International Diabetes Federation Definition Research Articles

Prevalence of Metabolic Syndrome According to Different Definitions in a Hypertensive Population

The metabolic syndrome (MetS) is associated with increased risk of cardiovascular disease (CVD) and diabetes mellitus (DM). Several definitions of MetS have been proposed. The aim of the present study was to estimate and compare the prevalence of MetS according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), American Heart Association-National Heart Lung and Blood Institute (AHA-NHLBI), International Diabetes Federation (IDF) and the more recent Joint Interim Statement (JIS) definitions in patients attending a hypertension clinic. The records of patients referred to the hypertension clinic at the University Hospital (Heraklion, Crete) from January 2001 to June 2009 were screened retrospectively. A total 384 patients (146 men) were included in the study. The prevalence of MetS according to the IDF and JIS definitions was significantly higher compared with that of the NCEP ATP III in both genders (IDF: P = .009 and P = .002, JIS: P = .002 and P = 0.001 for men and women, respectively); this was the case for the AHA-NHLBI definition only among women (P = .03). All MetS components differed significantly (P from < .0001 to .02) between patients with and without MetS for all definitions. The prevalence of MetS varies considerably depending on the definition used in a hypertensive population in a Mediterranean country. These differences will influence risk assessment.

Prevalence of Metabolic Syndrome Among Human Immunodeficiency Virus–Infected Subjects Is Widely Influenced by the Diagnostic Criteria

The aim of this study was to compare the prevalence of metabolic syndrome in human immunodeficiency virus (HIV)-infected patients treated with highly active antiretroviral therapy (HAART), using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), European Group for the Study of Insulin Resistance (EGIR), and International Diabetes Federation (IDF) definitions. A cross-sectional study was carried out with 159 consecutive adult HIV-infected subjects (120 males and 39 females) under HAART. Anthropometric and laboratory parameters were measured by standard methods. Hyperinsulinemia was defined by a fasting concentration >75th percentile of values obtained in healthy individuals (107.5 pmol/L). The prevalence of ATP III-defined metabolic syndrome was 10.1%; it was 28.3% according to EGIR criteria and 15.1% using the IDF definition. The concordance between the definitions was low (kappa coefficient ranging between 0.134 and 0.296). All subjects with EGIR-defined metabolic syndrome had hyperinsulinemia, but only 50% of those with ATP III-defined metabolic syndrome and 62.5% in the IDF metabolic syndrome population had hyperinsulinemia. The inclusion of hyperinsulinemia as a criterion in the EGIR metabolic syndrome definition made it more discriminative than the ATP III definition, both in men and women, and than the IDF definition in men to identify metabolic syndrome in HIV-infected subjects under HAART.

Appropriate Waist Circumference Cutoff Values for the Diagnosis of Metabolic Syndrome in Mexican American Adults

BackgroundMetabolic syndrome (MS) increases the risk of cardiovascular disease and diabetes. The International Diabetes Federation (IDF) recently proposed new criteria for the diagnosis of the MS, which requires the presence of central obesity as measured by ethnic specific waist circumference (WC) cutoff values. Currently, no specific WC thresholds for central obesity are available in Hispanics.ObjectiveTo determine appropriate gender specific WC thresholds for diagnosis of central obesity in Mexican American adults and to estimate the prevalence of MS using the IDF definition with and without our modified WC in this population.DesignData from 3265 Mexican American adults aged 20–80 years who participated in the National Health and Nutrition Examination Survey 1999–2006 were used.ResultsROC curve analysis suggested that yielding at least 80% sensitivity, the WC value of 90 cm in both genders was more appropriate in predicting the presence of two or more MS risk factors in this population. Based on our cutoff, there was 34% reduction in the prevalence of central obesity in women (82.5% to 54.2%). The age adjusted prevalence of MS decreased from 58.4 to 48.2%. The MS was more common among Mexican American men than women (55.8% in men versus 37.8% in women, P =0.0003).ConclusionOur findings provide practical guidance in the assessment and screening of central obesity and MS in Mexican Americans.

