Abstract
BackgroundWe investigated the effect of longitudinal status change in metabolic syndrome (MetS) assessed by two different criteria on new onset of type 2 diabetes (NODM) in a Japanese population.MethodsThe participants were 827 non-diabetic citizens who had undergone medical examinations in 1994 and 2003 or 2004. We used two different criteria of MetS: the interim criteria by 6 institutions (MetS-INT) and Japanese criteria (MetS-JP). According to the interim criteria, individuals defined as having MetS have any three of the following five components of MetS: obesity, hyperglycemia, high blood pressure, hypertriglyceridemia and low HDL cholesterolemia. According to the Japanese criteria, individuals defined as having MetS must have abdominal obesity plus any two of the following three factors; hyperglycemia, high blood pressure and dyslipidemia (hypertriglyceridemia and/or low HDL-cholesterolemia). According to the status change in MetS, participants were divided into four groups: a non-MetS to non-MetS group, a non-MetS to MetS group, a MetS to non-MetS group and a MetS to MetS group. We calculated odds ratios of these four groups for NODM.ResultsNODM occurred in 65 participants. The odds ratios for NODM were 4.86, 4.97 and 7.50 in the non-MetS-INT to MetS-INT group, MetS-INT to non-MetS-INT group and MetS-INT to MetS-INT group, respectively. On the other hand, the odds ratios were 4.28 and 15.55 in the non-MetS-JP to MetS-JP group and MetS-JP to MetS-JP group, respectively. After adjustment for high fasting plasma glucose at baseline, magnitude of the odds ratio of MetS to MetS group was larger in the Japanese criteria group than in the interim criteria group.ConclusionsDetermining the status of MetS routinely and paying attention to status change in MetS may be important for prevention of type 2 diabetes. MetS defined by the criteria which includes obesity as a prerequisite component may be a stronger risk for type 2 diabetes than MetS defined by the criteria which includes obesity as one of components.
Highlights
We investigated the effect of longitudinal status change in metabolic syndrome (MetS) assessed by two different criteria on new onset of type 2 diabetes (NODM) in a Japanese population
Waist circumference, TG, fasting plasma glucose (FPG) and percentages of participants with abdominal obesity assessed by the Japanese criteria, smoking, impaired fasting glucose (IFG), high TG, low HDL cholesterol (HDL-C) assessed by the Japanese criteria and MetSJP were significantly higher in men than in women
There were no significant differences in body mass index (BMI), diastolic blood pressure (DBP), percentages of participants with a family history of type 2 diabetes, abdominal obesity assessed by the Asian criteria, high blood pressure and MetS-INT between men and women
Summary
We investigated the effect of longitudinal status change in metabolic syndrome (MetS) assessed by two different criteria on new onset of type 2 diabetes (NODM) in a Japanese population. Abdominal obesity should not be a prerequisite for diagnosis, but it is 1 of 5 criteria, 3 of which constitute a diagnosis of metabolic syndrome [9]. On the other hand, according to the Japanese criteria [10], as in the previous IDF criteria [11], abdominal obesity is a prerequisite for diagnosis of MetS because there is an emphasis in the Japanese criteria that abdominal obesity is a background for risk accumulation in the pathological mechanism of metabolic syndrome. Especially abdominal obesity, is considered to be a strong risk factor for new onset of type 2 diabetes (NODM) [12, 13], there may be some difference in the predictive power for NODM if abdominal obesity is prerequisite or not
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