Relationship between metabolic syndrome and 10-year risk for incident type 2 diabetes mellitus

Abstract

To analyze the relationship of metabolic syndrome (MS) and its components at baseline to the 10-year incidence of diabetes mellitus. An investigation on cardiovascular disease (CVD) risk factors, including questionnaire survey, physical examination, and laboratory examination, was carried out in the populations of 4154 subjects, aged 35 approximately 64, in 2 communities (Peking University and Capital Iron and Steel Company area) collected by cluster sampling in the year 1992, with a response rate of 82.0%, so as to obtain baseline data. In 2002 a follow-up survey was conducted among these same populations, aged 45 approximately 74 then with a response rate of 70.0%. Complete data were obtained from 2740 subjects during the 2 investigations. The data of 2659 subjects who were diagnosed as without diabetes mellitus type 2 (T2DM) during the baseline survey, 1177 males (44.3%) and 1482 females (55.7%), were analyzed. (1) 112 patients with T2DM were discovered during the follow-up survey with an incidence of 4.2%, the incidence being 5.0% in males and 3.6% in females. (2) The proportions of those with different MS components were higher among the T2DM patients than those without T2DM. The proportion of baseline high fasting glucose was 71.43% among those who were diagnosed as with T2DM during the follow-up survey. Of the MS components high fasting glucose had the highest proportion among the T2DM patients. (3) Adjusted for age and sex, the results using a logistic regression model showed that abdominal obesity, triglycerides and fasting glucose were the independent factors associated with T2DM in addition of blood pressure and HDL cholesterol. Among them, fasting glucose contributed mostly to T2DM with a relative risk (RR) of 7.14 (4.62, 11.03). (4) Compared with those without both MS and high fasting glucose, the relative risk of T2DM for persons with MS but without high fasting glucose was 2.91 times that for those without MS and with normal fasting glucose. MS is an independent indicator for incidence of T2DM. Among the MS components, high fasting glucose contributes mostly to T2DM; however, the prediction of MS for T2DM cannot be entirely explained by high fasting glucose. Those without high fasting glucose but with MS should take early intervention measures to prevent the incidence of T2DM.