Prevalence of the metabolic syndrome in Danish psychiatric outpatients treated with antipsychotics

Background: The incidence of the metabolic syndrome, a major risk factor for diabetes and cardiovascular disease, is increasing worldwide and is suggested to be higher among psychiatric patients, especially those on antipsychotic treatment. Aims: To assess the prevalence of the metabolic syndrome in Danish psychiatric outpatients and compare it with the general population. Methods: In a cross-sectional, observational study in 2007–08, 170 Danish outpatients on antipsychotic drug treatment were monitored for the prevalence of the metabolic syndrome based on the International Diabetes Federation (IDF) definition and compared with a general population group of 3303 randomly selected Danes. Results: Of the antipsychotic-treated patients 48.2% fulfilled the IDF criteria for the metabolic syndrome, compared with 29.6% of the general population. The antipsychotic-treated patients had higher rates of increased waist circumference, triglyceride and glucose levels, and lower high-density lipoprotein cholesterol. Compared with the general population, the odds ratio (OR) of the metabolic syndrome among antipsychotic-treated patients was 2.2. After adjustment for age and sex, the OR increased to 2.7. In the antipsychotic-treated group, statistically different rates of the metabolic syndrome for patients in monopharmacy vs. polypharmacy, and for patients in monotherapy with first-generation vs. second-generation antipsychotics, could not be found. Conclusion: The metabolic syndrome is highly prevalent among a Danish outpatient population treated with antipsychotics compared with the general population. Monitoring of lipid and glucose levels, blood pressure and waist circumference before start-up and during treatment with antipsychotic medication is of pivotal importance in order to prevent diabetes and cardiovascular disease in this patient population.

The Prevalence of Metabolic Syndrome and Determination of the Optimal Waist Circumference Cutoff Points in a Rural South African Community

OBJECTIVETo determine the prevalence of metabolic syndrome and to define optimal ethnic-specific waist-circumference cutoff points in a rural South African black community.RESEARCH DESIGN AND METHODSThis was a cross-sectional survey conducted by random-cluster sampling of adults aged >15 years. Participants had demographic, anthropometric, and biochemical measurements taken, including a 75-g oral glucose tolerance test. Metabolic syndrome was defined using the 2009 Joint Interim Statement (JIS) definition.RESULTSOf 947 subjects (758 women) studied, the age-adjusted prevalence of metabolic syndrome was 22.1%, with a higher prevalence in women (25.0%) than in men (10.5%). Peak prevalence was in the oldest age-group (≥65 years) in women (44.2%) and in the 45- to 54-year age-group in men (25.0%). The optimal waist circumference cutoff point to predict the presence of at least two other components of the metabolic syndrome was 86 cm for men and 92 cm for women. The crude prevalence of metabolic syndrome was higher with the JIS definition (26.5%) than with the International Diabetes Federation (IDF) (23.3%) or the modified Third Report of the National Cholesterol Education Program Adult Treatment Panel (ATPIII) (18.5%) criteria; there was very good agreement with the IDF definition (κ = 0.90 [95% CI 0.87–0.94]) and good concordance with ATPIII criteria (0.77 [0.72–0.82]).CONCLUSIONSThere is a high prevalence of metabolic syndrome, especially in women, suggesting that this community, unlike other rural communities in Africa, already has entered the epidemic of metabolic syndrome. Waist circumference cutoff points differ from those currently recommended for Africans.

