Assessment of metabolic syndrome components in newly diagnosed type 2 diabetes

Abstract

Metabolic syndrome (MS) consists of multiple cardiometabolic risk factors that tend to aggregate in an individual more often than only by chance. It frequently coexists with type 2 diabetes mellitus (T2DM). The aim of the present study is to characterize the prevalence of MS and its traits, as well as the modalities of clustering of the components, in 1111 (49.6% female, 50.4% male; mean age of 59 years) newly diagnosed T2DM patients from an outpatient diabetes clinic. According to the International Diabetes Federation (IDF)'s definition, the abdominal obesity is one of "any three of five characteristics" in a person with MS. As all our patients were diabetics, in order to be defined as having MS they must have had a waist circumference ≥ 94 cm for men and ≥80 cm for women and at least one of any of the following factors: elevated triglycerides: ≥150 mg/dL or specific treatment for this lipid abnormality; decreased HDL-cholesterol: <40 mg/dL in men; <50 mg/dL in women, or specific treatment for this lipid abnormality; high blood pressure: systolic blood pressure ≥130 and/or diastolic blood pressure ≥85 mm Hg, or antihypertensive drug treatment. In the latest published consensus definition the visceral obesity is no longer an obligatory component for MS diagnosis, three or more of the following criteria must be met: (i) abdominal obesity: increased waist circumference, (ii) elevated triglycerides: ≥150 mg/dL, (iii) decreased HDL-cholesterol: <40 mg/dL in men, <50 mg/dL in women, (iv) increased blood pressure systolic ≥130 and/or diastolic ≥85 mm Hg, and (v) increased fasting glucose > 100 mg/dL. Metabolic syndrome incidence was high, no matter what definition was used: 89.7% (IDF's definition), 92.3% (the 2009 harmonized definition with a cut-off value for waist of 80 cm in women and 94 cm in men) and 88.6% (the 2009 harmonized definition with a cut-off value for waist of 88 cm in women and 102 cm in men). The concordance between the three definitions was 85.3% (higher in women). Most of the patients with MS fulfilled four of the criteria. Beside hyperglycemia, the decreasing frequency of MS traits was: increased waist circumference (96.4%), high blood pressure (84.8%), low HDL cholesterol (63.9%) and high triglycerides (57.9%). Among patients with MS, the increased waist and low HDL cholesterol were more frequent findings in women than in men, while hypertriglyceridemia was more frequent in men. Mean value for both systolic and diastolic pressure were higher in women. In sum, the results underline the high prevalence of MS among subjects with newly diagnosed T2DM and in majority of cases, four components are clustering. The clustering appears to be dependent on excess of visceral adipose tissue and has a different pattern depending on gender. Adipobiology 2012; 4: 91-96.