enormous medical costs [1]. This is partly due to the presence of peculiar body phenotype known as South Asian phenotype [5, 6] It is characterized by increased waist circumference, increased waist hip ratio, excessive body fat mass, increased plasma insulin levels and insulin resistance, and an atherogenic dyslipidaemia, with low levels of HDL cholesterol and increased triglyceride levels [6]. Presence of metabolic syndrome (MetS) in patients with type 2 diabetes mellitus (type 2 DM) increases the risk of cardiovascular morbidity and mortality. Aims of this study was to investigate the prevalence of MetS among patients with type 2DM using all three well known (WHO, IDF, and NCEP-ATP III) definitions and to identify the concordance and the difference of these three definitions. The highest prevalence of MetS was observed with WHO (70.6%) whereas lowest was observed with NCEP-ATP III definition
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