Relationship between nonalcoholic fatty liver disease and metabolic syndrome

The aim of this study was to investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) in subjects who underwent a routine health checkup. We intended to establish a clinical association between NAFLD and MS as well as to compare the diagnostic criteria of MS based on the definitions set forth by the International Diabetes Federation (IDF), the US National Cholesterol Education Program Adult Treatment Panel III (2001) (NCEP/ATP-III) and the Metabolic Syndrome Study Group of Chinese Diabetes Society (CDS). Weight, height, waist circumference, hip circumference, percentage of body fat, blood pressure and ultrasound of liver were performed on subjects undergoing routine health checkup. Serum triglyceride, total cholesterol, high density lipoprotein cholesterol and fasting plasma glucose level were measured. A total of 2394 subjects were included in this analysis and 437 had NAFLD. The prevalence of MS in the whole sample according to IDF, NCEP/ATP-III and CDS definitions was 11.11%, 8.48% and 5.30%, respectively. The total degree of agreement between IDF, NCEP/ATP-III and CDS definition was 87.76%. The prevalence of MS in NAFLD subjects is much higher than that in non-NAFLD subjects. The prevalence of NAFLD in MS subjects is also much higher than that in non-MS subjects. The prevalence of MS varied depending on the diagnostic criteria used. NAFLD was strongly associated with the MS, although it remains unknown whether NAFLD is a cause or effect of MS.

Abdominal obesity is the most significant metabolic syndrome component predictive of cardiovascular events in chronic hemodialysis patients

Five components of metabolic syndrome (MetS) have been identified as predictive of cardiovascular events (CVEs) in the general population: impaired fasting glucose, abdominal obesity, hypertriglyceridemia, hypertension and low high-density lipoprotein cholesterol. Whether MetS and its components are also predictive of CVEs in chronic hemodialysis (HD) patients remains unclear. We therefore investigated the role of MetS and its components in patients on chronic HD. MetS at baseline was diagnosed in 91 HD patients based on the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) and the International Diabetes Federation (IDF) definitions. During a 3-year period, all hospitalizations, CVEs and deaths were recorded and analyzed using Kaplan-Meier survival analysis and Cox regression. There were no differences in the number of CVEs, hospitalizations or deaths between patients with and without AHA/NHLBI-defined MetS; however, patients with IDF-defined MetS were found to be at a higher risk for CVEs (P = 0.006). Cox regression analysis showed that, of the MetS components, abdominal obesity was the single most significant predictor of CVEs (hazard ratio 6.25; 95% confidence interval: 1.65-23.6; P = 0.007). IDF-defined MetS was more predictive of CVEs than AHA/NHLBI-defined MetS. Of the MetS components, abdominal obesity was the single most significant predictor of CVEs in chronic HD patients.

Effect of Different Obesity Phenotypes on Cardiovascular Events in Tehran Lipid and Glucose Study (TLGS)

In this community-based study, 6,215 subjects aged ≥30 years (43% men, mean age 47 years) free of cardiovascular disease (CVD) at baseline were followed for a mean of 8.1 years to assess risk for CVD stratified by body mass index and dysmetabolic status. Participants were stratified by body mass index categories (18.5 to 24.9 kg/m² = normal, 25 to 29.9 kg/m² = overweight, and ≥30 kg/m² = obese) and dysmetabolic status. Dysmetabolic status was defined as having metabolic syndrome according to the International Diabetes Federation's definition or diabetes. First CVD events occurred in 446 subjects. Multivariate-adjusted hazard ratios for CVD events in normal-weight, overweight, and obese subjects without dysmetabolic status were 1.00 (reference), 1.10 (95% confidence interval [CI] 0.76 to 1.61), and 1.07 (95% CI 0.59 to 1.96), respectively, and for normal-weight, overweight and obese subjects with dysmetabolic status were 2.10 (95% CI 1.36 to 3.26), 2.35 (95% CI 1.71 to 3.22), and 2.35 (95% CI 1.71 to 3.22), respectively. There was an interaction between body mass index and metabolic abnormalities in predicting CVD. In conclusion, normal-weight subjects with dysmetabolic status had higher risk for future CVD compared to healthy obese subjects.

