Abstract

Background: Temporal changes in MetS status over two years may modify the 10-year risk of incident diabetes mellitus (DM). Methods: A prospective cohort study was conducted in 7,317 adults aged 40–70 years without DM at baseline. Subjects were categorized into four groups based on repeated longitudinal assessment of metabolic syndrome (MetS) status over two years, as defined by ATP III guidelines: non-MetS, resolved MetS, incident MetS, and persistent MetS. The hazard ratio (HR) of new-onset DM during 10 years was calculated in each group using Cox models. Results: During the 10-year follow-up, 1,099 (15.0%) developed DM. Compared to the non-MetS group, the fully adjusted hazard ratios (95% confidence interval) for new-onset DM were 1.27 (1.01–1.61) in the resolved MetS group, 1.78 (1.43–2.22) in the incident MetS group, and 1.85 (1.52–2.26) in the persistent MetS group (P for trend < 0.001). The 10-year risk of DM in subjects with resolved MetS was attenuated compared to those with persistent MetS over two years (P < 0.001). The adjusted hazard ratio for 10-year incident DM gradually increased according to the number of MetS components two years later. Conclusions: Temporal changes in MetS status over two years influenced the 10-year risk of incident DM, suggesting that determining the status of MetS regularly and strictly controlling MetS are important in preventing DM.

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