cameron-metabolicsyndromeasatool-2008.pdf (169.59 kB)
The metabolic syndrome as a tool for predicting future diabetes : the AusDiab study
journal contribution
posted on 2008-01-01, 00:00 authored by Adrian CameronAdrian Cameron, D Magliano, P Zimmet, T Welborn, S Colagiuri, A Tonkin, J ShawObjective. To compare the ability of the metabolic syndrome (MetS), a diabetes prediction model (DPM), a noninvasive risk questionnaire and individual glucose measurements to predict future diabetes.
Design. Five-year longitudinal cohort study. Tools tested included MetS definitions [World Health Organization, International Diabetes Federation, ATPIII and European Group for the study of Insulin Resistance (EGIR)], the FINnish Diabetes RIsk SCore risk questionnaire, the DPM, fasting and 2-h post load plasma glucose.
Setting. Adult Australian population.
Subjects. A total of 5842 men and women without diabetes ≥25 years. Response 58%. A total of 224 incident cases of diabetes.
Results. In receiver operating characteristic curve analysis, the MetS was not a better predictor of incident diabetes than the DPM or measurement of glucose. The risk for diabetes among those with prediabetes but not MetS was almost triple that of those with MetS but not prediabetes (9.0% vs. 3.4%). Adjusted for component parts, the MetS was not a significant predictor of incident diabetes, except for EGIR in men [OR 2.1 (95% CI 1.2–3.7)].
Conclusions. A single fasting glucose measurement may be more effective and efficient than published definitions of the MetS or other risk constructs in predicting incident diabetes. Diagnosis of the MetS did not confer increased risk for incident diabetes independent of its individual components, with an exception for EGIR in men. Given these results, debate surrounding the public health utility of a MetS diagnosis, at least for identification of incident diabetes, is required.
Design. Five-year longitudinal cohort study. Tools tested included MetS definitions [World Health Organization, International Diabetes Federation, ATPIII and European Group for the study of Insulin Resistance (EGIR)], the FINnish Diabetes RIsk SCore risk questionnaire, the DPM, fasting and 2-h post load plasma glucose.
Setting. Adult Australian population.
Subjects. A total of 5842 men and women without diabetes ≥25 years. Response 58%. A total of 224 incident cases of diabetes.
Results. In receiver operating characteristic curve analysis, the MetS was not a better predictor of incident diabetes than the DPM or measurement of glucose. The risk for diabetes among those with prediabetes but not MetS was almost triple that of those with MetS but not prediabetes (9.0% vs. 3.4%). Adjusted for component parts, the MetS was not a significant predictor of incident diabetes, except for EGIR in men [OR 2.1 (95% CI 1.2–3.7)].
Conclusions. A single fasting glucose measurement may be more effective and efficient than published definitions of the MetS or other risk constructs in predicting incident diabetes. Diagnosis of the MetS did not confer increased risk for incident diabetes independent of its individual components, with an exception for EGIR in men. Given these results, debate surrounding the public health utility of a MetS diagnosis, at least for identification of incident diabetes, is required.
History
Journal
Journal of internal medicineVolume
264Issue
2Pagination
177 - 186Publisher
Blackwell Scientific PublicationsLocation
Oxford, EnglandPublisher DOI
ISSN
0954-6820eISSN
1365-2796Language
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2008, Blackwell Publishing Ltd.Usage metrics
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AusDiabdiabetesepidemiologylongitudinal cohortmetabolic syndromerisk predictionScience & TechnologyLife Sciences & BiomedicineMedicine, General & InternalGeneral & Internal MedicineCORONARY-HEART-DISEASELIFE-STYLEGLUCOSE-TOLERANCECARDIOVASCULAR-DISEASEHIGH-RISKMELLITUSDEFINITIONSOBESITYIDENTIFICATIONINDIVIDUALS
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