Comparison of BMI and anthropometric measures among South Asian Indians using standard and modified criteria

To compare the prevalence rates of obesity based on BMI/anthropometric measures, using WHO standard and ethnicity-specific criteria, the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) and the International Diabetes Federation (IDF) definitions, among a migrant South Asian Indian population. Cross-sectional study conducted in October 2007. A total of 213 participants of South Asian descent over the age of 18 years. Measures included a questionnaire with basic demographic information and self-reported histories of diabetes, coronary artery disease and/or hypercholesterolaemia. Height, weight, waist and hip circumference and blood pressure measurements were obtained. Houston and surrounding suburbs. WHO-modified (WHO-mod) BMI and IDF waist circumference (WC) criteria independently identified higher numbers of overweight/obese participants; however, when the WHO-mod BMI or IDF WC criteria were applied, nearly 75% of participants were categorized as overweight/obese--a proven risk factor for the future development of metabolic syndrome. Obesity is likely under-diagnosed using the standard WHO and NCEP-ATPIII guidelines. Stressing the use of modified criteria more universally to classify obesity among South Asian Indians may be optimal to identify obesity and help appropriately risk stratify for intervention to prevent chronic diseases.

236 Prevalence of metabolic syndrome and insulin resistance in atherothrombotic disease in two modes of acute clinical presentation

While there are much data on the risk factors involved in the onset of atherothrombotic stroke (AS) or acute coronary syndrome (ACS), few studies have compared the prevalence of metabolic syndrome (MS) and insulin resistance (IR) in the occurrence of these events. In a pilot study, prospective, comparative, single centre, 137 patients who presented an AS (N = 68) or ACS (N = 69) were consecutively included. The cardiovascular risk factors (CRF) were collected, the prevalence of MS was determined using « the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) and the International Diabetes Federation (IDF) definitions. IR was determined using the homeostasis model assessment of insulin resistance (HOMA-IR) in patients without insulin treatment. There were no significant differences between groups for history of hypertension or diabetes, cardiovascular heredity, body mass index, nor lipid parameters. Sex ratio was similar in both groups but AS patients were older (58.2 ± 8.4 vs. 54.0 ± 8.8 respectively, p = 0.006. Active smoking was more prevalent in the ACS group (30 vs. 18%, p = 0.04). Plasma glucose and insulin levels were higher in the ACS group (5.59 ± 1.86 vs. 5.0 ± 1.0 mmol/l, p = 0.04; 9. ±1.04 vs. 6.7 ± 3.6 μUI/ml, p = 0.04, respectively). There was no difference in the prevalence of MS between ACS and AS groups, using NCEP-ATPIII definition (11 vs. 12%, p = NS) or IDF definitions (26 vs. 23%, p = NS). There was a significantly higher IR in the ACS group (HOMA-IR 2.17+1.90 vs. 1.50+0.81, p = 0.03). In our study, distribution of cardiovascular risk factors is different according to the athero-thrombotic disease. The metabolic disturbances in particular IR seems to be predominant in the onset of ACS.

Metabolic Syndrome in Older Patients

This paper presents an overview of the definitions of metabolic syndrome and the criteria used to determine this diagnosis. It discusses the pathological-physiological aspects of the syndrome´s individual components – insulin resistance and type 2 diabetes mellitus, hypertension, atherogenic hyperlipidemia, as well as the mutual relationship between hyperuricemia and metabolic syndrome. The paper also includes the authors´ original results- a study of the incidence of metabolic syndrome among community dwelling seniors. In South Moravia, 147 seniors were examined in cooperation with general practitioners and the Geriatrics Outpatient Clinic of the Department of Internal Medicine, Geriatrics and General Practice, Medical Faculty of Masaryk University and Faculty Hospital Brno. The criteria of metabolic syndrome diagnosis as per the International Diabetes Federation definition were met by 23 clients i.e. 15.7% of the sample studied. A considerable section of the sample, though, met three of the criteria- 18 clients, 12.1%. It was determined that the incidence of metabolic syndrome did not correlate significantly with age - r = - 0.10, p>0.05 - i.e. there was rather a trend towards lower incidence with advancing age. The incidence of metabolic syndrome appeared to have a significantly negative correlation with cognitive performance tested by Mini Mental State Examination - r= -0.44 and self-sufficiency tested by ADL (activities of daily living) - r=-0.44. Conclusions: Metabolic syndrome occurs in approx. 20-40% of older patients depending on the clinical criteria applied. The incidence of metabolic syndrome in the older population has a significantly negative effect on cognitive functions and the self-sufficiency of older patients as well as on the incidence of depression.

Prevalence of Metabolic Syndrome among Working Adults in Ethiopia

Objective. To evaluate the prevalence of metabolic syndrome (MetS) according to the International Diabetes Federation (IDF) and Adult Treatment Panel (ATP) III criteria among working East African adults. Design. This cross-sectional study of 1,935 individuals (1,171 men and 764 women) was conducted among working adults in Addis Ababa, Ethiopia. The study was conducted in accordance with the STEPwise approach of the World Health Organization. Results. According to ATP III and IDF definitions, the overall prevalence of MetS was 12.5% and 17.9%, respectively. Using ATP III criteria, the prevalence of MetS was 10.0% in men and 16.2% in women. Application of the IDF criteria resulted in a MetS prevalence of 14.0% in men and 24.0% in women. The most common MetS components among women were reduced high-density lipoprotein-cholesterol (HDL-C) (23.2%) and abdominal obesity (19.6%); whilst reduced HDL-C concentrations (23.4%) and high blood pressure (21.8%) were most common among men. Conclusion. MetS and its individual components are prevalent among an apparently healthy working population in Ethiopia. These findings indicate the need for evidence-based health promotion and disease prevention programs; and more robust efforts directed towards the screening, diagnosis and management of MetS and its components among Ethiopian adults.

Relationship between 25-hydroxyvitamin D and metabolic syndrome among Jordanian adults.

Evidence of the association between 25-hydroxyvitamin D (25(OH)D) and metabolic syndrome (MeS) remains uncertain and incongruent. This study aimed to determine the association between 25(OH)D and MeS among Jordanian adults. A complex multistage sampling technique was used to select a national population-based household sample. The present report deals exclusively with adults aged > 18 years who had complete information on all components of MeS (n = 3,234). A structured questionnaire was used to collect all relevant information. Anthropometric, clinical, and laboratory measurements were obtained. MeS was defined according to the International Diabetes Federation (IDF) definition. Of the total, 42.0% had MeS and 31.7% had 25(OH)D < 30 ng/ml. In a stratified analysis, the prevalence of MeS did not differ significantly between subjects with low and normal 25(OH)D levels for men and women in all age groups. In the multivariate analysis, the odds of MeS were not significantly different between subjects with low and normal 25(OH)D levels (OR = 0.85, 95% CI: 0.70, 1.05, P-value = 0.133). The association between 25(OH)D and MeS remained non-significant when 25(OH)D was analyzed as a continuous variable (OR = 1.004, 95% CI; 1.000, 1.008, P = 0.057) and when analyzed based on quartiles. None of the individual components of MeS were significantly associated with 25(OH)D level. This study does not provide evidence to support the association between 25(OH)D level and MeS or its individual components. Prospective studies are necessary to better determine the roles of 25(OH)D levels in the etiology of MeS.

Metabolic syndrome in South Asian immigrants: more than low HDL requiring aggressive management

Aggressive clinical and public health interventions have resulted in significant reduction in coronary artery disease (CAD) worldwide. However, South Asian immigrants (SAIs) exhibit the higher prevalence of CAD and its risk factors as compared with other ethnic populations. The objective of the current study is to assess the prevalence of metabolic syndrome (MS), its association with high density Lipoprotein (HDL) function, Apo lipoprotein A-I (APOA1) gene polymorphisms, and sub-clinical CAD using common carotid intima-media thickness (CCA-IMT) as a surrogate marker. A community-based cross-sectional study was conducted on SAIs aged 35-65 years. Dysfunctional/pro-inflammatory (Dys-HDL) was determined using novel cell free assay and HDL inflammatory index. Six intronic APOA1 gene polymorphisms were analyzed by DNA sequencing. According to the International Diabetes Federation definition, MS prevalence was 29.7% in SAIs without CAD and 26% had HDL inflammatory index ≥ 1 suggesting pro-inflammatory Dys-HDL. Six novel APOA1 single nucleotide polymorphisms (SNPs) were analyzed with logistic regression, three SNPs (G2, G3, and G5) were found to be significantly associated with MS (p = 0.039, p = 0.038, p = 0.054). On multi-variate analysis, MS was significantly associated with BMI > 23 (P = 0.005), Apo-A-I levels (p = 0.01), and Lp [a] (p < 0.0001). SAIs are known to be at a disproportionately high risk for CAD that may be attributed to a high burden for MS. There is need to explore and understand non-traditional risk factors with special focus on Dys-HDL, knowing that SAIs have low HDL levels. Large prospective studies are needed to further strengthen current study results.

Impact of metabolic syndrome and its components on cardiovascular disease event rates in 4900 patients with type 2 diabetes assigned to placebo in the field randomised trial

BackgroundPatients with the metabolic syndrome are more likely to develop type 2 diabetes and may have an increased risk of cardiovascular disease (CVD) events.We aimed to establish whether CVD event rates were influenced by the metabolic syndrome as defined by the World Health Organisation (WHO), the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) and the International Diabetes Federation (IDF) and to determine which component(s) of the metabolic syndrome (MS) conferred the highest cardiovascular risk in in 4900 patients with type 2 diabetes allocated to placebo in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial.Research design and methodsWe determined the influence of MS variables, as defined by NCEP ATPIII, IDF and WHO, on CVD risk over 5 years, after adjustment for CVD, sex, HbA1c, creatinine, and age, and interactions between the MS variables in a Cox proportional-hazards model.ResultsAbout 80% had hypertension, and about half had other features of the metabolic syndrome (IDF, ATPIII). There was no difference in the prevalence of metabolic syndrome variables between those with and without CVD at study entry. The WHO definition identified those at higher CVD risk across both sexes, all ages, and in those without prior CVD, while the ATPIII definition predicted risk only in those aged over 65 years and in men but not in women. Patients meeting the IDF definition did not have higher risk than those without IDF MS.CVD risk was strongly influenced by prior CVD, sex, age (particularly in women), baseline HbA1c, renal dysfunction, hypertension, and dyslipidemia (low HDL-c, triglycerides > 1.7 mmol/L). The combination of low HDL-c and marked hypertriglyceridemia (> 2.3 mmol/L) increased CVD risk by 41%. Baseline systolic blood pressure increased risk by 16% per 10 mmHg in those with no prior CVD, but had no effect in those with CVD. In those without prior CVD, increasing numbers of metabolic syndrome variables (excluding waist) escalated risk.ConclusionAbsence of the metabolic syndrome (by the WHO definition) identifies diabetes patients without prior CVD, who have a lower risk of future CVD events. Hypertension and dyslipidemia increase risk.

The New Unified International Diabetes Federation/American Heart Association/National Heart, Lung, and Blood Institute Metabolic Syndrome Definition: Does it Correlate Better with C-Reactive Protein in Chinese Patients Diagnosed with Type 2 Diabetes?

This study evaluated the association between high-sensitivity C-reactive protein (hsCRP) and metabolic syndrome, defined by the definition proposed by the International Diabetes Federation (IDF), American Heart Association (AHA) and National Heart, Lung, and Blood Institute (NHLBI) versus the older IDF definition, in 506 Chinese patients with type 2 diabetes. Anthropometric and biochemical parameters were compared and analysed using multivariate linear regression models. Serum hsCRP was higher in patients with metabolic syndrome compared with those without metabolic syndrome for both definitions and increased as the number of components of metabolic syndrome increased (after adjusting for age, gender and smoking). Patients with metabolic syndrome according to the IDF/AHA/NHLBI but not the IDF definition had significantly higher hsCRP levels than those not meeting either definition and similar hsCRP levels to those meeting both definitions. Serum hsCRP levels were significantly associated with metabolic syndrome according to the IDF definition after adjusting for age, gender and smoking. Adding metabolic syndrome status according to the IDF/AHA/NHLBI definition significantly increased the fit of the multivariate linear regression model. The new IDF/AHA/NHLBI definition of metabolic syndrome may have a stronger relationship with serum hsCRP than the IDF definition.

Risk factors associated with metabolic syndrome in type 2 diabetes mellitus patients according to World Health Organization, Third Report National Cholesterol Education Program, and International Diabetes Federation definitions

Risk factors associated with metabolic syndrome in type 2 diabetes mellitus patients according to World Health Organization, Third Report National Cholesterol Education Program, and International Diabetes Federation definitions Angel Rodr&iacute;guez1, Helena Delgado-Cohen1, Jes&uacute;s Reviriego1, Manuel Serrano-R&iacute;os21Clinical Research Department, Eli Lilly and Company, Madrid, Spain; 2Department of Internal Medicine II, Hospital Clinico San Carlos, Madrid, SpainBackground: The availability of several definitions of the metabolic syndrome has created potential confusion concerning its prognostic utility. At present, little data exist about the risk factors associated with metabolic syndrome in diabetic patients.Aim: To identify risk factors associated with metabolic syndrome in patients with type 2 diabetes mellitus according to three diagnostic criteria: World Health Organization (WHO), Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults &ndash; Adult Treatment Panel III (NCEP-ATP III), and International Diabetes Federation (IDF).Subjects and methods: A logistic regression model was used to identify demographic, clinical, and lifestyle variables related with metabolic syndrome (N = 1259).Results: Hypertension, dyslipidemia, and glycosylated hemoglobin (HbA1c) &ge;7% were associated with increased risk of WHO-defined metabolic syndrome (odds ratio [OR], 2.33; 95% confidence interval [CI]: 1.60&ndash;3.40; OR, 1.79 95% CI: 1.25&ndash;2.55; and OR, 1.58; 95% CI: 1.12&ndash;2.22, respectively). The risk of presenting metabolic syndrome according to NCEP-ATP III criteria was increased in female patients (OR, 2.02; 95% CI: 1.37&ndash;2.97), elevated fasting glucose levels (OR, 5.99; 95% CI: 3.56&ndash;10.07), dyslipidemia (OR, 2.28; 95% CI: 1.57&ndash;3.32), hypertension (OR, 2.36; 95% CI: 1.59&ndash;3.53), and endocrine disorders (OR, 1.64; 95% CI: 1.06&ndash;2.57). For the IDF criteria, female patients and patients with left ventricular hypertrophy or insulin treatment were at higher risk of metabolic syndrome (OR, 4.00; 95% CI: 2.35&ndash;6.80; OR, 2.72 95% CI: 1.22&ndash;6.04; and OR, 1.96 95% CI: 1.24&ndash;3.11, respectively).Conclusions: The risk factors for metabolic syndrome in type 2 diabetes mellitus patients are highly dependent on the criteria used to define the syndrome, supporting the need for a single clinically useful and epidemiologically useful definition.Keywords: metabolic syndrome, type 2 diabetes mellitus, epidemiologic studies, risk factors

Risk factors associated with metabolic syndrome in type 2 diabetes mellitus patients according to World Health Organization, Third Report National Cholesterol Education Program, and International Diabetes Federation definitions

Background:The availability of several definitions of the metabolic syndrome has created potential confusion concerning its prognostic utility. At present, little data exist about the risk factors associated with metabolic syndrome in diabetic patients.Aim:To identify risk factors associated with metabolic syndrome in patients with type 2 diabetes mellitus according to three diagnostic criteria: World Health Organization (WHO), Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults – Adult Treatment Panel III (NCEP-ATP III), and International Diabetes Federation (IDF).Subjects and methods:A logistic regression model was used to identify demographic, clinical, and lifestyle variables related with metabolic syndrome (N = 1259).Results:Hypertension, dyslipidemia, and glycosylated hemoglobin (HbA1c) ≥7% were associated with increased risk of WHO-defined metabolic syndrome (odds ratio [OR], 2.33; 95% confidence interval [CI]: 1.60–3.40; OR, 1.79 95% CI: 1.25–2.55; and OR, 1.58; 95% CI: 1.12–2.22, respectively). The risk of presenting metabolic syndrome according to NCEP-ATP III criteria was increased in female patients (OR, 2.02; 95% CI: 1.37–2.97), elevated fasting glucose levels (OR, 5.99; 95% CI: 3.56–10.07), dyslipidemia (OR, 2.28; 95% CI: 1.57–3.32), hypertension (OR, 2.36; 95% CI: 1.59–3.53), and endocrine disorders (OR, 1.64; 95% CI: 1.06–2.57). For the IDF criteria, female patients and patients with left ventricular hypertrophy or insulin treatment were at higher risk of metabolic syndrome (OR, 4.00; 95% CI: 2.35–6.80; OR, 2.72 95% CI: 1.22–6.04; and OR, 1.96 95% CI: 1.24–3.11, respectively).Conclusions:The risk factors for metabolic syndrome in type 2 diabetes mellitus patients are highly dependent on the criteria used to define the syndrome, supporting the need for a single clinically useful and epidemiologically useful definition.

Abnormal liver function in children with metabolic syndrome from a UK-based obesity clinic

AimTo examine transaminitis in obese children, its association with glucose metabolism and the metabolic syndrome and the response to weight loss through lifestyle modification.Methods216 children (90 male), aged 2.9–17.6 (median...

Metabolic syndrome in the elderly living in marginal peri-urban communities in Quito, Ecuador.

The proportion of the Latin American population aged >60 years is expected to double during the next few decades. Metabolic syndrome (MetS) is associated with high morbidity and mortality worldwide. However, little is known about MetS in Latin America in general, and in Ecuador in particular. The present study aimed to examine the prevalence of MetS and its association with blood micronutrient, homocysteine (Hcy) and C-reactive protein (CRP) concentrations in the elderly living in a low-income urban area. We performed a cross-sectional study. MetS, using the International Diabetes Federation definition, dietary intake and plasma micronutrient, CRP and Hcy concentrations were assessed. A total of 352 elderly (≥65 years) Ecuadorians. Quito, Ecuador. MetS was prevalent (40%)--considerably more so among women (81%) than men (19%; χ² = 32·6, P < 0·0001). Further, 53 % of those without MetS exhibited two or more of its components. Micronutrient deficiencies were prevalent, including those of vitamin C, zinc, vitamin B₁₂ and folate. Vitamin C and E concentrations were inversely (OR = 0·78, 95% CI 0·71, 0·86; OR = 0·16, 95% CI 0·03, 0·81, respectively) and CRP (OR = 1·79, 95 % CI 1·04, 3·06) was positively associated with MetS. The coexistence of MetS with micronutrient deficiencies suggests that elderly Ecuadorians suffer from the double burden of diseases that are increasingly being observed in less developed countries. More research is needed to determine the causal factors, but results presented suggest that these older adults would benefit from interventions to reduce the risk factors for MetS, in particular higher consumption of micronutrient-rich foods.